Maternity and Newborn Medications Practice Quiz 1

Answer: C – Respirations of 10 breaths per minute.

Explanation: Magnesium sulfate is a central nervous system depressant and anticonvulsant. It can cause smooth muscle relaxation. Signs of magnesium sulfate toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression, decreased urine output, loss of deep tendon reflexes, hypotension and a decrease maternal and fetal heart rate. Option A: Urine output should be maintained at 25-30ml/hr. Option B: Deep tendon reflexes must be present. Option D: Normal range for magnesium is between 4-7 mEq/L

Answer: B – I will flush the newborn’s eyes after instilling the ointment.

Explanation: Newborn eye prophylaxis is used for the protection against Gonorrhea or Chlamydia infection. The eyes are not flushed following the instillation of the medication because it will wash away the administered ointment. Option A: The correct administration of the ointment. Option C: Cleaning the newborn’s eye before instilling the ointment is a standard procedure. Option D: Instillation of eye ointment can be delayed for 1 hour to facilitate eye contact and parent-newborn bonding.

Answer: C – Developing Rh incompatibility.

Explanation: Rh incompatibility can develop when a Rh-negative mother becomes sensitized to the RH antigen. Sensitization may occur when a Rh-negative woman becomes pregnant with a fetus who is Rh positive. Blood cells from the baby may cross the maternal bloodstream, which can happen during pregnancy, labor, and delivery, causing the mother’s immune system to form antibodies, against Rh-positive blood. Administration of the Rhogam prevents the mother from developing antibodies against Rh-positive blood by providing passive antibody protection against the Rh antigen. Options A and B are not related to the Rh incompatibility. Option D is not indicated for the administration of Rhogam.

Answer: A – Naloxone (Narcan).

Explanation: Opioid analgesics are prescribed for to pregnant women who are experiencing moderate to severe labor pains. Respiratory depression may occur as a sign of opioid toxicity. Naloxone (Narcan) is an opioid antagonist, which reverses the effects of opioid toxicity such as respiratory depression. Options B, C, and D are opioid analgesic.

Answer: A – Ischemic heart disease.

Explanation: Methergine (Methylergonovine maleate) is a semi-synthetic ergot alkaloid used for the prevention and control of postpartum hemorrhage. Ergot alkaloids are contraindicated in patients with cardiovascular diseases such as ischemic heart disease, stroke, peripheral vascular disease, rheumatic heart disease. Options B, C, and D are not contraindicated with the use of methergine.

Answer: C – The vitamin K will protect the newborn from bleeding.

Explanation: Vitamin K is administered to the newborn in order to prevent bleeding disorders. Vitamin K promotes the formation of clotting factors II, VII, IX & X in which the infants lack because of insufficient intestinal bacteria needed for synthesizing fat-soluble vitamin K. Option A: Vitamin K does not promote the development of immunity. Option B: Vitamin K does not prevent the occurrence of hyperbilirubinemia. Option D: Vitamin K doesn’t prevent the newborn from having jaundice or anemia.

Answer: D – Uterine hyperstimulation.

Explanation: Oxytocin is used to induce labor by stimulating uterine contraction. Oxytocin infusion must be discontinued if any signs of uterine stimulation are present. Option A: Eary decelerations of the fetal heart rate are a reassuring sign, but it does not indicate fetal distress. Options B and C are probably caused by the labor experience itself.

Answer: C – Betamethasone (Celestone).

Explanation: Glucocorticoids such as betamethasone and dexamethasone are being used to increase the production of surfactant to aid in fetal lung maturation. It is being given to patients who are in preterm labor at 28-32 weeks of gestation if the labor can be stopped for 2 days. Option A, B, and D are opioid analgesic.

Answer: C – Random blood sugar.

Explanation: Elevation of blood glucose level is expected for patients receiving corticosteroid therapy such as dexamethasone so a routine check on the sugar level must be monitor. Option A: Instead of Red blood cell count, White blood cell count must be monitor for any signs of infection, because corticosteroid suppresses the immune system. Options B and D are not related to the use of dexamethasone.

Answer: B – Grade 1

Explanation: Grade 1 pertains to sluggished or diminished response. Option A: refers to no response. Option C: refers to active or expected response. Option D: refers to brisk, hyperactive, with intermittent or transient clonus.

Answer: C – Blood pressure.

Explanation: Methylergonovine causes uterine contractions and can elevate the blood pressure, so the priority assessment for the nurse to take is to check the blood pressure first. Options A, B, and D are part of postpartum assessment but does not specifically relate to the administration of the medication.

Answer: A – Intratracheal.

Explanation: Lung surfactant is instilled through the catheter inserted into the newborn’s endotracheal tube. Options B, C, and D are not the routes of administration for this medication.

Answer: B – Given intramuscularly in the lateral aspect of the middle third of the vastus lateralis muscle.

Explanation: Rubella Vaccine is administered subcutaneously prior hospital discharge to a nonimmune postpartum client. Option A: Common side effects on the injection site. Option C: The client should avoid pregnancy for 1 to 3 months after immunization with rubella vaccine. Option D: The possible presence of egg protein in the vaccine.

Answer: A – Have the client hold void before administration.

Explanation: Dinoprostone is a prostaglandin use in the induction of labor. It is administered vaginally so in order for the medication not to be contaminated with urine, the nurse should let the client void before administration. Options B, C, and D are the correct nursing interventions.