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 1. Fatigue
receiving oxytocin (Pitocin) to induce labor. 2. Drowsiness
Which assessment finding would cause the 3. Uterine hyperstimulation
nurse to immediately discontinue the 4. Early decelerations of the fetal heart rate
oxytocin infusion?
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 1. Proteinuria of 3 +
sulfate for the management of preeclampsia. 2. Respirations of 10 breaths/ minute
The nurse determines that the client is 3. Presence of deep tendon reflexes
experiencing toxicity from the medication if 4. Serum magnesium level of 6 mEq/ L
which finding is noted on assessment?
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 1. Flushing
labor who is receiving intravenous 2. Hypertension
magnesium sulfate. The nurse should 3. Increased urine output
monitor for which adverse effects of this 4. Depressed respirations
medication? Select all that apply. 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 1. “I will flush the eyes after instilling the ointment?”
describe the procedure for administering
erythromycin ointment to the eyes of a 2. “I will clean the newborn’s eyes before instilling ointment.”
newborn. Which student statement indicates
that further teaching is needed? 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 administered medication.
,5. A client in preterm labor (31 weeks) who is 1. Nalbuphine (Nubain)
dilated to 4 cm has been started on 2. Betamethasone (Celestone)
magnesium sulfate and contractions have 3. Rho(D) immune globulin (RhoGAM)
stopped. If the client’s labor can be inhibited 4. Dinoprostone (Cervidil vaginal insert)
for the next 48 hours, the nurse anticipates a
prescription for which medication? 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 Rh-negative
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 1. Uterine tone
for a woman to treat postpartum 2. Blood pressure ABC!!!
hemorrhage. Before administration of 3. Amount of lochia
methylergonovine, what is the priority 4. Deep tendon reflexes
nursing assessment?
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 1. Intradermal
beractant (Survanta) to a premature infant 2. Intratracheal
who has respiratory distress syndrome. The 3. Subcutaneous
nurse plans to administer the medication by 4. Intramuscular
which route?
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 1. Naloxone Antidote!
client in labor. The nurse assigned to care for 2. Morphine sulfate
the client ensures that which medication is 3. Betamethasone (Celestone)
readily available if respiratory depression 4. Meperidine hydrochloride (Demerol)
occurs?
, 9. Rho(D) immune globulin (RhoGAM) is 1. Having Rh-positive blood
prescribed for a client after delivery and the 2. Developing a rubella infection
nurse provides information to the client 3. Developing physiological jaundice
about the purpose of the medication. The 4. Being affected by Rh incompatibility
nurse determines that the woman
understands the purpose if the woman states Rationale: Rh incompatibility can occur when an Rh-negative
that it will protect her next baby from which mother becomes sensitized to Rh antigen. Sensitization may
condition? 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 1. Hypotension
for a client with postpartum hemorrhage. 2. Hypothyroidism
Before administering the medication, the 3. Diabetes mellitus
nurse contacts the health care provider who 4. Peripheral vascular disease
prescribed the medication if which condition
is documented in the client’s medical history? 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 1. “I should cuddle my child after giving the medication.”
instructions to a parent. Which statement 2. “I can give my child a frozen juice bar after he swallows the
by the parent indicates a need for further medication.”
instruction? 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 1. 1.1 mL
“ampicillin sodium 125 mg IV every 6 2. 0.54 mL
hours.” The medication label reads “1 g and 3. 7.425 mL
reconstitute with 7.4 mL of bacteriostatic 4. 0.925 mL
water.” The nurse prepares to draw up how
many mL to administer one dose? Rationale: 1 g= 1000 mg
Week 1: Chapter 35 “Maternity and Newborn Medications”
Questions Answers and Rationales
1. The nurse is monitoring a client who is 1. Fatigue
receiving oxytocin (Pitocin) to induce labor. 2. Drowsiness
Which assessment finding would cause the 3. Uterine hyperstimulation
nurse to immediately discontinue the 4. Early decelerations of the fetal heart rate
oxytocin infusion?
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 1. Proteinuria of 3 +
sulfate for the management of preeclampsia. 2. Respirations of 10 breaths/ minute
The nurse determines that the client is 3. Presence of deep tendon reflexes
experiencing toxicity from the medication if 4. Serum magnesium level of 6 mEq/ L
which finding is noted on assessment?
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 1. Flushing
labor who is receiving intravenous 2. Hypertension
magnesium sulfate. The nurse should 3. Increased urine output
monitor for which adverse effects of this 4. Depressed respirations
medication? Select all that apply. 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 1. “I will flush the eyes after instilling the ointment?”
describe the procedure for administering
erythromycin ointment to the eyes of a 2. “I will clean the newborn’s eyes before instilling ointment.”
newborn. Which student statement indicates
that further teaching is needed? 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 administered medication.
,5. A client in preterm labor (31 weeks) who is 1. Nalbuphine (Nubain)
dilated to 4 cm has been started on 2. Betamethasone (Celestone)
magnesium sulfate and contractions have 3. Rho(D) immune globulin (RhoGAM)
stopped. If the client’s labor can be inhibited 4. Dinoprostone (Cervidil vaginal insert)
for the next 48 hours, the nurse anticipates a
prescription for which medication? 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 Rh-negative
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 1. Uterine tone
for a woman to treat postpartum 2. Blood pressure ABC!!!
hemorrhage. Before administration of 3. Amount of lochia
methylergonovine, what is the priority 4. Deep tendon reflexes
nursing assessment?
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 1. Intradermal
beractant (Survanta) to a premature infant 2. Intratracheal
who has respiratory distress syndrome. The 3. Subcutaneous
nurse plans to administer the medication by 4. Intramuscular
which route?
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 1. Naloxone Antidote!
client in labor. The nurse assigned to care for 2. Morphine sulfate
the client ensures that which medication is 3. Betamethasone (Celestone)
readily available if respiratory depression 4. Meperidine hydrochloride (Demerol)
occurs?
, 9. Rho(D) immune globulin (RhoGAM) is 1. Having Rh-positive blood
prescribed for a client after delivery and the 2. Developing a rubella infection
nurse provides information to the client 3. Developing physiological jaundice
about the purpose of the medication. The 4. Being affected by Rh incompatibility
nurse determines that the woman
understands the purpose if the woman states Rationale: Rh incompatibility can occur when an Rh-negative
that it will protect her next baby from which mother becomes sensitized to Rh antigen. Sensitization may
condition? 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 1. Hypotension
for a client with postpartum hemorrhage. 2. Hypothyroidism
Before administering the medication, the 3. Diabetes mellitus
nurse contacts the health care provider who 4. Peripheral vascular disease
prescribed the medication if which condition
is documented in the client’s medical history? 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 1. “I should cuddle my child after giving the medication.”
instructions to a parent. Which statement 2. “I can give my child a frozen juice bar after he swallows the
by the parent indicates a need for further medication.”
instruction? 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 1. 1.1 mL
“ampicillin sodium 125 mg IV every 6 2. 0.54 mL
hours.” The medication label reads “1 g and 3. 7.425 mL
reconstitute with 7.4 mL of bacteriostatic 4. 0.925 mL
water.” The nurse prepares to draw up how
many mL to administer one dose? Rationale: 1 g= 1000 mg
