Which commonly prescribed is does the nurse identify as ototoxic?

Ondansetron and Metoclopramide

Aspirin and ibuprofen

Metoprolol and Furosemide

Pantoprazole Docusate Sodium

Answer and Explanation

The Correct Answer is B

A) Ondansetron and Metoclopramide:
Ondansetron is an antiemetic used to prevent nausea and vomiting, and Metoclopramide is a medication that promotes gastric emptying and is often used to treat nausea and gastroesophageal reflux. Neither of these medications are typically associated with ototoxicity. Ototoxicity is more commonly seen with medications that affect the inner ear or auditory pathways, particularly those that are used in high doses or over extended periods.

B) Aspirin and ibuprofen:
Both aspirin (a nonsteroidal anti-inflammatory drug, NSAID) and ibuprofen are associated with ototoxicity, especially when used in high doses or over prolonged periods. Ototoxicity from NSAIDs can result in symptoms such as tinnitus (ringing in the ears) or even hearing loss. This occurs due to their impact on the cochlea and auditory nerve.

C) Metoprolol and Furosemide:
Metoprolol is a beta-blocker used for managing hypertension, heart failure, and other cardiovascular conditions, and Furosemide is a diuretic often used to treat conditions such as heart failure and edema. Neither of these drugs is typically associated with ototoxicity. However, high doses of furosemide, particularly when given rapidly or intravenously, may be associated with transient hearing loss.

D) Pantoprazole and Docusate Sodium:
Pantoprazole is a proton pump inhibitor (PPI) used to treat gastrointestinal issues like acid reflux and ulcers. Docusate sodium is a stool softener used to treat constipation. Neither of these medications is known to cause ototoxicity. These drugs generally do not affect hearing or the auditory system.

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Correct Answer is D

Explanation

A) Gradual onset of several hours:
Hemorrhagic strokes, particularly those caused by a ruptured cerebral aneurysm, typically present with sudden onset of symptoms rather than a gradual onset. The symptoms of a hemorrhagic stroke generally occur immediately or within minutes after the rupture.

B) Maintains consciousness:
While some patients may remain conscious initially after a cerebral aneurysm rupture, it is common for individuals with a ruptured cerebral aneurysm to experience loss of consciousness, or at least a decreased level of consciousness. The rupture causes an increase in intracranial pressure and often results in symptoms such as nausea, vomiting, and confusion, and may progress to coma or unresponsiveness.

C) Neurologic deficits resolved in 1 hour:
In the case of a hemorrhagic stroke, neurologic deficits do not typically resolve quickly, particularly after the rupture of a cerebral aneurysm. Neurological deficits associated with hemorrhagic strokes may include hemiparesis, aphasia, visual disturbances, and confusion. The concept of deficits resolving within 1 hour is more indicative of a transient ischemic attack (TIA).

D) Complaints of the "worst headache of my life":
One of the classic and most characteristic symptoms of a ruptured cerebral aneurysm (leading to hemorrhagic stroke) is a severe headache, often described by the patient as the "worst headache of my life." This sudden and intense headache occurs due to the bleeding into the subarachnoid space from the aneurysm rupture, which irritates the meninges and causes intense pain.

A. “I will be able to recall events from childhood after completing rehabilitation B. "I will display all of my preinjury traits and characteristics. C. I will regain complete motor and sensory functions after rehabilitation D. I should actively participate in the rehabilitation process as appropriate

Correct Answer is D

Explanation

A) “I will be able to recall events from childhood after completing rehabilitation”:
This demonstrates an unrealistic expectation. While rehabilitation can significantly improve cognitive functions, a serious brain injury may affect memory and recall to a degree that may not be fully reversible. Complete recovery of specific memories, such as childhood events, is not guaranteed.

B) "I will display all of my pre-injury traits and characteristics.":
This also reflects an unrealistic goal. Brain injuries can result in permanent changes to cognitive, emotional, and physical functioning. While rehabilitation can help a patient regain many abilities, it is unlikely that they will fully return to their pre-injury state, particularly in terms of personality traits and behaviors.

C) “I will regain complete motor and sensory functions after rehabilitation”:
This is also unrealistic. While rehabilitation aims to help patients regain as much motor and sensory function as possible, it is often not possible to fully restore complete function after a significant brain injury. Recovery may be partial, and some deficits may remain, depending on the extent of the injury.

D) “I should actively participate in the rehabilitation process as appropriate”:
This reflects a realistic and positive approach to recovery. Active participation in rehabilitation is essential for maximizing recovery after a brain injury. The process involves setting attainable goals based on the patient’s current abilities and gradually working toward improving those functions.

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Which commonly prescribed is does the nurse identify as ototoxic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has suspected hemorrhagic stroke from a ruptured cerebral aneurysm. Which of the following manifestations would the nurse expect?

Correct Answer is D

Explanation

After sustaining a serious brain injury, the patient has recovered enough to be transferred to a rehabilitation unit for continued care. Which statement by the patient indicates that they understand realistic goal setting?

Correct Answer is D

Explanation

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