NCLEX Practice Exam for Pharmacology: Ophthalmic and Otic Medications

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Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.

Text Mode – Text version of the exam

1. A client went to a health care facility to ask instructions regarding on how to administer ophthalmic medications. The nurse correctly instructs the client to?

1. Gently allow the tip of the optic bottle to touch with the conjunctival sac.
2. Apply gentle pressure with a clean tissue to the nasolacrimal duct for 30 seconds after the administration.
3. Blink quickly to stimulate tearing after the administration.
4. Blow the nose to stimulate faster absorption.

2. The client is receiving an eye ointment and an eye drop. The nurse instructs the client to?

1. Administer the eye ointment first, followed by the eye drop.
2. Administer the eye drop first, followed by the eye ointment.
3. Administer the eye ointment, wait for 5 minutes then administer the eye drop.
4. Administer the eye drop, wait for 10 minutes then administer the eye ointment.

3. The nurse is preparing to administer Cyclopentolate (Cyclogyl) who will undergo a corneal surgery. The nurse administer the medication, knowing that the purpose of this eye drop is to?

1. Dilate the pupil of the operative eye.
2. Constrict the pupil of the operative eye.
3. Reduces the intraocular pressure.
4. Lubricate the operative eye.

4. A client with glaucoma is receiving Betaxolol hydrochloride (Betoptic) eye drops. Which of the following interventions will the nurse likely do before the administration?

1. Assessing orientation.
2. Assessing peripheral pulses.
3. Monitor blood sugar level.
4. Monitor pulse rate.

5. A miotic medication has been given to a patient with glaucoma. The nurse tells the client that the purpose of this medication is to?

1. It blocks the responses that are sent to the eye muscles.
2. It will relax the eye muscles and decrease blurring of vision.
3. It will constrict the eye to reduce intraocular pressure.
4. It will dilate the eye to reduce intraocular pressure.

6. A client went to a health care facility with a complaint of difficulty opening the eyelid because of pain. The physician diagnosed the client with keratitis and is prescribed with an eye lubricant. Which of the following medicine should the nurse expect to administer?

1. Hydroxypropyl methylcellulose (Lacril).
2. Pilocarpine hydrochloride (Isopto Carpine).
3. Timolol maleate (Timoptic).
4. Apraclonidine (Lopidine).

7. The nurse is monitoring a client with glaucoma. Which of the following drugs, if prescribed for the client, would the nurse question?

1. Metipranolol (Optipranolol).
2. Brimonidine (Alphagan P).
3. Dorzolamide (Trusopt).
4. Atropine (Isopto Atropine).

8. The nurse prepares an adult client for an ear irrigation as ordered by the physician. Which of the following procedure correctly performed by the nurse?

1. Position the client with the affected side up after the irrigation.
2. Pull the pinna down and back.
3. Warm the irrigating solution to 98º Fahrenheit.
4. Directs a slow steady current of irrigating solution into the eardrum.

9. The nurse is reviewing the drug list of an elderly client who is taking a lot of medications given by different health care provider. The client reports that “Lately, there has been roaring in my ears”. Which medication would the nurse determine could be responsible for the client’s complaint?

1. Amoxicillin (Amoxil).
2. Carvedilol (Coreg).
3. Atropine sulfate (Isopto Atropine).
4. Aspirin (Ecotrin).

10. A nurse is providing instructions to a client with an impacted cerumen who is prescribed with Carbamide peroxide (Debrox). Which of the following teachings made by the nurse indicates a further research?

1. Do not touch the dropper tip or let it touch your ear or any other surface.
2. Lie on your side or tilt the affected ear upward. Hold the dropper directly over the ear and place 5 to 10 drops into the ear canal.
3. Hold the earlobe up and back.
4. Use a cold preparation of the medication.

Answers and Rationale:

1. Answer: B. Apply gentle pressure with a clean tissue to the nasolacrimal duct for 30 seconds after the administration. Occluding the nasolacrimal duct with a tissue over the inner canthus for 30-60 seconds will minimize the systemic absorption of the medication.

• Option A: Allowing the tip to be touch with the conjunctival sac will contaminate the medication.
• Option C will prevent the maximum absorption of the medication.
• Option D is not related to the administration of the optic drops.

2. Answer: B. Administer the eye drop first, followed by the eye ointment. If both an eye drop and eye ointment are scheduled at the same time, administer the eye drop first; separate the installation by 3-5 minutes.

3. Answer: A. Dilate the pupil of the operative eye. Cyclopentolate is a mydriatic and cycloplegic medication that works by temporarily widening (dilating) the pupil of the eye and relaxing the muscles of the eye.

4 Answer: D. Monitor pulse rate. Betaxolol hydrochloride is a beta-adrenergic blocker eye medication. The nurse should monitor the blood pressure and pulse rate for signs of hypotension and bradycardia.

5. Answer: C. It will constrict the eye to reduce intraocular pressure. Miotics causes pupillary constrictions and are used to treat glaucoma. These medications reduce eye pressure by increasing the drainage of intraocular fluid through the trabecular meshwork.

• Options A, B, and D are related to mydriatic medications.

6. Answer: A. Hydroxypropyl methylcellulose (Lacril). Hydroxypropyl methylcellulose (Lacril) is an eye lubricant.

• Option B is a miotic.
• Option C is a β-adrenergic blocking eye medication.
• Option D is a α-adrenergic agonist.

7. Answer: D. Atropine (Isopto Atropine). Atropine (Isopto Atropine) is a mydriatic and is contraindicated with glaucoma because of the risk of increased ocular pressure.

• Options A, B, and C are used to treat glaucoma.

8. Answer: C. Warm the irrigating solution to 98º Fahrenheit. Warm the irrigating solution to 98ºF because a solution temperature that is not close the client’s body temperature will cause ear injury, vertigo, and nausea.

• Option A is not correct because the client is to lie on the affected side to complete draining the irrigating solution.
• Option B is applied only to children 3 years younger.
• Option D will cause a damage to the eardrum.

9. Answer: D. Aspirin (Ecotrin). Aspirin (Ecotrin) is potentially ototoxic. The prescribing physician should be notified that the condition and the prescribed drug can be evaluated.

• Options A, B, and C are not associated with hearing problems.

10. Answer: D. Use a cold preparation of the medication. Carbamide peroxide is a cerumenolytic medication. Using cold ear drops can cause dizziness in order to avoid it, hold the container in your hand for a few minutes to warm it.