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Topical Antimicrobials 2026/2027 Latest Actual
Questions with Verified Answers | Grade A Study Guide
1. A nurse is preparing to administer prophylactic antibiotic drops to a client
post-corneal abrasion. The nurse understands the primary goal of this
therapy is to:
A. Treat an existing microbial keratitis.
B. Prevent infection when the corneal epithelium is compromised.
C. Reduce inflammation in the anterior chamber.
D. Provide analgesia.
CORRECT ANSWER: B
Rationale: Prophylactic antibiotics are used to prevent infection when the
natural epithelial barrier is broken, such as after an abrasion, surgery, or
trauma.
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2. A client presents with acute redness, purulent discharge, and eyelid
crusting. The nurse suspects bacterial conjunctivitis. The nurse knows the
most common causative organisms in adults are:
A. Gram-negative Haemophilus influenzae and Streptococcus pneumoniae.
B. Gram-positive Staphylococcus epidermidis and Staphylococcus aureus.
C. Pseudomonas aeruginosa.
D. Chlamydia trachomatis.
CORRECT ANSWER: B
Rationale: In adults, bacterial conjunctivitis is most frequently caused by
gram-positive bacteria such as Staphylococcus epidermidis, Staphylococcus
aureus, and streptococcal species.
3. The nurse is reviewing orders for ofloxacin 0.3% eye drops for a client with
microbial keratitis. The nurse identifies this medication as belonging to which
class of antibiotics?
A. Aminoglycoside
B. Macrolide
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C. Fluoroquinolone
D. Sulfonamide
CORRECT ANSWER: C
Rationale: Ofloxacin 0.3% is a broad-spectrum fluoroquinolone antibiotic
commonly used for bacterial keratitis and conjunctivitis.
4. A client is prescribed a topical aminoglycoside. The nurse should monitor
for which potential systemic adverse effects associated with this drug
class? Select all that apply.
A. Nephrotoxicity
B. Ototoxicity
C. Tendon rupture
D. Grey baby syndrome
CORRECT ANSWER: A, B
Rationale: Aminoglycosides (e.g., gentamicin, tobramycin) are associated
with nephrotoxicity and ototoxicity, even with topical ophthalmic use if
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significant systemic absorption occurs. Tendon rupture is linked to
fluoroquinolones, and grey baby syndrome to chloramphenicol.
5. The nurse is educating an older adult client who is prescribed a systemic
fluoroquinolone. The nurse should instruct the client to report any signs of
tendon pain or swelling immediately due to the risk of:
A. Nephrotoxicity.
B. Tendonitis or tendon rupture.
C. Ototoxicity.
D. Epithelial toxicity.
CORRECT ANSWER: B
Rationale: Fluoroquinolones carry a black box warning for an increased risk
of tendonitis and tendon rupture, particularly in patients over 60 years of
age.
6. A nurse is preparing to administer chloramphenicol eye drops. Which
client history would be a contraindication for this medication?
A. History of penicillin allergy.
Topical Antimicrobials 2026/2027 Latest Actual
Questions with Verified Answers | Grade A Study Guide
1. A nurse is preparing to administer prophylactic antibiotic drops to a client
post-corneal abrasion. The nurse understands the primary goal of this
therapy is to:
A. Treat an existing microbial keratitis.
B. Prevent infection when the corneal epithelium is compromised.
C. Reduce inflammation in the anterior chamber.
D. Provide analgesia.
CORRECT ANSWER: B
Rationale: Prophylactic antibiotics are used to prevent infection when the
natural epithelial barrier is broken, such as after an abrasion, surgery, or
trauma.
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2. A client presents with acute redness, purulent discharge, and eyelid
crusting. The nurse suspects bacterial conjunctivitis. The nurse knows the
most common causative organisms in adults are:
A. Gram-negative Haemophilus influenzae and Streptococcus pneumoniae.
B. Gram-positive Staphylococcus epidermidis and Staphylococcus aureus.
C. Pseudomonas aeruginosa.
D. Chlamydia trachomatis.
CORRECT ANSWER: B
Rationale: In adults, bacterial conjunctivitis is most frequently caused by
gram-positive bacteria such as Staphylococcus epidermidis, Staphylococcus
aureus, and streptococcal species.
3. The nurse is reviewing orders for ofloxacin 0.3% eye drops for a client with
microbial keratitis. The nurse identifies this medication as belonging to which
class of antibiotics?
A. Aminoglycoside
B. Macrolide
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C. Fluoroquinolone
D. Sulfonamide
CORRECT ANSWER: C
Rationale: Ofloxacin 0.3% is a broad-spectrum fluoroquinolone antibiotic
commonly used for bacterial keratitis and conjunctivitis.
4. A client is prescribed a topical aminoglycoside. The nurse should monitor
for which potential systemic adverse effects associated with this drug
class? Select all that apply.
A. Nephrotoxicity
B. Ototoxicity
C. Tendon rupture
D. Grey baby syndrome
CORRECT ANSWER: A, B
Rationale: Aminoglycosides (e.g., gentamicin, tobramycin) are associated
with nephrotoxicity and ototoxicity, even with topical ophthalmic use if
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significant systemic absorption occurs. Tendon rupture is linked to
fluoroquinolones, and grey baby syndrome to chloramphenicol.
5. The nurse is educating an older adult client who is prescribed a systemic
fluoroquinolone. The nurse should instruct the client to report any signs of
tendon pain or swelling immediately due to the risk of:
A. Nephrotoxicity.
B. Tendonitis or tendon rupture.
C. Ototoxicity.
D. Epithelial toxicity.
CORRECT ANSWER: B
Rationale: Fluoroquinolones carry a black box warning for an increased risk
of tendonitis and tendon rupture, particularly in patients over 60 years of
age.
6. A nurse is preparing to administer chloramphenicol eye drops. Which
client history would be a contraindication for this medication?
A. History of penicillin allergy.
