Which prescribed medication should the nurse give first to a patient who has just been admitted to a hospital with acute angle-closure glaucoma?
Acetazolamide (Diamox) 250 mg orally
Mannitol (Osmitrol) 100 mg IV
Betaxolol (Betoptic) 1 drop in each eye
Morphine sulfate 4 mg IV
The Correct Answer is B
Rationale:
A. Acetazolamide, a carbonic anhydrase inhibitor, decreases aqueous humor production, but oral administration acts more slowly and is not the priority in acute angle-closure glaucoma.
B. Mannitol, an osmotic diuretic, is given intravenously to rapidly decrease intraocular pressure by drawing fluid from the eye into the bloodstream. This is the priority medication to prevent permanent vision loss.
C. Betaxolol, a beta-blocker, helps reduce intraocular pressure but acts more slowly than IV mannitol and is not the first-line emergency intervention.
D. Morphine may help with pain but does not address the dangerously elevated intraocular pressure that threatens vision in acute angle-closure glaucoma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Amitriptyline, a tricyclic antidepressant, is frequently used as an adjuvant analgesic for neuropathic pain, such as diabetic neuropathy. It works by modulating neurotransmitters that influence pain perception.
B. Aspirin is an NSAID useful for inflammation or mild pain but not effective for neuropathic pain.
C. Celecoxib is a COX-2 inhibitor NSAID, effective for inflammatory pain (like arthritis), but not neuropathic pain.
D. Acetaminophen is an analgesic and antipyretic but has no significant effect on neuropathic pain.
Correct Answer is D
Explanation
Rationale:
A. Bacterial conjunctivitis is highly contagious, so monitoring close contacts is appropriate.
B. "I will not share towels with my friends or family." Prevents spread of infection.
C. "I will wash my hands often during the day.": Frequent handwashing helps prevent transmission.
D. "I will remove my contact lenses at bedtime. "Patients with bacterial conjunctivitis should avoid wearing contact lenses entirely until the infection has resolved. Simply removing them at bedtime is not sufficient, so this statement indicates a need for further teaching.
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