AGNP BOARD EXAM QUESTIONS EYE EAR NOSE THROAT Prescription (102 Questions,Answers and Explanation).
Question:
Oral tetracycline (Sumycin), for the
... [Show More] treatment of acute frontal sinusitis, should be administered:
with milk.
with meals.
on an empty stomach. Correct
with an antacid.
Explanation:
Tetracycline (Sumycin) should be administered on an empty stomach (i.e., 1 hour prior to, or 2 hours after meals) to increase total absorption and with adequate amount of fluid to reduce the risk of esophageal irritation and ulceration. It should be administered at least 1 to 2 hours prior to, or 4 hours after, an antacid containing aluminum and magnesium cations. It may chelate with tetracycline (Sumycin) and reduce its total absorption. Serum concentrations may be decreased if taken with dairy products.
Question:
The brand name for sulfacetamide ophthalmic is:
AzaSite.
Bleph-10. Correct
Besivance.
Garamycin.
Explanation:
The brand name of sulfacetamide ophthalmic is Bleph-10. AzaSite is the brand name of azithromycin. Besifloxacin is the generic name for Besivance. The generic name of Garamycin is gentamicin sulfate.
Question:
The generic name for Polytrim ophthalmic is:
trimethoprim and polymyxin B. Correct
bacitracin/polymyxin B.
azithromycin.
besifloxacin.
Explanation:
The generic name for Polytrim is trimethoprim and polymyxin B. Polycin is the brand name for bacitracin/polymyxin B. The brand name for azithromycin is AzaSite. Besifloxacin brand name is Besivance.
Question:
Which of the following does NOT cause a drug-disease interaction when using a decongestant/antihistamine medication such as Naphazoline/pheniramine (Naphcon-A)?
Cardiovascular disease
Angle-closure glaucoma
Prostatic hypertrophy
Hypothyroidism Correct
Explanation:
Contraindications/cautions when using naphazoline/pheniramine (Naphcon-A) include angle-closure glaucoma, MAOI inhibitor use within 14 days, cardiovascular disease, hypertension, diabetes mellitus, prostatic hypertrophy and urinary tract obstruction.
Question:
The maximum daily dose of acetaminophen for ages 12 years and older is:
1200 milligrams/day.
2000 milligrams/day.
3000 milligrams/day.
4000 milligrams/day. Correct
Explanation:
Acetaminophen generally is safe to use. In high doses, however, it can cause liver damage. Doses of 4000 mg (4 grams) per day should not be exceeded in patients 12 years and older. Maximum dose in neonates is 60 mg/kg/day and 75 mg/kg/day in infants and children.
Question:
For treatment of blepharitis, patients should be instructed to apply erythromycin ointment to the affected eye using:
a 0.5 inch ribbon 3 times daily for 5 days.
a 0.5 cm ribbon 3 times daily for 5 days.
a 1-inch ribbon 5 times daily for 7 days.
a 1-cm ribbon 5 times daily for 7 days. Correct
Explanation:
Patients should be instructed to apply a 1-cm ribbon of erythromycin ophthalmic ointment up to 6 times daily for up to 10 days.
Question:
Ophthalmic cromolyn inhibits the degranulation of sensitized mast cells. It is indicated in the treatment of:
acute conjunctivitis.
vernal conjunctivitis. Correct
fungal keratitis.
herpes keratoconjunctivitis.
Explanation:
Ophthalmic cromolyn is a mast cell stabilizer used to prevent or control allergic conditions. It is indicated in the treatment of vernal keratoconjunctivitis, vernal conjunctivitis, and vernal keratitis. Vernal conjunctivitis is long-term inflammation of the outer lining of the eyes. It is due to an allergic reaction.
Question:
The most effective treatment for eradication of group A streptococcus in those who are apparent carriers is:
a single dose of intramuscular penicillin (Bicillin).
oral rifampin (Rifadin) for 4 days.
oral clindamycin (Cleocin) for 10 days. Correct
a single dose of intramuscular ceftriaxone (Rocephin).
Explanation:
The most effective treatment for eradication of group A streptococcus in those who are carriers is oral clindamycin (Cleocin) for 10 days. A single dose of intramuscular penicillin (Bicillin) plus 4 days of oral rifampin (Rifadin) is also effective.
Question:
The generic name for Dramamine is:
doxylamine.
diphenhydramine.
brompheniramine.
dimenhydrinate. Correct
Explanation:
The generic name of Dramamine is dimenhydrinate.
Question:
For empiric treatment of patients with acute bacterial rhinosinusitis (ABRS) who are allergic to penicillin, the best alternative first-line therapy is:
azithromycin (Zithromax).
clarithromycin (Biaxin).
doxycycline (Vibramycin). Correct
metronidazole (Flagyl).
Explanation:
Doxycycline (100 mg orally twice daily or 200 mg orally daily) is a reasonable alternative for first-line therapy and can be used in patients with penicillin allergy. A respiratory fluoroquinolone (levofloxacin 500 mg orally or moxifloxacin 400 mg orally once daily) is another alternative for penicillin-allergic patients. However, fluoroquinolones should be reserved for those who have no alternative treatment options, because the serious adverse effects associated with fluoroquinolones generally outweigh the benefits for patients with acute sinusitis. Macrolides (clarithromycin or azithromycin), trimethoprim-sulfamethoxazole, and second- or third-generation cephalosporins are not recommended for empiric therapy because of high resistance rates of S. pneumoniae.
Question:
Dosing of oseltamivir (Tamiflu) for adults and adolescents with active influenza is administered orally:
based on weight twice daily for 5 days.
75 mg daily x 5 days.
75 mg twice daily x 5 days. Correct
75 mg twice daily x 10 days.
Explanation:
Dosing of oseltamivir (Tamiflu) for adults and adolescents with active influenza is 75 mg twice daily for 5 days. No dosage adjustment is necessary in the morbidly obese patient. Prophylactic dosing of oseltamivir (Tamiflu) for adults and adolescents who have been exposed to influenza is 75 mg by mouth daily x 10 days.
Question:
The vasoconstrictive properties of alpha-1 agonist medications make them beneficial for the treatment of:
benign prostatic hypertrophy.
closed-angle glaucoma.
sinus congestion. Correct
hypertension.
Explanation:
Because of their properties as vasoconstrictive agents, alpha-1 agonists are used to reduce edema and inflammation within the sinus cavities. Alpha-1 agonist medications are also known as decongestants. Common decongestant drugs include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin) nasal.
Question:
The use of oral acyclovir (Zovirax) in older adults is more likely to cause:
confusion and hallucinations. Correct
constipation and hypertension.
headache and peripheral edema.
increased liver enzyme activity.
Explanation:
Older adults are more likely to have renal or CNS adverse events when receiving acyclovir (Zovirax). With respect to CNS adverse events observed during clinical practice, somnolence, hallucinations, confusion, and coma are reported more frequently in older adults. The most frequently reported side effects are malaise, headache, nausea, vomiting and diarrhea. Cardiovascular side effects have not been reported. Increased liver enzyme activity may occur with parenteral administration.
Question:
Cephalosporins are classified as:
macrolides.
beta-lactam antibiotics. Correct
non beta-lactam antibiotics.
aminoglycosides.
Explanation:
Beta-lactam antibiotics are among the most commonly prescribed drugs, grouped together based upon a shared structural feature, the beta-lactam ring. Beta-lactam antibiotics include penicillins, cephalosporins, carbapenems, monobactams, and beta-lactamase inhibitors.
Question:
The onset of action of oxymetazoline (Afrin) is:
5 minutes.
10 minutes. Correct
30 minutes.
60 minutes.
Explanation:
Oxymetazoline (Afrin) has an onset of action of 10 minutes and a duration of action of 12 hours. Oxymetazoline is a decongestant that shrinks blood vessels in the nasal passages. Indicated for short-term temporary relief of nasal congestion. Do not use in larger or smaller amounts or for longer than recommended. Overuse may cause rebound congestion. Recommended dosing is 2-3 sprays in each nostril every 10-12 hours as needed.
Question:
Erythromycin (Ilotycin) ophthalmic ointment is classified as a(n):
aminoglycoside.
macrolide. Correct
fluoroquinolone.
sulfonamides.
Explanation:
Erythromycin (Ilotycin) ophthalmic ointment is classified as a macrolide. Ofloxacin ophthalmic is a fluoroquinolone. Gentamicin ophthalmic is an aminoglycoside. Sulfacetamide ophthalmic is a sulfonamide.
Question:
A common side effect of amoxicillin in children is:
nausea.
joint pain.
abdominal pain. Correct
headache.
Explanation:
The most common side effects in children who take amoxicillin are abdominal pain or cramps, black tarry stools, diarrhea, chest pain and bleeding gums. Hypersensitivity reactions are a major problem with the use of penicillins such as amoxicillin (Amoxil). Symptoms of hypersensitivity reactions include adverse reaction resulting in nausea, vomiting, pruritus, urticaria, wheezing, laryngeal edema and ultimately, cardiovascular collapse.
Question:
The first-line antibiotic for acute otitis media in a child with a potential for beta-lactam resistance is:
amoxicillin (Amoxil).
amoxicillin-clavulanate (Augmentin). Correct
azithromycin (Zithromax).
trimethoprim-sulfamethoxazole (TMP-SMX).
Explanation:
Amoxicillin-clavulanate (Augmentin) is the first-line therapy for children with acute otitis media who are treated with antibiotics and are at increased risk for beta-lactam resistance. Trimethoprim-sulfamethoxazole (TMP-SMX) may be useful in regions where pneumococcal resistance to TMP-SMX is not a concern, but TMP-SMX should not be used if group A Streptococcus (S. pyogenes) is suspected. While macrolide or lincosamide antibiotics may be beneficial in patients with penicillin allergy, resistance is common and they may not be effective.
Question:
The ophthalmic preparation that is NOT available over the counter is:
hydroxypropyl cellulose (Lacrisert), a lubricant. Correct
propamidine (Brolene), an antimicrobial.
xylometazoline-antazoline (Otrivine-Antistin), an antihistamine.
sodium cromoglicate (Opticrom), a mast-cell stabilizer.
Explanation:
Hydroxypropyl cellulose (Lacrisert) is a prescription strength lubricant. Propamidine (Brolene) an antimicrobial, xylometazoline-antazoline (Otrivine-Antistin), an antihistamine, and sodium cromoglicate (Opticrom), a mast-cell stabilizer can all be purchased over-the-counter.
Question:
Refractory blepharitis is best treated with:
oral antibiotics. Correct
topical corticosteroid therapy.
antibiotic/steroid ophthalmic drops.
topical antibiotics.
Explanation:
Blepharitis that is unresponsive to topical antibiotics or corticosteroids alone may benefit from oral antibiotic therapy. Blepharitis that involves the cornea with visual impairment should also be treated with oral antibiotics. Tetracyclines are the drug of choice as they inhibit the lipase production from Staphylococcus epidermidis strains that are known to cause blepharitis.
Question:
A serious adverse reaction to clindamycin (Cleocin) is:
esophageal ulcerations.
nephrotoxicity.
Clostridium difficile-related colitis. Correct
photosensitivity.
Explanation:
A serious adverse reaction to clindamycin (Cleocin) is diarrhea and Clostridium difficile-related colitis. Nephrotoxicity has been seen with vancomycin (Vancocin). Doxycycline (Doryx) has been associated with esophageal ulcerations and photosensitivity.
Question:
Which of the following is NOT a potential adverse effect of sulfacetamide ophthalmic (Bleph-10) for the treatment of acute conjunctivitis?
Acute renal insufficiency Correct
Agranulocytosis
Toxic epidermal necrolysis
Fulminate hepatic necrosis
Explanation:
Concerns related to adverse effects of sulfonamides, including ophthalmic preparations, include blood dyscrasias (i.e. agranulocytosis), dermatologic reactions (i.e. toxic epidermal necrolysis) and hepatic necrosis (i.e. fulminant hepatic necrosis). Acute renal insufficiency hasn't been indicated as a potential adverse reaction.
Question:
The preferred class of oral antibiotic therapy for blepharitis with visual impairment is:
tetracyclines. Correct
macrolides.
quinolones.
penicillins.
Explanation:
The preferred class of antibiotics to treat blepharitis with visual impairment is tetracyclines. Tetracyclines are the drug of choice as they inhibit the lipase production from Staphylococcus epidermidis strains that are known to cause blepharitis.
Question:
Ocular steroids indicated for the treatment of allergic conjunctivitis can be used in patients with:
ocular hypertension.
epithelial herpes simplex.
herpes zoster keratitis. Correct
open-angle glaucoma.
Explanation:
Ocular steroids indicated for the treatment of allergic conjunctivitis, such as dexamethasone (Maxidex), are also indicated for treatment of herpes zoster keratitis. Ocular steroids are contraindicated in patients with ocular hypertension, epithelial herpes simplex, and open-angle glaucoma.
Question:
The brand name for meclizine is:
Antivert. Correct
Atarax.
Cyclivert.
Sominex.
Explanation:
The brand name for meclizine is Antivert. The generic name of Atarax is hydroxyzine; Cyclivert is cyclizine; Sominex is diphenhydramine.
Question:
Oxymetazoline nasal spray, a nasal decongestant, is manufactured under the brand name:
Afrin. Correct
Astelin.
AsthmaNefrin.
Omnaris.
Explanation:
Oxymetazoline is a decongestant nasal spray manufactured under several brand names, including Afrin, Neo-Synephrine 12 Hour Spray and Sinex. All are available over the counter. Azelastine (Astelin) is a nasal antihistamine. AsthmaNefrin is an inhaled bronchodilator. Ciclesonide (Omnaris) is a nasal corticosteroid.
Question:
The most effective method to minimize dizziness associated with the administration of otic solutions is to:
apply a cotton ball to the ear canal after administration of the drops.
push the tragus in over the canal after instilling the drops for 2-3 minutes.
warm the suspension by holding in the hand for 1-2 minutes. Correct
use a wick for application of the drops.
Explanation:
Instillation of cold fluids in the ear may cause dizziness. To minimize dizziness, warm the suspension by holding the bottle in the hand for 1-2 minutes.
Question:
Intranasal antihistamines are indicated in the treatment of:
epistaxis.
nasal congestion.
rhinosinusitis.
vasomotor rhinitis. Correct
Explanation:
Intranasal antihistamines are indicated in the treatment of seasonal allergic rhinitis, perennial allergic rhinitis and vasomotor rhinitis. Epistaxis and nasopharyngitis are the most commonly reported adverse reactions. Intranasal antihistamines are not indicated for nasal congestion.
Question:
Due to potential drug-drug interactions, therapy should be monitored when a patient is receiving erythromycin (Eyemycin) ointment and:
cyclosporine ophthalmic (Restasis).
dexamethasone ophthalmic (Maxidex).
lovastatin (Mevacor).
warfarin (Coumadin). Correct
Explanation:
Erythromycin (Eyemycin) ophthalmic ointment may increase the serum concentration of Vitamin K antagonists, such as warfarin (Coumadin).
Question:
When prescribing polymyxin B sulfate/bacitracin zinc (Polycin-B), patients should be instructed to:
discontinue at 3 days, even if conjunctivitis persists.
discontinue as soon as symptoms resolve.
discontinue if blurred vision occurs immediately after use.
complete therapy, even if symptoms resolve. Correct
Explanation:
Patients with bacterial conjunctivitis should respond in 1 to 2 days with a decrease in discharge, redness, and irritation. However, therapy should be continued for 7-10 days depending upon severity. Blurred vision is a common occurrence after the administration of an ointment.
Question:
Ceruminolytics are safe to use in patients with history of:
conductive hearing loss. Correct
infections.
perforations.
tympanostomy tubes.
Explanation:
Ceruminolytics are safe to use in patients with conductive hearing loss. Conductive hearing loss may be related to cerumen impaction. They should not be used if the patient has a recent history of infection, perforation, or otologic surgery. Ceruminolytics should be avoided if tympanic membrane damage is suspected. If a patient has a history of drainage from the ear, ear pain, or frequent ear infections, the tympanic membrane may be impaired and ceruminolytics should not be employed.
Question:
Polymyxin B/trimethoprim ophthalmic is NOT indicated for:
adult bacterial conjunctivitis.
pediatric bacterial conjunctivitis.
blepharoconjunctivitis.
ophthalmia neonatorum. Correct
Explanation:
Polymyxin B/trimethoprim ophthalmic is NOT indicated in the treatment of ophthalmia neonatorum as it does not treat the most common bacterial causes, including Neisseria gonorrhea and Chlamydia trachomatis. Chlamydial conjunctivitis may be treated with erythromycin drops or oral erythromycin. Gonococcal conjunctivitis should be treated with IV Penicillin G, topical bacitracin or erythromycin. Topical 1% silver nitrate, 0.5% erythromycin, and 1% tetracycline are considered equally effective for prophylaxis of ocular gonorrhea infection.
Question:
A common side effect of azelastine (Optivar) ophthalmic drops used for allergic conjunctivitis is:
ocular edema.
elevated blood pressure.
a bitter taste. Correct
dizziness.
Explanation:
The most frequently occurring side effects of azelastine (Optivar), an antihistamine/mast cell stabilizer combination, include headaches, transient burning/stinging, and bitter taste.
Question:
If ocular steroids are to be used for more than 10 days, monitoring should include:
blood pressure.
ocular pressure. Correct
BUN.
capillary blood sugar.
Explanation:
If ophthalmic steroids are used for more than 10 days there is an increased risk for Intraocular pressure; therefore this should be monitored.
Question:
Oxymetazoline (Visine-LR) is an ophthalmic:
antihistamine.
decongestant. Correct
mast cell stabilizer.
antihistamine/mast cell stabilizer.
Explanation:
Oxymetazoline (Visine-LR) is an ophthalmic vasoconstrictor or decongestant used to reduce hyperemia in the eye by causing vasoconstriction.
Question:
Potential adverse reactions of glucocorticoid nasal sprays do NOT include:
epistaxis.
nasal septal perforation.
nasopharyngitis.
sialorrhea. Correct
Explanation:
Sialorrhea (excessive salivation) has not been associated with nasal glucocorticoid use. Epistaxis and nasopharyngitis are the most commonly reported adverse reactions. Nasal septal perforation has been reported and may be related to spraying the nasal spray into the septum, rather than away from it.
Question:
The mechanism of action of trifluridine (Viroptic), an ophthalmic antiviral, used in the treatment of herpes simplex conjunctivitis is:
stimulation of alpha adrenergic receptors.
interference with viral replication by inhibiting thymidylate synthetase. Correct
inhibition of leukocyte migration.
increase in cell wall permeability and inhibition of nucleic acid and protein synthesis.
Explanation:
Trifluridine (Viroptic), an ophthalmic antiviral, works by interfering with viral replication through the inhibition of thymidylate synthetase. It is not a cure for the infection, but treatment of an outbreak can speed up healing and decrease swelling in the eye to lower the risk of complications.
Question:
After the administration of olopatadine (Pataday) ophthalmic for allergic conjunctivitis, contact lenses should not be inserted for at least:
5 minutes.
10 minutes. Correct
20 minutes.
30 minutes.
Explanation:
After instilling olopatadine (Pataday) ophthalmic drops, wait at least 10 minutes before inserting contact lenses. Do not insert contacts if eyes are red.
Question:
The duration of action of meclizine (Antivert) is:
2 hours.
4 hours.
6 hours.
8 hours. Correct
Explanation:
Meclizine (Antivert) is a first generation antihistamine, used in the treatment of nausea/vomiting, vertigo and motion sickness. The duration of meclizine (Antivert) is approximately 8-24 hours. The onset of action is about 1 hour with a half-life of 6 hours.
Question:
A common side effect of oral phenylephrine (Sudafed), a decongestant, is:
anxiety. Correct
blurred vision.
hypotension.
peripheral vasoconstriction.
Explanation:
The side effects of phenylephrine (Sudafed), an oral decongestant, include anxiety, headache, nausea, dry mouth, dizziness, insomnia, elevated blood pressure, and CNS stimulation.
Question:
Polycin-B is the brand name for:
polymyxin and trimethoprim.
polymyxin B, gramicidin, and neomycin.
polymyxin B and chloramphenicol.
polymyxin B and bacitracin. Correct
Explanation:
Polycin-B is the brand name for polymyxin B and bacitracin. Polytrim is the brand name for trimethoprim and polymyxin B. Neosporin eye drops contain polymyxin B, gramicidin and neomycin.
Question:
Naphazoline/pheniramine (Naphcon-A) is indicated in the treatment of:
allergic conjunctivitis. Correct
viral conjunctivitis.
trachoma.
hordeolum.
Explanation:
Naphazoline/pheniramine (Visine-A) is a combination decongestant/antihistamine used in the treatment of allergic conjunctivitis. It is used as a decongestant for reducing eye redness and an antihistamine for relieving itchy/watery eyes, as is seen in allergic conjunctivitis.
Question:
An example of a drug that is a cholinergic agonist is:
epinephrine.
atropine. Correct
ephedrine.
dopamine.
Explanation:
Atropine is considered a cholinergic agonist. Cholinergic agonists mimic the action of acetylcholine. The remainder of the choices are adrenergic antagonists, which act to inhibit the action of catecholamines at the adrenergic receptors.
Question:
Bacitracin (Ocu-Tracin) ophthalmic ointment inhibits bacterial cell wall synthesis by:
inhibiting RNA-dependent protein synthesis at the chain elongation step.
binding to 30S ribosomal subunit.
preventing the transfer of mucopeptides into the growing cell wall. Correct
inhibiting DNA-gyrase in susceptible organisms.
Explanation:
Bacitracin (Ocu-Tracin) ophthalmic ointment inhibits bacterial cell wall synthesis by preventing transfer of mucopeptides into the growing cell wall.
Question:
Which risk factor would NOT prohibit the nurse practitioner from prescribing prednisolone acetate (Pred Forte)?
Recent history of cataract surgery
Epithelial herpes simplex keratitis [Show Less]