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Pharmacology Exam 1 – Otic Drugs & Clinical Safety (2025/2026)

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Ace your pharmacology exam with this expertly prepared guide. It covers adult and pediatric eardrop techniques, prevention of mastoiditis, carbamide peroxide for cerumen removal, and the role of ciprofloxacin-dexamethasone combinations. Each answer is 100% correct and supported by clear rationales to ensure complete understanding.

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PHARM 1 - EXAM 1 QUESTIONS WITH 100% RATED
ANSWERS 2025/2026 LATEST UPDATED/GET A+

When teaching an adult patient about eardrops, which statement will the nurse include?

A. "Hold your ear down and back to instill the drops."
B. "If you feel dizzy after instilling the ear drops, stand up and walk around the room."
C. "Warm the ear drops up for 30 seconds in the microwave before using them."
D. "Lie on the opposite side of that of your affected ear for about 5 minutes after
instilling the drug." - -Correct answer: D
-Rationale: The adult ear should be held up and back to instill eardrops. Warn the
patient that dizziness may occur after application of the medication, requiring the patient
to remain supine or sitting during instillation and for a few minutes thereafter. Advise the
patient not to heat the medication; for example, a microwave oven must not be used for
warming—because eardrops that are overheated may lose potency.

While administering medications, the nurse finds a patient's eardrops in the medication
refrigerator. If the nurse gives the eardrops immediately, what response might the
patient have?

A. No unusual response
B. Immediate relief of ear discomfort
C. A vestibular-type reaction
D. Increased ear pain - -Correct answer: C
-Rationale: Administration of cold eardrops may cause a vestibular type of reaction,
resulting in vomiting and dizziness.

Gentle massage of the tragus area of the ear after administering eardrops results in

A. decreased absorption of the medication.
B. softening of the cerumen in the ear canal.
C. increased coverage of the medication in the ear canal.
D. reduced pain in the ear. - -Correct answer: C
-Rationale: Gentle massage of the tragus area of the ear after instillation of eardrops
helps to increase the coverage or distribution of the medication in the ear canal.

Which assessment does the nurse give priority before administering carbamide
peroxide (Debrox) for the removal of cerumen?
A. The patient's complaint
B. The patient's hearing acuity
C. The patient's ability to cooperate
D. The presence of an intact tympanic membrane - D. The presence of an intact
tympanic membrane

,The most important assessment before the administration of any medication in the ear
is whether the tympanic membrane is intact; if it is not, medication could reach the inner
ear. Complete understanding of the patient's complaint and assessment of the patient's
ability to hear and ability to cooperate are reasonable nursing interventions before the
administration of carbamide peroxide, but they are less important than protection of the
inner ear.

The nurse bases the plan of care regarding administration of eardrops on what
knowledge?
a. The pinna of an adult should be held down and back.
b. Eardrops may be warmed in the microwave before administration.
c. Proper administration includes holding the pinna up and out in an infant.
d. Warming the eardrops to room temperature before administration helps reduce a
vestibular-type reaction. - d. Warming the eardrops to room temperature before
administration helps reduce a vestibular-type reaction.

Eardrops that are administered too cold may cause vomiting and dizziness by
stimulating a vestibular-type reaction. Neither should the eardrops be warmed in the
microwave because too high a temperature can destroy the effectiveness of the
medication. Room air temperature is sufficient. Eardrops in adults should be
administered by holding the pinna up and out; in children younger than 3 years of age,
the pinna is held down and back.

A client is complaining of excessive earwax, leading to diminished hearing ability. The
nurse will anticipate to teach the client about which medication to treat this condition?
a. Pramoxine (Caladryl)
b. Ofloxacin (Floxin Otic)
c. Carbamide peroxide (Debrox)
d. Hydrocortisone (A-Hydrocort) - c. Carbamide peroxide (Debrox)

Carbamide peroxide works to soften earwax for easy removal while providing a weak
antibacterial action to prevent infection

The nurse is providing education to a client diagnosed with otitis externa (OE). Which
statement by the client indicates an understanding of the OE treatment plan?
a. "I will use the eardrops in the ear canal to treat this condition."
b. "I will finish taking all of my antibiotic pills for my ear infection."
c. "This is contagious, so I need to stay away from others for 24 hours."
d. "The cold I had last week caused this to occur; it will go away on its own." - a. "I will
use the eardrops in the ear canal to treat this condition."

The treatment for OE is use of otic drops in the ear canal.

The nurse is educating the mother of an infant on how to instill eardrops for otitis media
with a perforated eardrum. Which is an appropriate nursing outcome criterion for the
mother?

,a. Demonstrates accurate medication administration technique
b. Takes infant's oral temperature before administration of medication
c. Uses a hot washcloth over affected ear to reduce ear pain and discomfort
d. Instructs infant to remain supine for 5 minutes after instillation of ear drops - a.
Demonstrates accurate medication administration technique

The outcome criterion for this client is for the mother to demonstrate the appropriate
administration of the medication to the infant.

The health care provider has prescribed ciprofloxacin-dexamethasone (Ciprodex) otic
drops for a client with OE. The nurse knows the combination medication has both
antibacterial medication and topical steroid medication. What is the purpose of the
steroid in this medication?
a. Relieve pain
b. Treat infection
c. Reduce inflammation
d. Decrease the amount of earwax - c. Reduce inflammation

The purpose of a steroid included in otic drops is to assist in decreasing inflammation in
the canal and the itching associated with the inflammation.

A mother of a young child asks the nurse what over-the-counter (OTC) medication will
remove earwax build up in her child's ears. What OTC medication should the nurse
suggest?
a. Ofloxacin (Floxin)
b. Carbamide peroxide (Debrox)
c. Ciprofloxacin and dexamethasone otic (Ciprodex)
d. Chloroxylenol, hydrocortisone, and pramoxine (Aero Otic HC) - b. Carbamide
peroxide (Debrox)

Carbamide peroxide (Debrox) is a commonly used OTC earwax emulsifier. It is
combined with other components (e.g., glycerin, a lubricant) that help soften and
lubricate cerumen before irrigation. Carbamide peroxide slowly releases hydrogen
peroxide and oxygen when exposed to moisture. The others are antifungals or
antibacterial otic drugs.

The nurse is teaching the mother of a 1-year-old client how to instill ear drops for OE.
What instructions on instillation does the nurse provide to the mother?
a. "Hold the pinna down and back."
b. "Put a cotton ball in to keep the medication in the ear."
c. "Keep the ear drops in cold place so they work better."
d. "Just put in as many drops as you can get into the ear." - a. "Hold the pinna down and
back."

When administering eardrops to adults, hold the pinna up and back. In children younger
than 3 years of age, hold the pinna down and back. Allow a period of time for adequate

, coverage of the ear by the medication. Store eardrops, solutions, and ointments at room
temperature before instillation. Administration of solutions that are too cold may cause a
vestibular type of reaction with vomiting and dizziness.

The nurse is evaluating the effectiveness of the otic medication used for OE. What will
the nurse evaluate to determine if the goal of therapy has been met?
a. Improved hearing
b. Redness around the ear
c. Increased pain in the ear
d. Discharge in the ear canal - a. Improved hearing

The therapeutic effects of otic drugs, as with all drugs, are gauged by evaluating
whether goals and objectives have been met. The therapeutic effects of otic drugs
include less pain, redness, and swelling in the ear; a reduction in fever; and resolution
of any other signs and symptoms associated with the ear disorder. Improvement in
hearing may also be an anticipated therapeutic effect. The other options are indicative
the therapy was not effective and further evaluation needs to be completed by the
health care provider.

A client is diagnosed with a perforated tympanic membrane, OE, and otitis media. What
does the nurse anticipate the health care provider will prescribe?
a. Oral antibacterial only
b. Otic antibacterials only
c. Otic and oral antibacterials
d. Otic antibacterial and otic antifungal - c. Otic and oral antibacterials

The client will need a topical or local otic antibacterial for the OE and perforated
tympanic membrane in addition to a systemic (oral) antibacterial to treat the otitis media.

A 2-year-old is seen in the pediatrician's office with a bacterial middle ear infection.
Which medication does the nurse anticipate being prescribed for the child?
amoxicillin
Cortic
carbamide peroxide (Debrox)
Acetasol HC - Correct answer: A
Amoxicillin is the first-line drug for most children with bacterial otitis media. Cortic is
composed of hydrocortisone (a steroid), pramoxine (a local anesthetic), chloroxylenol
(an antiseptic antifungal), propylene glycol diacetate (an emulsifying drug), and
benzalkonium chloride (an antiseptic preservative), and is used for fungal infections of
the ear. Carbamide peroxide (Debrox) is a commonly used earwax emulsifier. Acetasol
HC is used to treat fungal infections of the ear.

The camp nurse reviews the "shopping list" of supplies needed for the upcoming
camping season. What product is recommended to prevent and treat chronic impaction
of cerumen?
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