SAUNDERS ATI PHARMACOLOGY STUDY GUIDE

Week 1: Chapter 35 “Maternity and Newborn Medications”

Questions Answers and Rationales

1. The nurse is monitoring a client who

is receiving oxytocin (Pitocin) to

induce labor. Which assessment

finding would cause the nurse to

immediately discontinue the

oxytocin infusion?

1. Fatigue

2. Drowsiness

3. Uterine hyperstimulation

4. Early decelerations of the fetal heart rate

Rationale: Often used to induce labor. High doses are

often used for uterine hyperstimulation & C/S births.

ADVERSE EFFECTS: Hyperstimulation of uterine

contractions & non-reassuring fetal HR

DISCONTINUE

2. A pregnant client is receiving

magnesium sulfate for the

management of preeclampsia. The

nurse determines that the client is

experiencing toxicity from the

medication if which finding is noted

on assessment?

1. Proteinuria of 3 +

2. Respirations of 10 breaths/ minute

3. Presence of deep tendon reflexes

4. Serum magnesium level of 6 mEq/ L

Rationale: Mg TOXICITY RESP. DEPRESSION, LOSS

OF TENDON REFLEXES & SUDDEN DECLINE IN FETAL

HR, MATERNAL HR, & BP caused by Mg tx. Must

remain within therapeutic serum levels 4–7.5 mEq/L.

Proteinuria 3+ is expected in a pt w/ preeclampsia.

3. The nurse is monitoring a client in

preterm labor who is receiving

intravenous magnesium sulfate. The

nurse should monitor for which

adverse effects of this medication?

Select all that apply.

1. Flushing

2. Hypertension

3. Increased urine output

4. Depressed respirations

5. Extreme muscle weakness

6. Hyperactive deep tendon reflexes

Rationale: Mg sulfate is a CNS depressant that relaxes

smooth muscles like the uterus. It’s used to STOP

preterm labor contractions and for preeclampsia pts.

to PREVENT SEIZURES. ADVERSE EFFECTS:

 Flushing

 Depressed respirations

 Depressed deep tendon reflexes

 Hypotension

 Extreme muscle weakness

 Decreased urine output

 Pulmonary Edema

 Elevated Mg serum levels

4. The nurse instructor asks a nursing

student to describe the procedure for

administering erythromycin ointment

to the eyes of a newborn. Which

student statement indicates that

further teaching is needed?

1. “I will flush the eyes after instilling the ointment?”

2. “I will clean the newborn’s eyes before instilling

ointment.”

3. “I need to administer the eye ointment within 1 hr.

after delivery.”

4. “I will instill the eye ointment into each of the NB’s

conjunctiva sacs.”

Rationale: Eye prophylaxis protects the NB against

Neisseria gonorrhea & Chlamydia trachomatis. The

eyes are NOT FLUSHED AFTER INSTILLATION of med

because the flush would WASH AWAY the

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administered medication.

5. A client in preterm labor (31

weeks) who is dilated to 4 cm has

been started on magnesium sulfate

and contractions have stopped. If the

client’s labor can be inhibited for the

next 48 hours, the nurse anticipates

a prescription for which medication?

1. Nalbuphine (Nubain)

2. Betamethasone (Celestone)

3. Rho(D) immune globulin (RhoGAM)

4. Dinoprostone (Cervidil vaginal insert)

Rationale: Betamethasone, a glucocorticoid

increases the production of surfactant to stimulate

fetal lung maturation. It is administered to clients in

preterm labor at 28 to 32 weeks of gestation if the

labor can be inhibited for 48 hours.

Nalbuphine (Nubain) is an opioid analgesic.

Rho(D) immune globulin (RhoGAM) is given to Rhnegative clients to prevent immunological condition

aka Rh disease (hemolytic disease of NB); it takes out

the + cells that were transported from maternal blood

stream  fetal circulation.

Dinoprostone (Cervidil vaginal insert) is a

prostaglandin given to ripen and soften the cervix and

to stimulate uterine contractions.

6. Methylergonovine (Methergine) is

prescribed for a woman to treat

postpartum hemorrhage. Before

administration of

methylergonovine, what is the

priority nursing assessment?

1. Uterine tone

2. Blood pressure  ABC!!!

3. Amount of lochia

4. Deep tendon reflexes

Rationale: Methylergonovine is an ERGOT ALKALOID

prevents or controls postpartum hemorrhage by

contracting the uterus. This med  continuous uterine

contractions and can elevate BP CHECK BP  report

to MD if HTN is present

7. The nurse is preparing to administer

beractant (Survanta) to a

premature infant who has

respiratory distress syndrome. The

nurse plans to administer the

medication by which route?

1. Intradermal

2. Intratracheal

3. Subcutaneous

4. Intramuscular

Rationale: Respiratory distress syndrome is a serious

lung disorder caused by immaturity and the inability

to produce surfactant hypoxia and acidosis. It is

common in premature infants and may be due to lung

immaturity as a result of surfactant deficiency. The

mainstay of tx=exogenous surfactant, which is

administered by the intratracheal route.

* Note relationship that question states “respiratory

distress syndrome” Intratracheal

8. An opioid analgesic is administered

to a client in labor. The nurse

assigned to care for the client

ensures that which medication is

readily available if respiratory

1. Naloxone  Antidote!

2. Morphine sulfate

3. Betamethasone (Celestone)

4. Meperidine hydrochloride (Demerol)

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depression occurs?

9. Rho(D) immune globulin (RhoGAM) is

prescribed for a client after delivery

and the nurse provides information to

the client about the purpose of the

medication. The nurse determines

that the woman understands the

purpose if the woman states that it

will protect her next baby from which

condition?

1. Having Rh-positive blood

2. Developing a rubella infection

3. Developing physiological jaundice

4. Being affected by Rh incompatibility

Rationale: Rh incompatibility can occur when an Rhnegative mother becomes sensitized to Rh antigen.

Sensitization may occur when an Rh-negative woman

becomes pregnant with a fetus who is positive

maternal circulation mother’s immune system to

form antibodies against Rh+ blood. This medication

prevents mothers from developing antibodies against

Rh+ blood by providing passive antibody protection

against Rh antigen.

10. Methylergonovine (Methergine) is

prescribed for a client with

postpartum hemorrhage. Before

administering the medication, the

nurse contacts the health care

provider who prescribed the

medication if which condition is

documented in the client’s medical

history?

1. Hypotension

2. Hypothyroidism

3. Diabetes mellitus

4. Peripheral vascular disease

Rationale: Ergot alkaloids are contraindicated in

clients with significant cardiovascular disease,

peripheral vascular disease, hypertension,

preeclampsia, or eclampsia. The vasoconstrictive

effects of the ergot alkaloids worsen these conditions.

Chapter 49: “Pediatric Med. Administration and Calculations”

Questions Answers and Rationales

1. The nurse is providing medication

instructions to a parent. Which

statement by the parent indicates a

need for further instruction?

1. “I should cuddle my child after giving the

medication.”

2. “I can give my child a frozen juice bar after he

swallows the medication.”

3. “I should mix the medication in the baby food and

give it when I feed my child.”

4. “If my child does not like the taste of the medicine, I

should encourage him to pinch his nose and drink the

medication through a straw.”

Rationale: It may give an unpleasant taste to the food,

and the child may refuse to accept the same food in the

future. In addition, the child may not consume the

entire serving and would not receive the required

medication dosage.

2. A health care provider’s prescription

reads “ampicillin sodium 125 mg IV

every 6 hours.” The medication

label reads “1 g and reconstitute

with 7.4 mL of bacteriostatic water.”

The nurse prepares to draw up how

many mL to administer one dose?

1. 1.1 mL

2. 0.54 mL

3. 7.425 mL

4. 0.925 mL

Rationale: 1 g= 1000 mg

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 3 / 3NURSING 304 - SAUNDERS ATI PHARMACOLOGY STUDY GUIDE (2019/2020) Complete Solution, A Guide.

NURSING 304 - SAUNDERS ATI PHARMACOLOGY STUDY GUIDE;Answers and Rationales Chaminade University. SAUNDERS ATI PHARMACOLOGY STUDY GUIDE Week 1: Chapter 35 “Maternity and Newborn Medications”