Comprehensive NCLEX-PN: CH 40 Eye and Ear Medications questions and answers 100% verified.

Comprehensive NCLEX-PN: CH 40 Eye and Ear Medications questions and answers 100% verified. A client being treated for glaucoma with eye drops complains of photophobia. What instructions should the nurse include in the client teaching? 1. Discontinue use of the medication. 2. Wipe eyes with a tissue after instilling eye drops. 3. Wear dark glasses when outside, or, when around bright lights. 4. Special glasses are necessary while being treated for glaucoma. - correct answers.3.Wear dark glasses when outside, or when around bright lights. Clients experiencing photophobia are instructed to wear dark sunglasses and to avoid bright lights. Not enough information is provided to warrant discontinuing the medication. Eyes should not be wiped with tissue immediately after instillation of drops. No special glasses are required. Which statement by the client indicates to the nurse that the client has an understanding regarding pilocarpine (Isopto Carpine)? 1. "I will see better at night." 2."I may have trouble adjusting to darkness." 3. "I will adjust quickly to changes from light to dark." 4. "I will not use this medication if I plan to drive." - correct answers.2."I may have trouble adjusting to darkness." Difficulty in adjusting quickly to changes in illumination occurs as a result of miosis, an effect of pilocarpine. The client will experience more difficulty seeing at night. Driving is not contradicted; however, nighttime driving might not be possible because of the miosis. The nurse is providing care to a client taking methazolamide (Neptazane), a carbonic anhydrase inhibitor for glaucoma. The nurse should include monitoring for which electrolyte imbalances when implementing the plan of care? SATA 1. Hyperkalemia 2. Hypokalemia 3. Hypocalcemia 4. Hypercalcemia 5. Hypernatremia - correct answers.2. Hypokalemia. 5. Hypernatremia. The diuretic effects of methazolamide could lead to electrolyte disturbances of hypokalemia and hypernatremia. The diuretic effects of methazolamide will not cause other options. A client ha a prescription for otic chloramphenicol (Chloromycetin). Which statement by the client should indicate a need for further instruction by the nurse? 1. "I will inform my doctor of increased ear pain." 2. "I will inform my doctor if my ear has not improved in seven days." 3. "I will inform my doctor if I have an increase in drainage from my ear." 4. "I will inform my doctor if I experience any hearing disturbances." - correct answers.2. "I will inform my doctor if my ear has not improved in seven days." Super infections are known to occur with this medication; therefore, 7 days is too long to seek further evaluation and treatment; this statement indicates a need of additional instruction. The other options are correct actions by the client. A client is receiving pilocarpine (Isopto Carpine) for the treatment of glaucoma. Which symptom, if experienced by the client, does the nurse attribute to systemic absorption? 1. Diaphoresis. 2. Constipation. 3. Tachycardia. 4. Hypertension. - correct answers.1. Diaphoresis. Symptoms of systemic absorption of pilocarpine include diaphoresis, diarrhea, bradycardia, and hypotension. The other options are not systemic absorption of pilocarpine. A client is receiving cyclopentolate and phenylephrine (Cyclomydril) before an ocular examination. How should the nurse explain the purpose of the medication? 1. To constrict the pupil. 2. To dilate the pupil. 3. To provide anesthesia. 4. To provide a prophylactic antibiotic. - correct answers.2. To dilate the pupil. Cyclomydril and other mydriatics are applied topically to produce mydriasis (dilated pupil) to facilitate ocular examination. Cyclomydril and other mydriatics do not provide anesthesia, nor do the prevent infection. Which symptoms, if described by a client, would lead the nurse to suspect a systemic side effect of atropine ophthalmic solution? SATA 1. Tachycardia. 2. Slurred speech. 3. Salivation. 4. Diaphoresis. 5. Confusion. - correct answers.1. Tachycardia. 2. Slurred speech. 5. Confusion. Systemic side effects of ophthalmic atropine include tachycardia, slurred speech, dry mouth, and confusion. Diaphoresis is unrelated to use of ophthalmic atropine. Which statement demonstrate the client's understanding of proper administration of ophthalmic solutions? 1. "I will discard a medication if it has turned brown." 2. "I will discontinue medication that causes eye burning." 3. "I will use a cotton swab to apply my medication." 4. "I will replace medications that are more than 1 month old." - correct answers.1. "I will discard a medication if it has turned brown." Ophthalmic solution that has darkened or become cloudy should be discarded. Many eye medications can cause the sensation of eye burning; medications should not be discontinued without first consulting the physician. Swabs should not be used to apply ophthalmic medication. Ophthalmic medications generally have a shelf life of 3 months. When describing side effects of over-the-counter medications, for which medications would the nurse discuss ototoxicity? SATA 1. Salicylates (aspirin). 2. Vitamin C. 3. Diphenhydramine (Benadryl). 4. Vitamin A. 5. Ibuprofen. - correct answers.1. Salicylates (aspirin). 5. Ibuprofen. Salicylates can cause tinnitus, vertigo, and hearing loss, if ingested in high doses. Over-the-counter ibuprofen, if ingested in high doses, can cause ototoxicity. During a follow-up visit at the clinician's office a client states, "I insert the ear dropper deep into my ear so the medication doesn't run back out." What should be the nurse's response and priority teaching to the client? 1. The client's ear canal is likely obstructed with cerumen. 2. The client is using the appropriate technique for administering an otic solution. 3. The client should lie on the affected side for 5 minutes to promote absorption. 4. The medication dropper should not be inserted into the ear canal. - correct answers.4. The medication dropper should not be inserted into the ear canal. Inserting objects, including medication droppers, into the ear canal can perforate the tympanic membrane; this is the priority teaching need. The ear canal may or may not be obstructed with serum, the client needs teaching about the appropriate instillation technique; addressing the issue of serum is not the priority. The client is not demonstrating the proper technique for instilling ear medication. The client is instructed to lie on the unaffected side, not the affected side, to allow flow of medication into the ear. Which action, if observed by the nurse, demonstrates appropriate client technique for self-administering an ophthalmic medication? 1. Administers two different ophthalmic solutions 5 minutes apart. 2. Administers ophthalmic solution 5 minutes after ophthalmic ointment. 3. Administers two different ophthalmic solutions 2 minutes apart. 4. Administers ophthalmic ointment 2 minutes after ophthalmic solution. - correct answers.1. Administers two different ophthalmic solutions 5 minutes apart. The recommended wait time between administrations of two ophthalmic solutions is 5 minutes. If ophthalmic ointment is instilled, the waiting time is 10 minutes between the ointment and the next medication. The nurse is observing a client give a return demonstration of the administration of eye drops. Which client actions indicate a need for further teaching? SATA 1. The client pulls the lower lid of the eye down, forming a sac. 2. The client instills the medication into the conjunctival sac. 3. The client cleanses the eyelid with cotton balls moisten with warm tap water. 4. The client cleanses the eye from the inner canthus to outer canthus. 5.The client promotes drainage of the medication toward the inner canthus. - correct answers.3. The client cleanses the eyelid with cotton balls moisten with warm tap water. 5.The client promotes drainage of the medication toward the inner canthus. The eye is cleansed with sterile irrigation solution or sterile normal saline, to decrease risk of contamination; this action indicates a need for additional teaching, Drainage of the medication should be directed toward the outer canthus and gentle pressure applied to the inner canthus to prevent systemic absorption of the medication; this action requires additional teaching. The nurse is monitoring a client with open-angle glaucoma who is receiving timolol (Timoptic) for treatment. The nurse should expect the timolol to exert which action that leads to the therapeutic response? 1. A decrease in the outflow of aqueous humor. 2. An increase in the outflow of aqueous humor. 3. A decrease in aqueous humor production. 4. An increase in aqueous humor production. - correct answers.3. A decrease in aqueous humor production. Timolol is a beta-adrenergic blocker that decreases the production of aqueous humor, thereby decreasing intraocular pressure. Sympathomimetics also decrease aqueous humor production. A decrease in the outflow of aqueous humor is contraindicated for a client with glaucoma. Prostaglandins increase the outflow of aqueous humor to decrease intraocular pressure. An increase in aqueous humor production would be harmful for a client with glaucoma. The nurse is providing information on safety measures to the family of an older adult client being treated with carbachol (Carboptic), an ophthalmic cholinesterase inhibitor, to counteract which drug effect? 1. Difficulty in making quick changes in illumination due to miosis. 2. Difficulty in making quick changes in illumination due to mydriasis. 3. Medication side effects of constipation. 4. Medication side effects of hypertension. - correct answers.1. Difficulty in making quick changes in illumination due to miosis. Carbachol causes miosis (pupil constriction), making quick changes in illumination difficult. Nighttime is particularly hazardous for the elderly client. The client and family are instructed on methods such as lighting hallways and bathrooms at night, to reduce the potential for injury. Mydriasis, pupil dilation, is not a concern when taking carbachol. Systemic side effects of carbachol include diarrhea, not constipation. Systemic side effects of carcachol include hypotension, not hypertension. A client who just self-administered the first dose of vidarabine (Vira-A) calls the clinic and reports eye redness and swelling not present before treatment began. The nurse should instruct the client to take which action?