n n
lOMoAR cPSD| 8510046
N316 MIDTERM EXAM OB (OBSTETRICAL NURSING)
n n n n n n
STILL LEARNING MOTHER AND BABY TESTBANK Q
n n n n n n
UESTIONS AND EXPLAINED ANSWERS 2025
n n n n
Whichn statementsn would n thennursen includen whenn teachingn an client n whon isn consideringn medroxypro
gesteronen injectionn asn an formn ofnhormonaln birthncontrol?n Select nalln that napply.n One,n some,n orn alln resp
onsesn mayn ben correct.
-It n lastsn forn 3n months.
-It n cann causen nausean and n vomiting.
-It n containsn bothn progestinn and n estrogen.
-It n decreasesn then riskn of n age-related n lossn of n bonen density.
-Sideneffectsn includen drowsinessn orn insomnian and n depression.
-Thenmost n severen undesirablen effectsn aren livern dysfunctionn and n thromboembolicn disorders.
*It n lastsn forn 3n months.
*It n cann causen nausean and n vomiting.
*Sideneffectsn includen drowsinessn orn insomnian and n depression.
*Thenmost n severen undesirablen effectsn aren livern dysfunctionn and n thromboembolicn disorders.
Rationale
Medroxyprogesteronen doesn last n forn 3nmonths.n It ncanncausen nausean and n vomiting,n asn welln asn letharg
yn orn insomnian and n depression,n althoughn then most nundesirablen severen effectsnaren livern dysfunctionn a
nd n thromboembolicn disorders,n includingn thrombophlebitis,n cerebrovascularn disorder,n pulmonaryn e
mbolism,n and n retinaln thrombosis.n Medroxyprogesteronen doesn not n containn bothnprogestinn andn estro
gen;n it n isn progestin-only.n Medroxyprogesteronen doesn not n decreasen then riskn of n age-
related n lossn of n bonen density;n inn fact,n it n hasn an black-
boxn warningn becausen it n cann causen bonenmineraln densitynlossn that nputsn womenn atn highernriskn fornoste
oporosisn and n bonen fracturesn latern inn life.
Anclient n withn myasthenian gravisn hasn beennreceivingn neostigminen and nasksn aboutnitsnaction.n Whichnin
formationn would n then nursen considern whenn formulatingn an response?
- Stimulatesn then cerebraln cortex
- Blocksn then actionn of n cholinesterase
- Replacesndeficient n neurotransmitters
- Acceleratesntransmissionnalongnneuralnsheathsn
Blocksn then actionn of n cholinesterase
Rationale:
Neostigmine,n ann anticholinesterase,n inhibitsn then breakdownn ofn acetylcholine,n thusn prolongingn
neurotransmission.n Neostigmine'sn actionn isn atn then myoneuraln junction,n notn then cerebraln cortex.n
Neostigminen preventsn neurotransmittern breakdown,n but n it n isn not n an neurotransmitter.
Neostigmine'sn actionn isn at n then myoneuraln junction,n not n then sheath.
Then healthn caren providern prescribesn neostigminen forn an client n withn myasthenian gravis.n Whichn cl
ient n statement n indicatesn understandingn regardingn medicationn management n plans?
- 'I nmust n keepn then medicationn inn an containern inn then refrigerator.'
- I nshould n taken then medicationn at n then exact n timen that n isn listed n onn then prescription.'
,-'I n willn plann ton taken then medicationn betweenn meals.'
-'I nexpect n that n then onset n of n then medication'sn actionn willn occurn severaln hoursn aftern I n taken it.'
- I nshould n taken then medicationn at n then exact n timen that n isn listed n onn then prescription.'
Rationale:
Neostigminen should n ben takenn asnprescribed,n usuallyn beforen meals,n tonlimit n dysphagian andnpossiblen a
spiration.n Keepingn neostigminen refrigerated n isn not n necessary;n it n mayn ben kept n at n roomn temperature.n
Neostigminen should n ben takennwithnmilkn tonprevent ngastrointestinaln irritation;n usuallyn it n isn takenn abo
ut n 30n minutesn beforen meals.n Then onset n ofnthenactionn ofnneostigminen occursn 45n ton 75n minutesn aftern a
dministration;n then durationn of n itsn actionn isn 2.5n ton 4n hours.
Pyridostigminen bromiden isn prescribed n forn anclient n withn myasthenian gravis.n Thennursenevaluatesn tha
t n then medicationn regimenn isn understood n whenn then client n makesn whichn statement?
-'I n willn taken then medicationn onn ann emptyn stomach.'
-I n need n ton set n ann alarmn son I n taken then medicationn onn time.'
-'It n willn ben important n ton checkn mynheart n raten beforen takingn then medication.'
'-I n should n monitorn forn ann increasen inn blood n pressuren aftern takingn then medication.'
-I n need n ton set n ann alarmn son I n taken then medicationn onn time.'
Rationale:
Pyridostigminen isn an vitaln medicationn that n must n bentakennonntime;n an missed n orn latendosen cannresult n inn
severen respiratoryn and n neuromuscularn consequencesn orn evenn death.n Pyridostigminen should n ben take
nn withn an smalln amount n ofnfoodntonprevent ngastricn irritation.n Itnisn unnecessaryntontaken then pulsen raten b
eforen takingn pyridostigmine.n Pyridostigminen mayn causen hypotension,n not n hypertension,n whichn isn a
n signn of n cholinergicn crisis.
An client n withn myasthenian gravisn isn receivingn pyridostigminen bromiden ton controln symptoms.n Recent
ly,n then client n hasn begunnexperiencingnincreased n difficultyninn swallowing.n Whichn nursingn actionn isn ef
fectiven inn preventingn aspirationn of n food?
-Placen an tracheostomyn set n inn then client'sn room.
-Assessn respiratoryn statusn aftern meals.
-Request n forn then diet n ton ben changed n fromn soft n ton clearn liquids.
-Coordinaten mealtimesn withn then peakn effect n of n then medication.
-Coordinaten mealtimesn withn then peakn effect n of n then medication.
Rationale
Dysphagian should n ben minimized n duringn peakn effectn ofnpyridostigminen bromide,n therebyndecreasing
n then probabilityn of n aspiration.n A n tracheostomyn set n isn antreatment n for,n rathernthannequipment n ton preve
nt,n aspiration.n Althoughn it nisn vitalnthatnthenclient'sn respiratoryn functionnben monitored,n assessingn then c
lient'sn respiratoryn statusn willn not n prevent n aspiration.n Theren aren insufficient n datanton determinen wheth
ern changingn then diet n fromn softn foodsn ton clearn liquidsn isn appropriate;n also,n liquidsn aren aspirated n moren
easilyn thann semisolids.
Pyridostigminen isn prescribed n forn an client nwithnmyasthenian gravis.n Whynwould n thennursen instruct n th
en client n ton taken pyridostigminen about n 1n hourn beforen meals?
-Thisn timingn limitsn first n passn metabolism.
-Takingn it n onn ann emptyn stomachn increasesn absorption.
,-Takingnit n beforen mealsn decreasesn gastricn irritation.
-Takingnit n beforen mealsn improvesn then abilityn ton chew.
-Takingnit n beforen mealsn improvesn then abilityn ton chew.
Rationale:
Peakn actionn of n thenmedicationn willn occurn duringn mealsn ton promotenchewingn andnswallowingn andn pr
event n aspiration.n It n should n bengivenn withn ansmalln amount n of nfoodnton prevent n gastricn irritation.n First n
passn metabolismn isn an processn of n metabolism,n whichn isn not n affectedn bynmedicationn timing.n Absorpti
onn isn not n affected nsignificantlynbynthenpresencen ofnfoodninnthen stomach.n Gastricn irritationn isn reducedn
best n byn then administrationn of n medicationsn withn food,n not n onn ann emptyn stomach.
Anclient n presentsn ton then clinicn forn an follow-
upn appointment n afternstartingnpyridostigminen fornmanagement n of nmyasthenian gravis.n Whichn new n cli
ent n problemsn aren adversen effectsn ofn pyridostigmine?n Select n alln that napply.n One,nsome,n orn alln respons
esn mayn ben correct.
-Respiratoryndepression
-Increased n urinarynfrequency
-Diplopia
-Musclen twitching
-Diarrhea
-Increased n urinarynfrequency
-Musclen twitching
-Diarrhea
Rationale:
Pyridostigminen isn ann acetylcholinesterasen inhibitor.n Byn inhibitingn then enzymen that n breaksn downn ac
etylcholine,n it n increasesn cholinergicn activity.n Then increased n cholinergicn activityn isn responsiblen forn t
hen most n commonn adversen effectsnof npyridostigminen suchn asn diarrhean and nincreased n urinaryn frequen
cy.n Anothern adversen effect nisn musclen twitchingn that noccursn asn pyridostigminen affectsnthenmusclen we
aknessn that n isn characteristicn of n myasthenian gravis.n Respiratoryn depressionn isn an clinicaln manifestatio
nn of n myasthenian gravisn thatncannoccurn duentonrespiratorynmusclen weakness.n Weaknessn of neyen muscle
sn resultsn inn ptosisn orn diplopian inn about n half n of n clientsn withn myasthenian gravis.
Anclient n developsn extrapyramidaln effectsn afterntakingn anneurolepticn medication,nandnthennursen notes
n extrapyramidaln effects.n Whichn medicationn cann limit n thesen siden effects?
-Zolpidem
-Hydroxyzine
-Dantrolene
-Benztropinenmesylate
-Benztropinenmesylate
Rationale:
Benztropinen mesylate,n ann anticholinergic,n helpsn balancen neurotransmittern activityn inn then centraln ne
rvousn systemn (CNS)n and n helpsn controln extrapyramidaln tract n symptoms.n Zolpidemn isn ansedative-
n hypnoticn medicationn used n forn short-termn insomnia.n Hydroxyzinen isn an sedativen that n depresses
, activityn inn then subcorticaln areasn inn then CNS;nit n isn usedntonreducenanxiety.n Dantrolene,n an musclen relax
ant,n hasn an direct n effect n onn skeletaln musclen bynactingn onn then excitation-
contractionn couplingn of n musclen fibersn and n notnat nthenleveln of nthen CNS,n unliken most n othern musclen rel
axationn medications.
Anclient n receivingn fluphenazinen decanoaten developsn dystonian earlyninn therapy.n Whichnmedicationnw
ould n then nursen anticipaten administeringn ton reversen thisn siden effect?
-Nafarelin
-Fluoxetine
-Trandolapril
-Benztropine
-Benztropine
Rationale:
Dystonian isn ann extrapyramidaln siden effectn (EPS)nof nfluphenazinen decanoate.nThen anticholinergicn be
nztropinen isn used n ton reversen then signsn and n symptomsn (e.g.,n oculogyricn crisis,n torticollis,n retrocollis)n
of n dystonia.n Nafarelinn isn an gonadotropinn thatn stimulatesn then releasen of nluteinizingn hormonenand n folli
cle-
stimulatingn hormone.n Fluoxetinen isnanselectiven serotoninn reuptaken inhibitorn antidepressant.n Trandol
apriln isn ann angiotensin-convertingn enzymen inhibitorn antihypertensive.
An client n suspectedn ofn havingn myasthenian gravisn isn schedulednforn ann edrophoniumn chloriden test.n
Ton treatn an commonn complicationn associated n withnthen test,n then nursenwilln havenwhichn medicationn a
vailable?
-Atropine
-Phenytoin
-Neostigmine
-Diphenhydramine
-Atropine
Rationale:
Atropine,n ann anticholinergic,n should n alwaysn ben availablen ton treat n an cholinergicn crisisn (sudden,n sever
en episoden of n musclen weaknessn that naffectsn breathingn andnswallowing)n should n then edrophoniumn chlo
riden test n triggern thisn response.n Phenytoinn isn annanticonvulsant n that nwilln notnavert n orntreat n complicatio
nsn resultingn fromn ann edrophoniumn test.n Neostigminen isn an cholinergicn that n hasn then samen actionn asnedr
ophoniumn chloride;n it n isn contraindicated n if n an cholinergicn crisisn occurs.
Diphenhydraminen isn ann antihistaminen that nwilln not navert ncomplicationsn orn effectivelyntreat n ancholine
rgicn crisis.
Then nursen isn caringn forn an client n whon hasn beenn prescribed n atropinen preoperatively.n Then nursen unders
tandsn then intended n purposen forn administeringnthisn preoperativelynisn ton inducen whichn effect?
AReducen heart n raten BEl
evatenblood npressuren CE
nhancen sedationn DDecre
asen secretionsn DDecreas
en secretions
Rationale:
lOMoAR cPSD| 8510046
N316 MIDTERM EXAM OB (OBSTETRICAL NURSING)
n n n n n n
STILL LEARNING MOTHER AND BABY TESTBANK Q
n n n n n n
UESTIONS AND EXPLAINED ANSWERS 2025
n n n n
Whichn statementsn would n thennursen includen whenn teachingn an client n whon isn consideringn medroxypro
gesteronen injectionn asn an formn ofnhormonaln birthncontrol?n Select nalln that napply.n One,n some,n orn alln resp
onsesn mayn ben correct.
-It n lastsn forn 3n months.
-It n cann causen nausean and n vomiting.
-It n containsn bothn progestinn and n estrogen.
-It n decreasesn then riskn of n age-related n lossn of n bonen density.
-Sideneffectsn includen drowsinessn orn insomnian and n depression.
-Thenmost n severen undesirablen effectsn aren livern dysfunctionn and n thromboembolicn disorders.
*It n lastsn forn 3n months.
*It n cann causen nausean and n vomiting.
*Sideneffectsn includen drowsinessn orn insomnian and n depression.
*Thenmost n severen undesirablen effectsn aren livern dysfunctionn and n thromboembolicn disorders.
Rationale
Medroxyprogesteronen doesn last n forn 3nmonths.n It ncanncausen nausean and n vomiting,n asn welln asn letharg
yn orn insomnian and n depression,n althoughn then most nundesirablen severen effectsnaren livern dysfunctionn a
nd n thromboembolicn disorders,n includingn thrombophlebitis,n cerebrovascularn disorder,n pulmonaryn e
mbolism,n and n retinaln thrombosis.n Medroxyprogesteronen doesn not n containn bothnprogestinn andn estro
gen;n it n isn progestin-only.n Medroxyprogesteronen doesn not n decreasen then riskn of n age-
related n lossn of n bonen density;n inn fact,n it n hasn an black-
boxn warningn becausen it n cann causen bonenmineraln densitynlossn that nputsn womenn atn highernriskn fornoste
oporosisn and n bonen fracturesn latern inn life.
Anclient n withn myasthenian gravisn hasn beennreceivingn neostigminen and nasksn aboutnitsnaction.n Whichnin
formationn would n then nursen considern whenn formulatingn an response?
- Stimulatesn then cerebraln cortex
- Blocksn then actionn of n cholinesterase
- Replacesndeficient n neurotransmitters
- Acceleratesntransmissionnalongnneuralnsheathsn
Blocksn then actionn of n cholinesterase
Rationale:
Neostigmine,n ann anticholinesterase,n inhibitsn then breakdownn ofn acetylcholine,n thusn prolongingn
neurotransmission.n Neostigmine'sn actionn isn atn then myoneuraln junction,n notn then cerebraln cortex.n
Neostigminen preventsn neurotransmittern breakdown,n but n it n isn not n an neurotransmitter.
Neostigmine'sn actionn isn at n then myoneuraln junction,n not n then sheath.
Then healthn caren providern prescribesn neostigminen forn an client n withn myasthenian gravis.n Whichn cl
ient n statement n indicatesn understandingn regardingn medicationn management n plans?
- 'I nmust n keepn then medicationn inn an containern inn then refrigerator.'
- I nshould n taken then medicationn at n then exact n timen that n isn listed n onn then prescription.'
,-'I n willn plann ton taken then medicationn betweenn meals.'
-'I nexpect n that n then onset n of n then medication'sn actionn willn occurn severaln hoursn aftern I n taken it.'
- I nshould n taken then medicationn at n then exact n timen that n isn listed n onn then prescription.'
Rationale:
Neostigminen should n ben takenn asnprescribed,n usuallyn beforen meals,n tonlimit n dysphagian andnpossiblen a
spiration.n Keepingn neostigminen refrigerated n isn not n necessary;n it n mayn ben kept n at n roomn temperature.n
Neostigminen should n ben takennwithnmilkn tonprevent ngastrointestinaln irritation;n usuallyn it n isn takenn abo
ut n 30n minutesn beforen meals.n Then onset n ofnthenactionn ofnneostigminen occursn 45n ton 75n minutesn aftern a
dministration;n then durationn of n itsn actionn isn 2.5n ton 4n hours.
Pyridostigminen bromiden isn prescribed n forn anclient n withn myasthenian gravis.n Thennursenevaluatesn tha
t n then medicationn regimenn isn understood n whenn then client n makesn whichn statement?
-'I n willn taken then medicationn onn ann emptyn stomach.'
-I n need n ton set n ann alarmn son I n taken then medicationn onn time.'
-'It n willn ben important n ton checkn mynheart n raten beforen takingn then medication.'
'-I n should n monitorn forn ann increasen inn blood n pressuren aftern takingn then medication.'
-I n need n ton set n ann alarmn son I n taken then medicationn onn time.'
Rationale:
Pyridostigminen isn an vitaln medicationn that n must n bentakennonntime;n an missed n orn latendosen cannresult n inn
severen respiratoryn and n neuromuscularn consequencesn orn evenn death.n Pyridostigminen should n ben take
nn withn an smalln amount n ofnfoodntonprevent ngastricn irritation.n Itnisn unnecessaryntontaken then pulsen raten b
eforen takingn pyridostigmine.n Pyridostigminen mayn causen hypotension,n not n hypertension,n whichn isn a
n signn of n cholinergicn crisis.
An client n withn myasthenian gravisn isn receivingn pyridostigminen bromiden ton controln symptoms.n Recent
ly,n then client n hasn begunnexperiencingnincreased n difficultyninn swallowing.n Whichn nursingn actionn isn ef
fectiven inn preventingn aspirationn of n food?
-Placen an tracheostomyn set n inn then client'sn room.
-Assessn respiratoryn statusn aftern meals.
-Request n forn then diet n ton ben changed n fromn soft n ton clearn liquids.
-Coordinaten mealtimesn withn then peakn effect n of n then medication.
-Coordinaten mealtimesn withn then peakn effect n of n then medication.
Rationale
Dysphagian should n ben minimized n duringn peakn effectn ofnpyridostigminen bromide,n therebyndecreasing
n then probabilityn of n aspiration.n A n tracheostomyn set n isn antreatment n for,n rathernthannequipment n ton preve
nt,n aspiration.n Althoughn it nisn vitalnthatnthenclient'sn respiratoryn functionnben monitored,n assessingn then c
lient'sn respiratoryn statusn willn not n prevent n aspiration.n Theren aren insufficient n datanton determinen wheth
ern changingn then diet n fromn softn foodsn ton clearn liquidsn isn appropriate;n also,n liquidsn aren aspirated n moren
easilyn thann semisolids.
Pyridostigminen isn prescribed n forn an client nwithnmyasthenian gravis.n Whynwould n thennursen instruct n th
en client n ton taken pyridostigminen about n 1n hourn beforen meals?
-Thisn timingn limitsn first n passn metabolism.
-Takingn it n onn ann emptyn stomachn increasesn absorption.
,-Takingnit n beforen mealsn decreasesn gastricn irritation.
-Takingnit n beforen mealsn improvesn then abilityn ton chew.
-Takingnit n beforen mealsn improvesn then abilityn ton chew.
Rationale:
Peakn actionn of n thenmedicationn willn occurn duringn mealsn ton promotenchewingn andnswallowingn andn pr
event n aspiration.n It n should n bengivenn withn ansmalln amount n of nfoodnton prevent n gastricn irritation.n First n
passn metabolismn isn an processn of n metabolism,n whichn isn not n affectedn bynmedicationn timing.n Absorpti
onn isn not n affected nsignificantlynbynthenpresencen ofnfoodninnthen stomach.n Gastricn irritationn isn reducedn
best n byn then administrationn of n medicationsn withn food,n not n onn ann emptyn stomach.
Anclient n presentsn ton then clinicn forn an follow-
upn appointment n afternstartingnpyridostigminen fornmanagement n of nmyasthenian gravis.n Whichn new n cli
ent n problemsn aren adversen effectsn ofn pyridostigmine?n Select n alln that napply.n One,nsome,n orn alln respons
esn mayn ben correct.
-Respiratoryndepression
-Increased n urinarynfrequency
-Diplopia
-Musclen twitching
-Diarrhea
-Increased n urinarynfrequency
-Musclen twitching
-Diarrhea
Rationale:
Pyridostigminen isn ann acetylcholinesterasen inhibitor.n Byn inhibitingn then enzymen that n breaksn downn ac
etylcholine,n it n increasesn cholinergicn activity.n Then increased n cholinergicn activityn isn responsiblen forn t
hen most n commonn adversen effectsnof npyridostigminen suchn asn diarrhean and nincreased n urinaryn frequen
cy.n Anothern adversen effect nisn musclen twitchingn that noccursn asn pyridostigminen affectsnthenmusclen we
aknessn that n isn characteristicn of n myasthenian gravis.n Respiratoryn depressionn isn an clinicaln manifestatio
nn of n myasthenian gravisn thatncannoccurn duentonrespiratorynmusclen weakness.n Weaknessn of neyen muscle
sn resultsn inn ptosisn orn diplopian inn about n half n of n clientsn withn myasthenian gravis.
Anclient n developsn extrapyramidaln effectsn afterntakingn anneurolepticn medication,nandnthennursen notes
n extrapyramidaln effects.n Whichn medicationn cann limit n thesen siden effects?
-Zolpidem
-Hydroxyzine
-Dantrolene
-Benztropinenmesylate
-Benztropinenmesylate
Rationale:
Benztropinen mesylate,n ann anticholinergic,n helpsn balancen neurotransmittern activityn inn then centraln ne
rvousn systemn (CNS)n and n helpsn controln extrapyramidaln tract n symptoms.n Zolpidemn isn ansedative-
n hypnoticn medicationn used n forn short-termn insomnia.n Hydroxyzinen isn an sedativen that n depresses
, activityn inn then subcorticaln areasn inn then CNS;nit n isn usedntonreducenanxiety.n Dantrolene,n an musclen relax
ant,n hasn an direct n effect n onn skeletaln musclen bynactingn onn then excitation-
contractionn couplingn of n musclen fibersn and n notnat nthenleveln of nthen CNS,n unliken most n othern musclen rel
axationn medications.
Anclient n receivingn fluphenazinen decanoaten developsn dystonian earlyninn therapy.n Whichnmedicationnw
ould n then nursen anticipaten administeringn ton reversen thisn siden effect?
-Nafarelin
-Fluoxetine
-Trandolapril
-Benztropine
-Benztropine
Rationale:
Dystonian isn ann extrapyramidaln siden effectn (EPS)nof nfluphenazinen decanoate.nThen anticholinergicn be
nztropinen isn used n ton reversen then signsn and n symptomsn (e.g.,n oculogyricn crisis,n torticollis,n retrocollis)n
of n dystonia.n Nafarelinn isn an gonadotropinn thatn stimulatesn then releasen of nluteinizingn hormonenand n folli
cle-
stimulatingn hormone.n Fluoxetinen isnanselectiven serotoninn reuptaken inhibitorn antidepressant.n Trandol
apriln isn ann angiotensin-convertingn enzymen inhibitorn antihypertensive.
An client n suspectedn ofn havingn myasthenian gravisn isn schedulednforn ann edrophoniumn chloriden test.n
Ton treatn an commonn complicationn associated n withnthen test,n then nursenwilln havenwhichn medicationn a
vailable?
-Atropine
-Phenytoin
-Neostigmine
-Diphenhydramine
-Atropine
Rationale:
Atropine,n ann anticholinergic,n should n alwaysn ben availablen ton treat n an cholinergicn crisisn (sudden,n sever
en episoden of n musclen weaknessn that naffectsn breathingn andnswallowing)n should n then edrophoniumn chlo
riden test n triggern thisn response.n Phenytoinn isn annanticonvulsant n that nwilln notnavert n orntreat n complicatio
nsn resultingn fromn ann edrophoniumn test.n Neostigminen isn an cholinergicn that n hasn then samen actionn asnedr
ophoniumn chloride;n it n isn contraindicated n if n an cholinergicn crisisn occurs.
Diphenhydraminen isn ann antihistaminen that nwilln not navert ncomplicationsn orn effectivelyntreat n ancholine
rgicn crisis.
Then nursen isn caringn forn an client n whon hasn beenn prescribed n atropinen preoperatively.n Then nursen unders
tandsn then intended n purposen forn administeringnthisn preoperativelynisn ton inducen whichn effect?
AReducen heart n raten BEl
evatenblood npressuren CE
nhancen sedationn DDecre
asen secretionsn DDecreas
en secretions
Rationale:
