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