Question 1

A 26-year-old patient with preeclampsia is receiving IV magnesium sulfate. The 1400 assessment includes blood pressure, 100/70 mm Hg, respiration, 10, fetal heart tone, 100/min, urine output 20 mL/hour, absent patellar reflex. Which is the priority nursing action?

A) Decrease IV magnesium sulfate to half the dose and reassess the patient and fetus in 15 minutes.
B) Stop the IV magnesium sulfate and contact the health care provider.
C) Place the patient on her left side and administer oxygen.
D) Stop the IV magnesium sulfate and administer calcium gluconate 5 mEq IV over 3 minutes.

Accepted Answer

The patient is showing signs of magnesium toxicity (respiratory depression, absent reflexes, low urine output). The priority is to stop the magnesium sulfate and administer calcium gluconate as an antidote.

Question 2

Which is characterized by seizures?&#10;A) Pregnancy-induced hypertension&#10;B) Preeclampsia&#10;C) Eclampsia&#10;D) Premature rupture of membranes

Accepted Answer

Eclampsia is characterized by seizures in women who have previously been diagnosed with preeclampsia (severe high blood pressure and organ damage during pregnancy). The other options do not typically involve seizures as a symptom.

Question 3

A 36-week primigravida patient has been admitted to the unit with a blood pressure of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order?

A) Nifedipine (Procardia)
B) Furosemide (Lasix)
C) Magnesium sulfate
D) Terbutaline (Brethine)

Magnesium sulfate

Accepted Answer

The patient's symptoms and blood pressure reading indicate severe pre-eclampsia, which is a potentially life-threatening condition. Magnesium sulfate is commonly used to prevent seizures in patients with pre-eclampsia. Nifedipine may be used to lower blood pressure, but magnesium sulfate is the more urgent and appropriate treatment in this scenario. Furosemide and Terbutaline are not used to treat pre-eclampsia. Furosemide is a diuretic used to treat fluid overload, while Terbutaline is a tocolytic medication used to prevent preterm labor.

Question 4

Which will the nurse include when teaching a postpartum patient about expected adverse effects of Rh_o(D) immune globulin? (Select all that apply.) A) Nausea B) Constipation C) Fever D) Insomnia E) Aches F) Diarrhea G) Anorexia

Accepted Answer

The answer of Which will the nurse include when teaching...

Question 5

Which emergency drug must be available when caring for a patient receiving magnesium sulfate?&#10;A) Naloxone&#10;B) Calcium gluconate&#10;C) Dextrose&#10;D) Dopamine

Accepted Answer

Calcium gluconate is the emergency drug that must be available when caring for a patient receiving magnesium sulfate. Magnesium competes with calcium for the same receptors, and its high levels can lead to calcium deficiency, causing various symptoms, including cardiac arrest. Calcium gluconate is the antidote for magnesium toxicity, and it works by increasing calcium levels in the blood, counteracting magnesium's effects. The other choices are not related to magnesium sulfate administration or toxicity.

Question 6

Which drug will the nurse administer to prevent neonatal conjunctivitis in the newborn?&#10;A) Silver nitrate&#10;B) Dexamethasone&#10;C) Erythromycin&#10;D) Vitamin K

Accepted Answer

Erythromycin ophthalmic ointment is the standard prophylactic treatment for neonatal conjunctivitis caused by chlamydia or gonorrhea. Silver nitrate and tetracycline were previously used but have been largely replaced by erythromycin due to better efficacy and fewer side effects. Dexamethasone is a corticosteroid used to treat inflammation and is not indicated for prophylaxis against neonatal conjunctivitis. Vitamin K is given to newborns to prevent hemorrhagic disease of the newborn but has no role in preventing neonatal conjunctivitis.

Question 7

A patient is a gravida 1, 28 weeks' gestation, Rh-negative woman. The father of her child is Rh-positive. The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered. What is the nurse's best reply?

A) "Your child will do well after birth once transfusions are administered."
B) "If the baby is Rh-negative at birth, he or she will need RhoGAM also."
C) "RhoGAM kills antibodies you make, so your child will be protected."
D) "Your baby may be Rh-positive and cause you to make antibodies. These won't affect this baby, but could affect future children if RhoGAM isn't given."

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Accepted Answer

RhoGAM is given to an Rh-negative mother during pregnancy to prevent her from developing antibodies against Rh-positive red blood cells that may be present in the fetus's blood. Without RhoGAM, these antibodies could harm future Rh-positive fetuses. The nurse should explain that if the baby is Rh-positive, the mother will make antibodies that won't affect this child but could harm future ones if RhoGAM isn't given.

Question 8

A patient at 33 weeks' gestation is admitted to the obstetric unit in active labor with symptoms associated with pregnancy-induced hypertension (PIH). Which actions will the nurse implement? (Select all that apply.)

A) Vital signs hourly
B) Administration of IV pitocin
C) Administration of magnesium sulfate IV
D) Fetal stress test
E) Assessment of deep tendon reflexes

Accepted Answer

A) Vital signs should be taken hourly to monitor the patient's condition.
B) Administration of IV pitocin is not indicated in this situation since the patient is already in active labor.
C) Administration of magnesium sulfate IV is indicated to prevent seizures associated with PIH.
D) A fetal stress test is necessary to assess the well-being of the fetus during labor.
E) Assessment of deep tendon reflexes is important to monitor for signs of toxicity from magnesium sulfate, which can cause decreased reflexes and respiratory depression.

Question 9

Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered?&#10;A) Oxytocin (Pitocin)&#10;B) Magnesium sulfate&#10;C) Vitamin K&#10;D) Dopamine

Accepted Answer

Oxytocin (Pitocin) is the drug administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered. It helps stimulate uterine contractions and minimize bleeding. Magnesium sulfate is used to prevent seizures in women with preeclampsia or eclampsia, vitamin K is given to newborns to prevent bleeding, and dopamine is not typically used in this scenario.

Question 10

Which test would the nurse anticipate to be done to determine if preterm labor is present in a patient whose symptoms are questionable?&#10;A) Sonogram&#10;B) Fetal fibronectin test&#10;C) Amniocentesis&#10;D) Doppler study

Accepted Answer

The fetal fibronectin test is used to determine if preterm labor is present in a patient whose symptoms are questionable. This test checks for the presence of fetal fibronectin, a protein that is found in vaginal secretions during early pregnancy and later in pregnancy before labor begins. If the test results are positive, it indicates that labor may occur within the next two weeks, allowing for prompt intervention. The other options listed are not used to determine preterm labor.

Question 11

For which reason will betamethasone IM be administered to the mother in premature labor?&#10;A) To stop uterine contractions&#10;B) To prevent precipitous labor&#10;C) To stimulate lung maturity in the fetus&#10;D) To stimulate prolactin to enhance breast-feeding

Accepted Answer

The answer of For which reason will betamethasone IM be...

Question 12

Which drug is administered when a patient is experiencing premature labor?&#10;A) Magnesium sulfate&#10;B) Oxytocin (Pitocin)&#10;C) Levonorgestrel (Mirena)&#10;D) Terbutaline (Brethine)

Accepted Answer

The answer of Which drug is administered when a patient...

Question 13

Which drug will the health care provider prescribe to soften the cervix of a woman who is at 42 weeks of gestation?&#10;A) Methylergonovine (Methergine)&#10;B) Dinoprostone (Prepidil)&#10;C) Betamethasone (Celestone)&#10;D) Terbutaline (Brethine)

Accepted Answer

The answer of Which drug will the health care provider...

Question 14

Which medication is used to treat a patient with atonic uterus?&#10;A) Estradiol&#10;B) Ergonovine&#10;C) Ergotamine&#10;D) Egophony

Accepted Answer

The answer of Which medication is used to treat a...

Question 15

Which assessments will the nurse complete during routine pregnancy visits? (Select all that apply.)&#10;A) Blood pressure&#10;B) Hemoglobin&#10;C) Weight&#10;D) Fetal heart sounds&#10;E) Glucose tolerance test (GTT)

Accepted Answer

The answer of Which assessments will the nurse complete during...

Deck 40: Drugs Used in Obstetrics