Deck 22: Pregnancy and Breast Feeding

Question 1

All of the following measures should be taken when prescribing drugs to a pregnant woman EXCEPT one.Which is the EXCEPTION?

A)No unnecessary drugs should be administered.
B)An adequate health history should be taken at each appointment.
C)Schedule morning appointments during the first trimester.
D)Closely coordinate with the patient's obstetrician.

Answer 1

Schedule morning appointments during the first trimester.

Question 2

Which of the following opioids has been associated with teratogenicity?

A)Morphine
B)Codeine
C)Lomotil
D)Methadone

Answer 2

Codeine

Question 3

Which dental anesthetic is contra-indicated for a pregnant woman?

A)Lidocaine
B)Mepivacaine
C)Bupivacaine
D)Epinephrine

Answer 3

Bupivacaine

Question 4

Which of the following statements is true concerning the effect of opioids such as codeine on an infant after administration to the mother?

A)Opioids appear in breast milk when analgesic doses are administered.
B)If the mother is addicted,the infant will experience withdrawal symptoms after birth.
C)The infant should be observed for signs of euphoria.
D)Both A and B are true.
E)Both B and C are true.

Question 5

Which of the following antiinfective agents is regarded as safe to use during pregnancy?

A)Doxycycline
B)Azithromycin
C)Minocycline
D)Amoxicillin

Question 6

Metronidazole

A)should only be used during the second trimester of pregnancy.
B)is expressly contraindicated for the nursing mother.
C)has been shown to produce birth defects in animals.
D)Both A and B are correct.
E)Both B and C are correct.

Question 7

Which of the following adverse effects is associated with smoking?

A)Neonatal dependence
B)Intrauterine growth retardation,sudden infant death syndrome
C)Abnormal development patterns,neonatal withdrawal syndrome
D)Increased spontaneous abortion,premature labor,abnormal development,decreased school performance

Question 8

Which of the following is a potential consequence of administering a drug to a pregnant woman?

A)Teratogenicity to the fetus
B)Spontaneous abortion
C)Delayed and long-term physiologic and psychologic consequences
D)Adverse reactions in the near-term fetus
E)All of the above

Question 9

Which of the following statements is true regarding the dental management of the pregnant dental patient?

A)Avoid elective dental treatment except in the third trimester.
B)Oral prophylaxis is best performed during the second trimester.
C)The patient should be positioned in the Trendelenburg position during the last trimester.
D)Both A and B are true.
E)Both B and C are true.

Question 10

The pregnant dental patient is most comfortable during which trimester?

A)First trimester
B)Second trimester
C)Third trimester
D)None of the above

Question 11

Each of the following agents has been demonstrated to produce skeletal abnormalities in the fetus EXCEPT one.Which is the EXCEPTION?

A)Doxycycline
B)Erythromycin other than the estolate form
C)Warfarin
D)Aspirin

Question 12

Which of the following agents can cause premature closure of the patent ductus arteriosus?

A)Acetaminophen
B)Clindamycin
C)Triazolam
D)Ibuprofen

Question 13

Which of the following tetracyclines is (are)contraindicated in pregnancy: (1)tetracycline, (2)minocycline, (3)doxycycline?

A)1,2,3
B)1,2
C)2,3
D)1,3
E)1 only

Question 14

Erythromycin is concentrated in breast milk.A nursing mother should be given erythromycin only if the breast milk is expressed and discarded during treatment and 48 hours after the last dose.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second is false.
D)The first statement is false;the second is true.

Question 15

Which of the following antiinfective agents should be used for dental infections during pregnancy for susceptible anaerobic infections not sensitive to penicillin?

A)Amoxicillin
B)Cephalosporins
C)Clindamycin
D)Metronidazole

Question 16

Which of the following local anesthetics would be the best choice for dental application in the pregnant patient?

A)Prilocaine
B)Lidocaine
C)Bupivacaine
D)Mepivacaine

Question 17

Proving that a drug is teratogenic is difficult because

A)drugs are uniformly teratogenic.
B)the timing of the drug exposure is consistent for each drug.
C)one drug can produce a variety of abnormalities,and different drugs can produce the same abnormality.
D)different animal species and humans are uniformly consistent in their responses to drugs.

Question 18

Which antiinfective agent is least teratogenic?

A)Clarithromycin
B)Acetaminophen
C)Cephalexin
D)Tetracycline

Question 19

Each of the following is a subsection of the US Food and Drug Administration (FDA)pregnancy categories EXCEPT one.Which is the EXCEPTION?

A)Pregnancy
B)Lactation
C)Females and Males of Reproductive Potential
D)Pregnancy categories A,B,C,D and X

Question 20

Which of the following is the NSAID of choice for a nursing mother?

A)Ibuprofen
B)Naproxen
C)Diflunisal
D)Ketoprofen

Question 21

Aspirin is generally considered to be the best analgesic to administer during pregnancy.

Question 22

Which is the best choice of analgesic for a pregnant patient?

A)Acetylsalicylic acid (aspirin,ASA)
B)Ibuprofen (Motrin)
C)Naproxen (Naprosyn)
D)Acetaminophen (Tylenol)

Question 23

Small doses of epinephrine in dental local anesthetic are similar to those produced endogenously.Large doses could have adverse effects on the fetus.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second is false.
D)The first statement is false;the second is true.

Question 24

Use of which of the following agents during pregnancy is associated with producing an abnormal number of digits in the newborn?

A)Alcohol
B)Codeine
C)Erythromycin
D)Ketoconazole

Question 25

All NSAIDs carry a warning to avoid use during pregnancy.

Question 26

Benzodiazepines are indicated for the treatment of _____ during pregnancy.

A)anxiety during oral surgery procedures
B)discomfort during scaling and root planing procedures
C)status epilepticus
D)Both A and B
E)Both B and C

Question 27

Use of which of the following agents during pregnancy is associated with "floppy infant syndrome"?

A)Naproxen
B)Diazepam
C)Nystatin
D)Warfarin

Question 28

In managing the pregnant patient,avoiding elective dental treatment is best until the third trimester.

Question 29

Although opioids appear in breast milk when analgesic doses are administered,the small amounts appear have an insignificant effect on the nursing infant.

Question 30

Which of the following statements is true of the use of nystatin in either a pregnant woman or a nursing infant?

A)Nystatin may be used by either a pregnant woman or a nursing infant.
B)Nystatin may be used by a pregnant woman,but not by a nursing infant.
C)Nystatin may be used by a nursing infant,but not by a pregnant woman.
D)Nystatin is not to be used by either a pregnant woman or a nursing infant.

Question 31

The wives of dental personnel who are exposed to trace amounts of nitrous oxide in the workplace have a higher incidence of spontaneous abortion.

Question 32

Which operating personnel who are exposed to trace amounts of nitrous oxide have significantly higher incidence of spontaneous abortion and birth defects in their children?

A)Both women and men.
B)Women but not men.
C)Men but not women.
D)Pregnant women only.

Question 33

Which of the following statements is true concerning fetal alcohol syndrome (FAS)?

A)FAS involves growth retardation,central nervous system (CNS)abnormalities,and flat maxillary area or a thin lip.
B)Infants born to mothers who drank throughout pregnancy show more tremors,hypertonia,restlessness,crying,and abnormal reflexes compared with control groups after birth.
C)The safe alcohol threshold for the pregnant woman is 2 ounces of alcohol or 24 ounces of beer a day.
D)Both A and B are true.
E)Both B and C are true.