A nurse is caring for a 46-year-old patient who has had a major ischemic stroke in the last 25 minutes.
The patient’s vital signs are: Temp 98.7, HR: 98, RR: 28, BP: 165/98. Which medication does the nurse anticipate the doctor will order?

Choice A rationale
Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (cranial nerve VIII). Sensorineural hearing loss can be mild, moderate, severe, or profound, and it affects the ability to hear faint sounds or understand speech. However, in the Rinne test, if the air-conducted sound is louder than the bone-conducted sound, it indicates that the patient’s hearing is likely normal.
Choice B rationale
Tinnitus is the perception of noise or ringing in the ears. It is a common problem that affects about 15 to 20 percent of people and is especially common in older adults. However, the Rinne test is not used to diagnose tinnitus. It is used to compare air and bone conduction of sound.
Choice C rationale
In a normal Rinne test, air conduction (AC) is better than bone conduction (BC). This is referred to as a positive Rinne test. If a patient reports that air-conducted sound is louder than bone-conducted sound, it suggests that the patient’s hearing is likely normal.
Choice D rationale
Otosclerosis is a condition that affects the bones in the middle ear, causing hearing loss. It is a common cause of conductive hearing loss, particularly in young adults. However, in otosclerosis, bone conduction (BC) is better than air conduction (AC), which is referred to as a negative Rinne test.

Choice A rationale
Postoperative delirium is a common condition that can occur in older patients after surgery, especially major procedures like hip arthroplasty. It is characterized by a sudden onset of confusion and altered consciousness. This type of delirium is indeed treatable and most patients’ cognition will return to its previous levels. The treatment often involves addressing the underlying causes, such as pain, medication effects, or metabolic imbalances, and providing supportive care. It’s important for the family to understand that this is a temporary condition and does not indicate a permanent change in their loved one’s mental status.
Choice B rationale
While anesthetics can contribute to postoperative delirium, the condition is usually multifactorial and not solely due to the anesthetic used in surgery. Therefore, administering antidotes to the anesthetic is not typically how postoperative delirium is managed. Instead, the focus is on treating the underlying causes and providing supportive care.
Choice C rationale

Delirium does involve a disturbance in cognition, including memory impairment, but it does not involve a progressive decline in memory loss and overall cognitive function. That description is more characteristic of dementia, a different condition. Delirium is typically a temporary condition that improves once the underlying cause is addressed.
Choice D rationale
While postoperative delirium is often self-limiting, meaning it resolves on its own over time, it is not accurate to say there is nothing to worry about. Postoperative delirium can be distressing for the patient and their family, and in some cases, it can be associated with longer hospital stays and increased morbidity. Therefore, it is a condition that should be taken seriously and managed appropriately.