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NR 566 Advanced Pharmacology – Focused Practice Weeks 5–8:
Eyes, Ears, Skin, Mental Health, CNS Disorders, Health
Promotion Original Questions with Answers & Rationales
Section 1: Ophthalmic Pharmacology (Questions)
1. A patient is diagnosed with open-angle glaucoma. Which
medication class is considered first-line to reduce
intraocular pressure by increasing aqueous humor
outflow?
A. Beta-blockers
B. Prostaglandin analogs
C. Alpha-2 agonists
D. Carbonic anhydrase inhibitors
Answer: B
Rationale: Prostaglandin analogs (latanoprost,
bimatoprost, travoprost) are first-line for open-angle
glaucoma. They increase uveoscleral outflow of aqueous
humor and lower IOP by 25-35%.
2. Latanoprost can cause which unique side effect?
A. Blue discoloration of the sclera
B. Permanent darkening of the iris and eyelashes
C. Retinal detachment
D. Corneal ulceration
Answer: B
Rationale: Prostaglandin analogs can cause increased
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brown pigmentation of the iris (permanent), darkening of
eyelashes, and periocular skin. Patients should be
informed of this cosmetic effect.
3. A patient is prescribed timolol ophthalmic drops for
glaucoma. Which systemic adverse effect should the nurse
practitioner monitor for?
A. Tachycardia
B. Bronchospasm and bradycardia
C. Hyperglycemia
D. Hypertension
Answer: B
Rationale: Timolol is a non-selective beta-blocker. Even
when given topically, it can be systemically absorbed and
cause bradycardia, bronchospasm (especially in
asthma/COPD patients), and hypotension.
4. Which medication is used to dilate the pupil for
ophthalmic examination and causes cycloplegia?
A. Pilocarpine
B. Tropicamide
C. Latanoprost
D. Timolol
Answer: B
Rationale: Tropicamide is an anticholinergic that causes
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mydriasis (pupil dilation) and cycloplegia (paralysis of
ciliary muscle) for eye exams. Pilocarpine causes miosis.
5. A patient with acute angle-closure glaucoma presents with
severe eye pain and blurred vision. Which medication is
used emergently to lower IOP?
A. Latanoprost
B. Timolol
C. Pilocarpine and IV acetazolamide
D. Tropicamide
Answer: C
Rationale: Acute angle-closure glaucoma is an emergency.
Pilocarpine causes miosis to open the angle, and IV
acetazolamide (carbonic anhydrase inhibitor) rapidly
lowers IOP by reducing aqueous humor production.
6. A patient on brinzolamide (a carbonic anhydrase inhibitor
eye drop) should be monitored for:
A. Hypokalemia
B. Metabolic acidosis and bitter taste
C. Hyperglycemia
D. Bradycardia
Answer: B
Rationale: Carbonic anhydrase inhibitors can cause
metabolic acidosis, bitter/metallic taste, and electrolyte
NR 566 Advanced Pharmacology – Focused Practice Weeks 5–8:
Eyes, Ears, Skin, Mental Health, CNS Disorders, Health
Promotion Original Questions with Answers & Rationales
Section 1: Ophthalmic Pharmacology (Questions)
1. A patient is diagnosed with open-angle glaucoma. Which
medication class is considered first-line to reduce
intraocular pressure by increasing aqueous humor
outflow?
A. Beta-blockers
B. Prostaglandin analogs
C. Alpha-2 agonists
D. Carbonic anhydrase inhibitors
Answer: B
Rationale: Prostaglandin analogs (latanoprost,
bimatoprost, travoprost) are first-line for open-angle
glaucoma. They increase uveoscleral outflow of aqueous
humor and lower IOP by 25-35%.
2. Latanoprost can cause which unique side effect?
A. Blue discoloration of the sclera
B. Permanent darkening of the iris and eyelashes
C. Retinal detachment
D. Corneal ulceration
Answer: B
Rationale: Prostaglandin analogs can cause increased
,https://www.stuvia.com/user/performance
brown pigmentation of the iris (permanent), darkening of
eyelashes, and periocular skin. Patients should be
informed of this cosmetic effect.
3. A patient is prescribed timolol ophthalmic drops for
glaucoma. Which systemic adverse effect should the nurse
practitioner monitor for?
A. Tachycardia
B. Bronchospasm and bradycardia
C. Hyperglycemia
D. Hypertension
Answer: B
Rationale: Timolol is a non-selective beta-blocker. Even
when given topically, it can be systemically absorbed and
cause bradycardia, bronchospasm (especially in
asthma/COPD patients), and hypotension.
4. Which medication is used to dilate the pupil for
ophthalmic examination and causes cycloplegia?
A. Pilocarpine
B. Tropicamide
C. Latanoprost
D. Timolol
Answer: B
Rationale: Tropicamide is an anticholinergic that causes
, https://www.stuvia.com/user/performance
mydriasis (pupil dilation) and cycloplegia (paralysis of
ciliary muscle) for eye exams. Pilocarpine causes miosis.
5. A patient with acute angle-closure glaucoma presents with
severe eye pain and blurred vision. Which medication is
used emergently to lower IOP?
A. Latanoprost
B. Timolol
C. Pilocarpine and IV acetazolamide
D. Tropicamide
Answer: C
Rationale: Acute angle-closure glaucoma is an emergency.
Pilocarpine causes miosis to open the angle, and IV
acetazolamide (carbonic anhydrase inhibitor) rapidly
lowers IOP by reducing aqueous humor production.
6. A patient on brinzolamide (a carbonic anhydrase inhibitor
eye drop) should be monitored for:
A. Hypokalemia
B. Metabolic acidosis and bitter taste
C. Hyperglycemia
D. Bradycardia
Answer: B
Rationale: Carbonic anhydrase inhibitors can cause
metabolic acidosis, bitter/metallic taste, and electrolyte
