Chapter 59 Drug Therapy for Disorders of the Ear


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Chapter 59  Drug Therapy for Disorders of the Ear



Complete chapter Questions And Answers

Sample Questions



1. A young boy has just returned home from his family’s tropical vacation and is now complaining of worsening tenderness in his right ear. He is subsequently diagnosed with otitis externa. What causative factor of this infection should the nurse suspect?

  1. A)  Immunocompromised state resulting from sleep deprivation while on vacation
  2. B)  The potential for foodborne pathogens ingested while on vacation
  3. C)  Frequent swimming and water sports while the boy was on vacation
  4. D)  Ear trauma related to pressurization and depressurization while flying

Ans: C
People whose ears are frequently exposed to moisture are more prone to the development of otitis externa. Swimming is a more likely cause of infection than pressure changes, foodborne pathogens, or impaired immunity.

2. A pediatric nurse practitioner has diagnosed a 4-year-old girl with otitis media. The nurse should understand that infectious microorganisms likely entered the girl’s middle ear by what means?

  1. A)  Through an alteration in the eustachian tube
  2. B)  Through the external ear
  3. C)  From within the cochlea or vestibule
  4. D)  From the interstitial spaces in the middle ear

Ans: A
The causative pathogens implicated in otitis media include Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. They enter the middle ear as a result of an alteration in the eustachian tube, not from the inner ear, external ear, or interstitial spaces.

3. A patient has responded appreciably to first-line treatments for necrotizing otitis externa, and the care team is concerned about the possible progression of the disease. The nurse should be aware that this infection has the potential to progress to

  1. A)  meningitis.
  2. B)  osteomyelitis.
  3. C)  necrotizing fasciitis.
  4. D)  epiglottitis.

Ans: B
The advancement of necrotizing otitis externa results in osteomyelitis of the skull and temporomandibular joint. It does not cause meningitis, necrotizing fasciitis, or epiglottitis.

Page 1

4. A 12-year-old boy has been diagnosed with acute otitis externa. The patient’s mother has asked if oral medications might be more effective than ear drops. The nurse should respond in the knowledge that systemic medications for the treatment of otitis externa are only indicated in what circumstances?

  1. A)  The infection is accompanied by ear discharge.
  2. B)  The patient is allergic to penicillins.
  3. C)  The patient is unable to self-administer ear drops.
  4. D)  A deep tissue infection develops.

Ans: D


For acute otitis externa, use of topical agents, as opposed to systemic agents, is more common. Systemic medications are indicated only if a deep tissue infection develops outside the external canal or if immunocompromised status is an issue. Allergy status, ability to self-administer, and the presence or discharge are not indications for systemic antibiotics.

5. The nurse is providing health education for the parents of a child whose otitis media has warranted treatment with Cortisporin Otic. The nurse should explain that this medication contains which of the following components? Select all that apply.

  1. A)  An analgesic
  2. B)  A topical anesthetic
  3. C)  An antibiotic
  4. D)  A steroid
  5. E)  An immunomodulator

Ans: C, D


Health care providers use the combination drug Cortisporin Otic (neomycin–polymyxin B–hydrocortisone) for the treatment of acute external otitis media. Neomycin and polymyxin B are antibiotics, which combat bacterial infections. Hydrocortisone is a steroid, which reduces the actions of chemicals in the body that cause inflammation, redness, and swelling. This medication does not contain analgesics, anesthetics, or immunomodulators.

Page 2

  1. A child’s primary health care provider has prescribed Cortisporin Otic for a child who has otitis media in her right ear. What administration instructions should the nurse provide to the parents of the child?
    1. A)  “Put one drop into her right ear each morning.”
    2. B)  “Place two drops in her right ear each morning and then again before bedtime.”
    3. C)  “Put one to two drops in her right ear whenever you notice discharge or she

      complains of pain.”

    4. D)  “Place three drops into her ear four times a day.”

    Ans: D
    For children 6 months and older, 3 drops of Cortisoprin Otic are instilled into the affected ear three to four times daily. Dosage is not matched to acute symptoms.

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