Hunter College - CUNY NURS 3310: Drugs Used in Treating Eye and Ear Disorders | Complete Q&A's + Rationales | latest Fall 2025/26.

Drugs Used in Treating Eye and Ear Disorders Quiz: 100% Q&A’s + Rationales 2025/26. Question 1. Which medication is used for the treatment of simple viral conjunctivitis caused by adenovirus? 1.Azithromycin 1% solution 2.Polytrim ointment 3.Sulfacetamide 10% solution 4.Erythromycin ointment 0.5% Rationales Option 1:Azithromycin 1% ophthalmic solution is indicated for treatment of uncomplicated bacterial conjunctivitis and blepharitis. Option 2:Uncomplicated bacterial conjunctivitis may be treated with trimethoprim/polymyxin B (Polytrim). Option 3:Viral conjunctivitis is usually caused by an adenovirus, herpes simplex virus (HSV), or herpes zoster. Simple viral conjunctivitis caused by adenovirus is treated with sulfacetamide 10% solution or ointment. Option 4:Erythromycin is a bacteriostatic macrolide antibiotic that is active against a wide range of organisms. It does not, however, have any viral infection indication. Question 2. Otitis externa (OE) is an acute painful condition of the external auditory canal. It is also referred to as which of the following? 1.Otomycosis 2.Tinnitus 3.Swimmer's ear 4.Cerumen Rationales Option 1:Otomycosis is the infection of the external ear canal caused by a fungus Option 2:Tinnitus is a ringing in the ears. Option 3:OE is an acute, painful inflammatory condition of the external auditory canal, commonly known as swimmer's ear. Option 4:Cerumen refers to ear wax and is bacteriostatic and serves a protective function in the ears. It is not considered a problem unless it accumulates leading to potential impaction, which would require its removal. Question 3. In choosing an antibiotic that provides good coverage for the common organisms that cause bacterial conjunctivitis, the provider should consider which antibiotic? 1.Sulfacetamide 2.Polysporin 3.Fluoroquinolones 4.Ganciclovir Rationales Option 1:A determination of the suspected organism guides the choice of an ophthalmic antibiotic. If H. influenzae is high on the list of suspected organisms, then sulfacetamide should not be the first choice for treatment because it has poor coverage for H. influenzae. Option 2:A combination product such as Polysporin or Polytrim provides good coverage for the common organisms that cause bacterial conjunctivitis. Option 3:Fluoroquinolones are more expensive, up to 10 times the cost of erythromycin and other antibiotics with good coverage. Option 4:Ganciclovir covers antiviral organisms and is not the first choice. Question 4. Which of these is the second leading cause of blindness in the world? 1.Bacterial conjunctivitis 2.Herpes keratitis 3.Ophthalmia neonatorum 4.Glaucoma Rationales Option 1:Bacterial conjunctivitis is considered a self-limited disease (unless due to gonorrhea) and is effectively treated with antibiotics; therefore, it is not correlated with blindness. Option 2:Herpes keratitis is a potentially serious consequence of infection with herpes simplex virus (HSV) but is not a leading cause of blindness. Option 3:Conjunctivitis occurring within the first 4 weeks of life is defined as ophthalmia neonatorum. Gonococcal conjunctivitis is the most serious cause of ophthalmia neonatorum owing to concerns about the bacteria causing blindness, but it is not the second leading cause of blindness in the world. Option 4:In the United States, glaucoma affects 3 million people and is the second leading cause of blindness in the world. Question 5. Ocular NSAIDs have an analgesic, antipyretic, and anti-inflammatory activity. This occurs by which mechanism? 1.Inhibition of histamine-stimulated vascular permeability 2.Inhibition of the production of aqueous humor 3.Inhibition of prostaglandin biosynthesis 4.Inhibition of viral DNA replication Rationales Option 1:Ocular histamines block the H1 histamine receptors and inhibit histamine-stimulated vascular permeability in the conjunctiva. Option 2:Beta-adrenergic antagonists interfere with the production of aqueous humor induced by cyclic adenosine monophosphate (cAMP) through the ciliary processes in the eye. Option 3:The ocular NSAIDs have analgesic, antipyretic, and anti-inflammatory activity. The ophthalmic NSAIDs reduce prostaglandin E2 in aqueous humor by inhibition of prostaglandin biosynthesis. Option 4:Vidarabine inhibits viral DNA replication, although the exact mechanism of action is not known. Vidarabine has antiviral activity against herpes simplex virus (HSV) types 1 and 2, varicella-zoster virus, cytomegalovirus, vaccinia, and hepatitis B. Question 6. Prevention of acute otitis externa (OE) can occur if which kind of eardrops are instilled into the ear canal to dry the ear after swimming? 1.Burow's Otic 2.Cortisporin 3.Isopropyl 4.Gentamycin Rationales Option 1: A topical acid or alcohol solution (Otic Domeboro, Burow's Otic, VoSol) can be instilled into the ear four times a day if the tympanic membrane (TM) is intact for the treatment of acute OE. Burow's Otic eardrops are not indicated for prevention. Option 2:The medications used in the treatment of OE include combination products (Cortisporin, Pediotic, Ciprodex, Cipro HC) that contain a corticosteroid (hydrocortisone) and antibiotic(s). Cortisporin is not indicated for prevention. Option 3: Most cases of acute OE (swimmer's ear) can be prevented by instilling isopropyl eardrops (Swim-Ear, EarSol) or 1 or 2 drops of rubbing alcohol into the ear canal to dry the ear after swimming. Option 4:Gentamycin is an anti-infective and is not indicated for prevention. Question 7. The treatment for vernal conjunctivitis includes use of a mast cell stabilizer such as which medication? 1.Ketotifen 2.Levocabastine 3.Cromolyn sodium 4.Azelastine Rationales Option 1:The ophthalmic H1 blocker ketotifen can be prescribed for allergic conjunctivitis and ocular pruritus and is an antihistamine. Option 2:Levocabastine is another prescription ophthalmic H1 blocker and is an antihistamine. Option 3:Vernal conjunctivitis refers to conjunctivitis that occurs primarily in the spring, usually because of an allergen. The mast cell stabilizer cromolyn sodium may be used to treat vernal conjunctivitis. Option 4:Azelastine is another prescription ophthalmic H1 blocker and is an antihistamine. Question 8. Beta blocker ophthalmic medications are contraindicated in patients with which chronic disease? 1.Epilepsy 2.Chronic obstructive pulmonary disease (COPD) 3.Rheumatoid arthritis 4.HIV Rationales Option 1:There is no contraindication with epilepsy patients. Option 2:The beta blocker ophthalmic medications are contraindicated in patients with asthma, a history of asthma, COPD, or other pulmonary disease. Option 3:There is no contraindication with rheumatoid arthritis patients. Option 4:There is no contraindication with HIV patients. Question 9. Which is a common antiviral agent? 1.Trifluridine 2.Erythromycin 3.Bacitracin 4.Sulfacetamide Rationales Option 1:Commonly used antiviral agents are ganciclovir, trifluridine, and vidarabine. Option 2:Erythromycin is not an antiviral medication. Option 3:Bacitracin is not an antiviral medication. Option 4:Sulfacetamide is not an antiviral medication. Question 10. Which treatment option should the APN include for a patient who presents with a purulent bacterial ocular infection? 1.Corticosteroid eye drops 2.Ocular antiallergic agents 3.Prostaglandin analogues 4.Referral to an ophthalmologist Rationales Option 1:Corticosteroid eye medications should not be administered to patients with acute, untreated purulent bacterial, viral, or fungal ocular infection. Option 2:Ocular antiallergic agents are not indicated for a purulent bacterial ocular infection. Option 3:Prostaglandin analogues are not indicated for a purulent bacterial ocular infection. Option 4:Referral to an ophthalmologist is warranted for patients who appear to need corticosteroid therapy. Question 11. Which consideration should the APN include when counseling a pregnant patient who has a bacterial eye infection? 1.All ocular NSAIDs can be used during pregnancy 2.Ciprofloxacin drops can be used as needed 3.Use of ocular NSAIDs should be used cautiously during pregnancy 4.Gentamicin drops can be used as needed Rationales Option 1:Safety for use of ocular NSAIDs has not been determined. Option 2:The safety of ciprofloxacin has not been determined for use in pregnancy. Option 3:Ocular NSAIDs should be used cautiously during pregnancy if the benefits outweigh the risks. Option 4:The safety of gentamicin has not been determined for use in pregnancy. Question 12. A 40-year-old male who was prescribed antiglaucoma ophthalmology medication comes to see the APN for a routine physical examination. He states that he develops a bitter taste in his mouth after taking his eye drops. Which medication is the most likely cause? 1.Acetazolamide 2.Pilocarpine 3.Timolol 4.Netarsudil Rationales Option 1:Many patients (about 25%) report dysgeusia, or a bitter taste in the mouth, after ocular administration of carbonic anhydrase (CA) inhibitors, including acetazolamide. Option 2:Pilocarpine is a miotic. With miotics, patients may have systemic anticholinergic effects if excessive absorption occurs. These symptoms include headache, hypertension, salivation, sweating, nausea, and vomiting. Option 3:Headaches and dizziness may occur with the use of beta blockers, including timolol. Patients may exhibit systemic beta blocker effects with the use of ophthalmic preparations. Symptoms include bradycardia, hypotension, bronchospasm, and, rarely, atrioventricular block. Option 4:In addition to discomfort and hyperemia, netarsudil may cause corneal staining, blurred vision, increased lacrimation, corneal verticillata, and reduced visual acuity with instillation. Question 13. Which agent can be prescribed only by specialists due to concerns regarding systemic absorption and complications of chronic conditions? 1.Ophthalmic antiglaucoma agents 2.Ophthalmic anti-infective agents 3.Ophthalmic antiviral agents 4.Ophthalmic anti-inflammatory agents Rationales Option 1:Ophthalmic antiglaucoma medications are absorbed, and systemic levels are reached in sufficient amounts to cause complications of chronic conditions. Option 2:Ophthalmic anti-infective agents generally penetrate the ocular fluid and tissues. Systemic absorption is minimal, although there may be enough absorption for sensitization to occur. Option 3:Ophthalmic antiviral agents can cause burning and irritation upon instillation but are not systemically absorbed. Option 4:Ophthalmic anti-inflammatory agents have limited systemic absorption. Question 14. A 2½-year-old child presents to the clinic with allergic conjunctivitis, and the APN wants to prescribe an ophthalmic antiallergic agent. Which agent would the APN prescribe? 1.Emedastine 2.Cromolyn 3.Nepafenac 4.Lodoxamide Rationales Option 1:The safety of emedastine in children younger than age 3 years has not been established. Option 2:Cromolyn sodium ophthalmic can be prescribed to children older than age 4 years. Option 3:Nepafenac is not recommended for children younger than age 10 years. Option 4:Lodoxamide is safe in children as young as age 2 years. Question 15. Which is the most important nonpharmacological measure to decrease the spread of infection? 1.Apply warm compresses to the eyes before and after instilling medication. 2.Wash hands before and after eyes are touched and before instilling medication. 3.Squeeze the medication into the eye without touching the eye. 4.Wipe excess medication from around the eye with a clean tissue each time. Rationales Option 1:Applying warm compresses to the eyes is not the most important measure to decrease the spread of infection. Option 2:The most important nonpharmacological measure is for the patient and family members to wash their hands thoroughly whenever the infected eyes are touched and before instilling medication. Hand washing will decrease the spread of the infection to other contacts. Option 3:Squeezing the medication into the eye without touching the eye is not the most important measure to decrease the spread of infection. Option 4:Wiping excess medication from the eye with a clean tissue is not the most important measure to decrease the spread of infection. Question 16. If a patient presents to the clinic with symptoms consistent with an adverse effect from an ophthalmic antiglaucoma medication, the primary care provider should take which action? 1.Prescribe another antiglaucoma medication. 2.Facilitate a referral back to the ophthalmologist. 3.Instruct the patient to stop taking the medication. 4.Instruct the patient to continue taking the medication and return to see the primary care provider in 2 weeks. Rationales Option 1:Antiglaucoma medications are prescribed by ophthalmologists. Option 2:If the patient is experiencing adverse effects from the medication, the primary care provider can facilitate a referral back to the ophthalmologist. Option 3:Abruptly stopping the medication can increase adverse effects. Option 4:If the patient is experiencing adverse effects from the medication, the primary care provider can facilitate a referral back to the ophthalmologist. Question 17. Which information would the APN include when educating the patient on viral conjunctivitis? 1.The course of viral conjunctivitis runs 12 to 15 days. 2.The course of viral conjunctivitis runs 8 to 10 days. 3.The course of viral conjunctivitis runs 10 to 12 days. 4.The course of viral conjunctivitis runs 15 to 18 days. Rationales Option 1:The course of the viral conjunctivitis runs 12 to 15 days. Option 2:The course of the viral conjunctivitis runs longer than 8 to 10 days. Option 3:The course of the viral conjunctivitis runs longer than 10 to 12 days. Option 4:The course of the viral conjunctivitis runs shorter than 15 to 18 days. Question 18. Ocular antihistamines are selective for which receptor? 1.H1 histamine receptor 2.H2 histamine receptor 3.H3 histamine receptor 4.H4 histamine receptor Rationales Option 1:Ocular antihistamines are selective for the H1 histamine receptor. They block the H1 histamine receptors and inhibit histamine-stimulated vascular permeability in the conjunctiva. Option 2:Ocular antihistamines are not selective for H2 histamine receptors. Option 3:Ocular antihistamines are not selective for H3 histamine receptors. Option 4:Ocular antihistamines are not selective for H4 histamine receptors. Question 19. Dorzolamide is contraindicated in patients with which allergy? 1.Penicillin 2.Ragweed 3.Codeine 4.Sulfonamide Rationales Option 1:Penicillin does not have a cross reactivity with dorzolamide. Option 2:Ragweed does not have a cross reactivity with dorzolamide. Option 3:Codeine does not have a cross reactivity with dorzolamide. Option 4:Dorzolamide contains sulfonamide and is absorbed in amounts great enough to cause hypersensitivity reactions in patients with sulfonamide sensitivity. Question 20. Upon examination of an 18-year-old patient with otitis media, the APN notes that the tympanic membrane is perforated. Which medication would be appropriate to prescribe? 1.Cortisporin otic suspension 2.Cortisporin otic solution 3.Ciprofloxacin HC otic suspension 4.Hydrocortisone-neomycin-colistin solution Rationales Option 1:Cortisporin otic suspension may be used if the tympanic membrane is perforated. Option 2:Cortisporin otic solution is contraindicated if the tympanic membrane is perforated. Option 3:Aminoglycoside-containing products are contraindicated if the tympanic membrane is perforated. Option 4:Aminoglycoside-containing products are contraindicated if the tympanic membrane is perforated. Question 1. Erythromycin is a bacteriostatic macrolide antibiotic that is active against a wide range of organisms. Which mechanism of action makes it effective? 1.The mechanism of action is unknown. 2.The mechanism of action involves inhibiting bacterial dihydrofolate synthetase. 3.The mechanism of action is achieved by inhibiting bacterial protein synthesis. 4.The mechanism of action involves binding to cell membranes with high affinity. Rationales Option 1:The mechanism of action for erythromycin is known. Option 2:Sulfacetamide is a synthetic sulfonamide that inhibits bacterial dihydrofolate synthetase, not erythromycin. Option 3:Erythromycin is a bacteriostatic macrolide antibiotic that is active against a wide range of organisms. It binds to the 50S ribosomal subunit, inhibiting bacterial protein synthesis. Option 4:Polymyxin B binds to cell membranes with high affinity, which is not true of erythromycin. Question 2. Which antiviral ophthalmologic agent inhibits replication by herpes simplex viruses (HSVs) by inhibiting the synthesis of viral DNA? 1.Vidarabine 2.Ganciclovir 3.Polymyxin B 4.Trifluridine Rationales Option 1:Vidarabine inhibits viral DNA replication, although the exact mechanism of action is not known. Vidarabine has antiviral activity against HSV types 1 and 2, varicella-zoster virus, cytomegalovirus, vaccinia, and hepatitis B. Option 2:Ganciclovir inhibits replication by herpes simplex viruses by inhibiting the synthesis of viral DNA. Option 3:Polymyxin B is an antibacterial preparation that binds to cell membranes with high affinity, specifically the phospholipids in the cell wall. This causes increased cellular permeability. It does not have antiviral properties. Option 4:The exact mechanism of action of trifluridine is not known, although it is thought to interfere with DNA synthesis. Trifluridine is active against HSV-1 and HSV-2, adenovirus, and vaccinia virus. Question 3. First-line treatment for uncomplicated conjunctivitis includes which agent? 1.Erythromycin ointment 2.Ganciclovir drops 3.Gentamicin ointment 4.Tobramycin drops Rationales Option 1:Uncomplicated conjunctivitis may be treated with erythromycin ointment, trimethoprim/polymyxin B (Polytrim), bacitracin/polymyxin B (Polysporin), or fluoroquinolone drops. Option 2:Ganciclovir is an antiviral ophthalmic agent that is not indicated for treatment of uncomplicated conjunctivitis. Option 3:The aminoglycosides have adverse effects on the cornea and conjunctiva, and they are not recommended as first-line treatment. Option 4:The aminoglycosides have adverse effects on the cornea and conjunctiva, and they are not recommended as first-line treatment. Question 4. Gentamicin is a broad spectrum aminoglycoside that is effective against which type of organisms? 1.Fungal organisms 2.Parasitic organisms 3.Gram positive and negative organisms 4.Viral organisms Rationales Option 1:Gentamicin does not contain antifungal properties. Option 2:Gentamicin does not contain antiparasitic properties. Option 3:Gentamicin is a broad-spectrum antibiotic that is active against a wide range of grampositive and gram-negative organisms. Option 4:Gentamicin does not contain antiviral properties. Question 5. Ophthalmic anti-infectives including antibiotic and antiviral preparations are effective through which action? 1.Penetration of the ocular fluid and tissues 2.Systemic absorption 3.Metabolism by the liver 4.Excretion by the urinary system Rationales Option 1:Ophthalmic antibiotic and antiviral preparations generally penetrate only the ocular fluid and tissues. Option 2:Systemic absorption is minimal, although there may be enough absorption for sensitization to occur, specifically with sulfacetamide. Option 3:There is no information regarding the metabolism of ophthalmic anti-infectives. Option 4:There is no information regarding the excretion of ophthalmic anti-infectives. Question 6. Sulfacetamide is a synthetic sulfonamide eye drop that inhibits bacterial dihydrofolate synthetase. It is active against which susceptible organism? 1.Corynebacterium diphtheriae 2.Escherichia coli 3.Haemophilus influenzae 4.Moraxella species Rationales Option 1:Corynebacterium diphtheriae is susceptible to erythromycin, but not sulfacetamide. Option 2:Sulfacetamide is a synthetic sulfonamide that inhibits bacterial dihydrofolate synthetase. It is active against the following susceptible organisms: streptococci, staphylococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas pyocyanea, Neisseria gonorrhoeae, and C. trachomatis. Option 3:Tobramycin is active against staphylococci, streptococci, Corynebacterium species, K. pneumoniae, Moraxella species, Proteus species, beta-hemolytic streptococci, and Haemophilus influenzae. Option 4:Tobramycin is active against staphylococci, streptococci, Corynebacterium species, K. pneumoniae, Moraxella species, Proteus species, beta-hemolytic streptococci, and Haemophilus influenzae. Question 7. Why is erythromycin ophthalmic ointment indicated in the treatment of blepharitis? 1.Ointment is preferred in the treatment of blepharitis due to the possibility of a secondary bacterial infection. 2.Ointment is preferred in the treatment of blepharitis due to the possibility that it is caused by adenovirus. 3.Ointment is preferred in the treatment of blepharitis due to the possibility of a fungal infection. 4.Ointment is preferred in the treatment of blepharitis due to the increased contact with the ocular tissue. Rationales Option 1:Risk of secondary bacterial infection is not the reason for use of ointment in the treatment of blepharitis. Option 2:Adenovirus is not the reason for use of ointment in the treatment of blepharitis. Option 3:Risk of fungal infection is not the reason for use of ointment in the treatment of blepharitis. Option 4:Use of ointment increases contact with the ocular tissue. Question 8. Which organism most commonly causes ophthalmia neonatorum? 1.Chlamydial 2.Staphylococcal 3.Streptococcal 4.Herpes simplex virus (HSV) Rationales Option 1:Ophthalmia neonatorum is defined as conjunctivitis occurring within the first 4 weeks of life. Infection is usually transmitted during passage through the birth canal, although ascending infection can occur. Chlamydia is the most common organism to cause ophthalmia neonatorum. Option 2:Staphylococcal origin can be seen in ophthalmia neonatorum, but it is a less common organism identified and is a non–sexually transmitted bacteria. Option 3:Streptococcal origin can be seen in ophthalmia neonatorum, but it is a less common organism identified and is a non–sexually transmitted bacteria. Option 4:HSV origin can be seen in ophthalmia neonatorum, but it is a less common organism identified and is a non–sexually transmitted bacteria. Question 9. An adverse drug reaction to which ophthalmic anti-infective preparation can cause temporary blurred vision? 1.Bacitracin 2.Aminoglycosides 3.Sulfacetamide 4.Fluoroquinolones Rationales Option 1:Bacitracin may cause blurred vision, which usually lasts only a few minutes. Option 2:Aminoglycosides can cause localized ocular toxicity and hypersensitivity. Option 3:Sulfacetamide can cause hypersensitivity. Option 4:Fluoroquinolones can cause a white crystalline precipitate. Question 10. Which organisms are most commonly implicated in bacterial conjunctivitis caused by dacryocystitis? 1.Moraxella species and Streptococcus pneumoniae 2.Haemophilus influenzae and Neisseria gonorrhoeae 3.Neisseria gonorrhoeae and Moraxella species 4.Streptococcus pneumoniae and Haemophilus influenzae Rationales Option 1:Moraxella species is not associated with bacterial conjunctivitis caused by dacryocystitis but S. pneumoniae is. Option 2:Neisseria gonorrhoeae is not associated with bacterial conjunctivitis caused by dacryocystitis but H. influenzae is. Option 3:These organisms are not the most commonly implicated organism in bacterial conjunctivitis caused by dacryocystitis. Option 4:Bacterial conjunctivitis caused by dacryocystitis is most commonly caused by S. pneumoniae and H. influenzae. Question 11. Which anti-infective agent can be prescribed to infants and children of all ages? 1.Polymyxin B 2.Erythromycin 3.Moxifloxacin 4.Azithromycin Rationales Option 1:Polymyxin B should not be prescribed to infants younger than 2 months. Option 2:Erythromycin and tobramycin are safe and effective in children. Option 3:Moxifloxacin (Moxeza) is only approved for children 4 months of age and older. Option 4:The safety of azithromycin in children younger than age 1 has not been established. Question 12. Facial nerve palsies can be noted with which condition? 1.Acute otitis externa 2.Malignant otitis externa 3.Chronic otitis externa 4.Inflammatory otitis externa Rationales Option 1:Acute otitis externa, "swimmer’s ear," can cause deafness, but facial nerve palsy is not a complication. Option 2:Malignant otitis externa is a rare but potentially lethal infection that occurs mainly in older adults with diabetes. It can extend, causing osteomyelitis of the base of the skull and purulent meningitis, accompanied by multiple cranial nerve palsies. Option 3:Chronic otitis externa can have inflammatory components and chronic itching. Multiple nerve palsies are not a complication of chronic otitis externa. Option 4:Inflammatory otitis externa is a form of chronic otitis externa, and chronic itching can be a complication. Multiple nerve palsies are not a complication of inflammatory otitis media. Question 13. Which ophthalmic preparation may cause a rare adverse reaction called Stevens–Johnson syndrome? 1.Bacitracin 2.Sulfacetamide 3.Aminoglycosides 4.Fluoroquinolones Rationales Option 1:Bacitracin may cause blurred vision, which usually lasts only a few minutes. Option 2:Sulfacetamide ophthalmic preparations may cause a hypersensitivity reaction in patients who have previously exhibited sensitivity to sulfonamides. Stevens–Johnson syndrome is a rare adverse reaction that has been reported with sulfacetamide ophthalmic ointment use. Option 3:Aminoglycosides may cause localized ocular toxicity and hypersensitivity. Option 4:Fluoroquinolones may cause a white crystalline precipitate to form in the superficial portion of the cornea. Question 14. Which ophthalmic preparation is incompatible with products containing silver salts, including silver nitrate? 1.Gentamicin 2.Erythromycin 3.Sulfacetamide 4.Polymyxin B Rationales Option 1:There are no drug interactions reported for ophthalmic preparations of bacitracin. Option 2:There are no drug interactions reported for ophthalmic preparations of erythromycin. Option 3:Sulfacetamide is incompatible with silver-containing preparations and should not be used in conjunction with ophthalmic products containing silver salts, including silver nitrate. Option 4:There are no drug interactions reported for ophthalmic preparations of polymyxin B. Question 15. Which patient instruction should the APN provide to a patient who is using an OTC ocular lubricant? 1.Patient should use this product sparingly as needed 2.Mild stinging or blurred vision may occur with use 3.Lab tests may be ordered to assess serum levels 4.Apply the tip directly on the eye to ensure maximum coverage Rationales Option 1:These medications are typically administered 1 to 2 drops into the eye(s), 3 to 4 times a day to be effective. Option 2:Mild stinging and/or blurred vision may occur with use and are considered common adverse drug reactions. Option 3:There are no laboratory tests needed for this type of product. Option 4:The APN should instruct the patient not to touch the applicator to the eye as it would lead to contamination. Question 16. Which agent is first-line treatment of a patient with conjunctivitis-otitis syndrome? 1.Penicillin IV 2.Augmentin PO 3.Azithromycin PO 4.Erythromycin ointment Rationales Option 1:Penicillin is not first-line treatment of a patient with conjunctivitis-otitis syndrome. Option 2:Amoxicillin-clavulanate (Augmentin) with amoxicillin dosed at 80 to 90 mg/kg/d is the first-line drug of choice. Option 3:Azithromycin is not first-line treatment of a patient with conjunctivitis-otitis syndrome. Option 4:If systemic antibiotics are prescribed, topical ophthalmic treatment is usually not needed. Question 17. Fluoroquinolone eye preparations are effective against which organism? 1.Staphylococcus aureus 2.Streptococcus pneumoniae 3.Moraxella 4.Neisseria gonorrhoeae Rationales Option 1:Erythromycin is active against Staphylococcus aureus. Option 2:The fluoroquinolones are active against staphylococci, S. pneumoniae, H. influenzae, K. pneumoniae, Proteus species, Enterobacter species, and Pseudomonas aeruginosa. Option 3:Tobramycin is active against Moraxella species. Option 4:Sulfacetamide is active against Neisseria gonorrhoeae. Question 18. Bacteriostatic ophthalmic antibiotics are effective through which mechanism of action? 1.Inhibiting movement of bacteria 2.Inhibiting bacteria from multiplying 3.Inhibiting viral DNA 4.Inhibiting DNA gyrase Rationales Option 1:Bacteriostatic ophthalmic antibiotics do not inhibit the movement of bacteria. Option 2:Ophthalmic antibiotics may be bacteriostatic or bactericidal. Bacteriostatic eye drops do not kill bacteria; they just stop bacteria from multiplying. Option 3:Bacteriostatic ophthalmic antibiotics do not inhibit viral DNA. Option 4:Bacteriostatic ophthalmic antibiotics do not inhibit DNA gyrase. Question 19. When treating blepharitis with erythromycin ophthalmic ointment, the APN would include which information in patient instructions? 1.Apply the ointment twice a day until symptoms clear and then for an additional 10 days. 2.Apply the ointment twice a day until symptoms clear. 3.Apply the ointment twice a day until symptoms clear and then for an additional 7 days. 4.Apply the ointment twice a day until symptoms clear and then for an additional 3 days. Rationales Option 1:The ointment does not need to be applied for 10 days after symptoms clear. Option 2:The ointment needs to continue to be applied after symptoms clear. Option 3:Blepharitis is an acute or chronic inflammation of the eyelash follicles and meibomian glands of the eyelids. Treatment consists of applying erythromycin ophthalmic ointment (0.25-in. ribbon to each eye twice a day) until the symptoms clear and then for an additional 7 days. Option 4:The ointment needs to be applied for longer than 3 days following clearing of symptoms. Question 20. There can be a cross-sensitivity between individual aminoglycosides and which antibiotic class? 1.Macrolide 2.Sulfacetamide 3.Trimethoprim 4.Fluoroquinolones Rationales Option 1:A bacteriostatic macrolide antibiotic can be active against a wide range of organisms. There is no cross-reactivity with aminoglycosides. Option 2:Sulfacetamide is a synthetic sulfonamide that has no cross-sensitivity with fluoroquinolones. Option 3:Trimethoprim inhibits bacterial dihydrofolate reductase. There is no known crosssensitivity with fluoroquinolones. Option 4:There may be cross-sensitivity between the individual aminoglycosides (tobramycin and gentamicin). The same is found with the fluoroquinolones.