Which commonly prescribed is does the nurse identify as ototoxic?
Ondansetron and Metoclopramide
Aspirin and ibuprofen
Metoprolol and Furosemide
Pantoprazole Docusate Sodium
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Intestines:
While abdominal trauma can affect the intestines, Kehr's sign, Cullen's sign, and Gray Turner's sign are more commonly associated with damage to the spleen rather than the intestines. Kehr's sign, in particular, is a hallmark of splenic injury, with pain referred to the left shoulder due to diaphragmatic irritation from blood in the peritoneum.
B) Liver:
Liver injuries often present with right upper quadrant pain, jaundice, and elevated liver enzymes. While liver injuries can cause internal bleeding, Cullen's and Gray Turner's signs are more closely associated with retroperitoneal bleeding from the spleen rather than liver injuries. Kehr's sign, which is left-sided shoulder pain, would not typically indicate a liver injury.
C) Spleen:
The spleen is the most likely abdominal organ affected in this case due to the left-sided rib fractures. When the spleen is injured (often as a result of blunt trauma), it can cause intraperitoneal hemorrhage. This bleeding can irritate the diaphragm, leading to Kehr's sign, which presents as left shoulder pain. Additionally, Cullen's sign (periumbilical bruising) and Gray Turner's sign (flank bruising) are indicative of retroperitoneal bleeding, which can occur with splenic rupture or laceration.
D) Stomach:
While stomach injuries can occur with blunt abdominal trauma, they are less likely to cause the signs and symptoms seen in this patient (Kehr's, Cullen's, and Gray Turner's signs). Stomach trauma typically leads to pain and potential perforation, but it doesn't often cause the peritoneal bleeding patterns seen with splenic injuries.
Correct Answer is ["A","B","D"]
Explanation
A) Tachycardia: Tachycardia is commonly seen in left-sided heart failure as the heart attempts to compensate for the reduced cardiac output. To maintain adequate perfusion, the body increases the heart rate. The sympathetic nervous system is activated, causing an increase in heart rate to try to pump blood more efficiently despite the reduced pumping ability of the left ventricle.
B) Crackles: Crackles (also known as rales) are typically heard upon auscultation of the lungs in patients with left-sided heart failure. When the left ventricle fails to effectively pump blood, it causes blood to back up into the lungs, resulting in pulmonary congestion. This leads to fluid accumulation in the alveoli, causing crackling sounds during inhalation.
C) Ascites: Ascites is more commonly seen in right-sided heart failure or in cases of congestive heart failure where both sides of the heart are affected. Ascites is the accumulation of fluid in the abdomen, which is a consequence of right-sided heart failure causing blood to back up into the abdomen. In left-sided heart failure, ascites is generally not a primary symptom unless the failure becomes severe and involves both sides of the heart.
D) Dyspnea: Dyspnea, or shortness of breath, is a hallmark symptom of left-sided heart failure. The left ventricle's inability to pump blood efficiently leads to pulmonary congestion, which causes fluid to accumulate in the lungs. This fluid buildup reduces the lung's ability to exchange oxygen, resulting in difficulty breathing, especially on exertion or when lying down (orthopnea).
E) Peripheral edema: Peripheral edema is more characteristic of right-sided heart failure due to the backup of blood in the systemic circulation. While it can occur in cases of biventricular heart failure (both right and left sides of the heart are affected), it is not the primary finding in left-sided heart failure. Left-sided heart failure typically presents with pulmonary symptoms rather than systemic symptoms like peripheral edema.
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