HESI maternal

a client abuses alcohol during pregnancy. which condition would the nurse anticipate to see in the newborn? a. stillbirth b. heart defects c. growth delay d. multiple defects

a. stillbirth A client who is an alcohol abuser may deliver a stillborn baby. Heart defects occur in the newborn when the mother is exposed to antimicrobials during her pregnancy. Newborn growth delays may be caused by anti seizure medication exposure in the mother. Multiple defects may be seen in a child whose mother was exposed to vitamin A derivatives

Which antihistamine is considered safe for a woman who plans to breast-feed? a. Sertraline b. Loratadine c. Clemastine d. Bromocriptine

b. Loratadine Loratadine does not get excreted in the breast milk Sertraline is an antidepressant that is safe for lactating women Clemastine and bromocriptine are contraindicated in lactating women.

Which medication with the nurse identify as being used both for cervical ripening during labor and has a stomach protectant? a. raloxifene b. clomiphene c. misoprostol d. dinoprostone

c. misoprostol Misoprostol can be used for cervical ripening and as a stomach protectant. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used for ovulation. Dinoprostone can be used for cervical ripening, but this medication does not act as a stomach protectant.

Which hormone would the nurse identify as causing ovulation and promoting lactation? a. estrogen b. oxytocin c. progestin d. vasopressin

b. oxytocin Oxytocin stimulates uterine contractions, aids in ovulation, and promotes the movement of milk from the mammary glands to the nipples in lactating moms. Estrogen and progesterone may cause ovulation but do not promote lactation. Vasopressin may help in the retention of water by the kidneys

Which medication with the nurse identify as being used to induce spontaneous abortions? a. oxytocin b. estradiol c. progestins d. clomiphene

a. oxytocin Oxytocin is used for spontaneous or induced abortions. Estradiol may be given to alleviate postmenopausal hot flashes. Progestins are used for birth control. Clomiphene may be used as a fertility medication.

Which medication used to promote fertility would the nurse identify as a potential cause of esophageal burns? a. Estrogen b. Clomiphene c. Nifedipine d. Indomethacin

b. Clomiphene Clomiphene is a serum selective receptor modulator that may cause esophageal burns. Estrogen may cause a thromboembolism. Nifedipine may cause maternal-fetal problems. Indomethacin may cause birth defects

Which medication may cause Ebstein anomaly as a teratogenic effect and contraindicated and breast-feeding clients? a. Lithium b. Ibuprogen c. Vitamin A d. Nitrofurantoin

a. Lithium Lithium because Ebstein anomaly as a teratogenic effect. This medication is also contraindicated in breast-feeding clients. Ibuprofen is a NSAID that may cause premature closure of the ductus arterioles as a teratogenic effect. This medication is safe for breast-feeding clients to use. Vitamin A may cause heart defects as a teratogenic effect. Nitrofurantoin may cause heart defects.

the nurse understands which tocolytic agent can be used safely without combining with other agents to inhibit labor and maintain a pregnancy? a. nifedipine b. terbutaline c. indomethacin d. magnesium sulfate

a. nifedipine Terbutaline should not be used for prevention or prolonged treatment of preterm labor Indomethacin is given in combo with sucralfate to protect the stomach from the effects of indomethacin Magnesium sulfate should be administered with calcium gluconate to prevent magnesium toxicity

Which hormone levels do not require monitoring during the ministration of menotropins for infertility? a. estrogen b. luteinizing hormone c. follicle-stimulating hormone d. gonadotropin-releasing hormone

d. gonadotropin-releasing hormone Menotropins that are administered for infertility act at the pituitary level. Gonadotropin-releasing hormones act at the hypothalamus level; therefore this hormone does not need to be monitored. Menotropins is a standardized mixture of follicle-stimulating hormone and luteinizing; these hormones should be monitored. Also, estrogen levels need to be monitored because the luteinizing hormone directly stimulates the production of estrogen

Which medication because photophobia as an adverse effect? a. Nifedipine b. Alendronate c. Clomiphene d. Indomethacin

c. Clomiphene Clomiphene is a fertility medication that may cause photophobia. Nifedipine may cause maternal fetal problems. Alendronate may cause dysphagia Indomethacin may cause birth defects

a newborn with a cleft lip and palate is born to a mother who has a history of epilepsy. Which medication would the nurse suspect as being responsible for this malformation? a. phenytoin b. topiramate c. valproic acid d. carbamazepine

b. topiramate used to treat epilepsy, topiramate may have teratogenic effects that cause a newborn to develop a cleft lip with cleft palate. Carbamazepine and valproic acid may cause fetal neural tube defects. Phenytoin may cause fetal CNS defects

which baseline assessment is essential before the nurse initiates an infusion of magnesium sulfate for a client with preeclampsia? a. serum glucose b. respiratory rate c. body temperature d. level of consciousness

b. respiratory rate magnesium sulfate toxicity depresses respiration; therefore, it is essential to obtain a baseline respiratory rate before initiating therapy. The serum glucose level is unrelated to magnesium sulfate toxicity. A decreased level of consciousness may indicate worsening preeclampsia, not magnesium sulfate toxicity

a client at 35 weeks' gestation is admitted with preeclampsia and receives magnesium sulfate intravenously. Which is the most important parameter for the nurse to assess while monitoring the client for magnesium sulfate toxicity? a. heart rate b. daily weight c. deep tendon reflex d. blood pressure

c. deep tendon reflex An absence of DTRs is one of the first signs of magnesium sulfate toxicity. Magnesium sulfate interferes with the release of acetylcholine at the synapses, thereby decreasing neuromuscular irritability. Magnesium sulfate toxicity cannot be determined by alterations in the maternal HR or BP. Diuresis and its related weight loss are signs of the therapeutic effect of magnesium sulfate.

A new mother is diagnosed with depression. Which antidepressant may be prescribed to this client? a. Sertraline b. Fluoxetine c. Amphetamine d. Carbamazepine

a. sertraline sertraline is considered safe in lactating females. Dosing immediately after breast-feeding can reduce the risk for excretion of the medication in the breast milk by the next feeding time. Fluoxetine and amphetamine are not recommended for breast-feeding clients. Carbamazepine is not used to treat depression.

A client in active labor becomes very uncomfortable and asks the nurse for pain medication. Nalbuphine is prescribed. The nurse understands that this medication relieves pain by which mechanism? a. by producing amnesia b. by acting as a preliminary anesthetic c. by inducing sleep until the time of birth d. by acting on opioid receptors to reduce pain

d. by acting on opioid receptors to reduce pain Nalbuphine is classified as an opioid analgesic and is effective in relieving pain; it induces little or no newborn respiratory depression. Nalbuphine does not induce amnesia, act as an anesthetic, or induce sleep.

Which drug is derived from a natural source and may be prescribed for the treatment of osteoporosis? a. calcitonin b. raloxifene c. clomiphene d. bisphosphonates

a. calcitonin Calcitonin is derived from natural sources such as fish; this medication may be prescribed to prevent osteoporosis. Raloxifene is prescribed to prevent postmenopausal osteoporosis. Clomiphene is prescribed to induce ovulation. Bisphosphonates are prescribed to treat osteoporosis; this medication is not derived from natural sources.

which medication is indicated for evacuation in case of a miscarriage? a. clomiphene b. dinoprostone c. methylergonovine d. magnesium sulfate

b. dinoprostone Dinoprostone is a prostaglandin E2 abortifacient and cervical ripening medication, which is indicated for uterine evacuation in cases of miscarriage. Clomiphene is indicated for female infertility in some clients. methylergonovine is used to treat postpartum uterine atony and hemorrhage. Magnesium sulfate is used to treat pregnancy-induced hypertension

A client in labor is receiving an oxytocin (Pitocin) infusion. For which adverse reaction resulting from prolonged administration should the nurse monitor the client? a. Change in affect b. Hyperventilation c. Water intoxication d. Increased temperature

c. Water intoxication Oxytocin (Pitocin) has an antidiuretic effect, acting to reabsorb water from the glomerular filtrate. Oxytocin does not alter the client's affect. Hyperventilation is caused by an inappropriate breathing pattern, not prolonged use of oxytocin. Fever occurs with infection or dehydration, not prolonged administration of oxytocin.

Which medication may cause malformations of the male external genitalia? a. Etretinate b. Dutasteride c. Methimazole d. Propylthiouracil

b. Dutasteride Dutasteride is a 5-alpha-reductase inhibitor that causes malformations of external genitalia in males. Etretinate is a vitamin A derivative that may cause multiple CNS defects. Methimazole and propylthiouracil are antithyroid medications that may cause goiters and hypothyroidism.

A client who has a diagnosis of endometriosis is concerned about the side effect of hot flashes from her prescribed medications. Which medication should the nurse explain causes this side effect? a. Estrogen b. Leuprolide c. Diclofenac d. Ergonovine

b. Leuprolide Leuprolide decreases the levels of luteinizing hormone and follicle-stimulating hormone, as well as hormone-dependent tissue. One of its side effects is hot flashes. Estrogen affects the release of pituitary gonadotropins and inhibits ovulation; it is contraindicated because the goal of treatment is to suppress the action of estrogen on the endometrial tissue. Diclofenac is used for primary dysmenorrhea; it is a NSAID medication that inhibits prostaglandin synthesis. Ergonovine is used to induce contraction of the postpartum uterus.

a laboring client is to have a pudendal block. which effect of the pudenddal block would the nurse include in the teaching plan? a. bladder sensation may be lost b. she will not feel an episiotomy c. she may lose the ability to push d. contractions will no longer be felt

b. she will not feel an episiotomy A pudendal block provides anesthesia to the perineum. This block affects only the perineum, not the bladder, so it does not affect bladder sensation. It does not affect muscle control so it will not affect the ability to push. It anesthetizes only the perineum, not the cervix or body of the uterus, so contractions will still be felt

Which medication may be used to treat postpartum hemorrhage? a. clomiphene b. menotropins c. dinoprostone d. methylergonovine

d. methylergonovine Methylergonovine is a medication of choice used to treat postpartum hemorrhage. Clomiphene and menotropins are ovulation stimulants given to induce ovulation in infertile women. Dinoprostone is used to induce cervical ripening and cause termination of a pregnancy.

The nurse understands which medication taken by a pregnant woman may show a delayed teratogenic effect in the offspring? A. Aspirin B. Heparin C. Ethyl alcohol D. Diethylstilbestrol

Diethylstilbestrol Diethylstilbestrol may cause vaginal cancer in a female child 18 or more years after birth. Aspirin suppresses contractions during labor and may cause bleeding in the mother. Heparin does not cause fetal harm but may cause osteoporosis in the mother. Ethyl alcohol causes drug dependence or alcohol withdrawal syndrome in neonates.

Which is the first-line medication used to manage intrauterine fetal death? a. Dinoprostone b. Misoprostol c. Mifepristone d. Methylergonovine

a. Dinoprostone Dinoprostone is a synthetic derivative of the hormone prostaglandin E2. It is used to manage intrauterine fetal death up to 28 weeks of gestational age. Misoprostol is used for cervical ripening, and it is used along with mifepristone to induce abortion. Methylergonovine is prescribed to reduce postpartum hemorrhage.

A women undergoing chemotherapy for cancer gave birth to a newborn with limb malformations. Which medication may cause limb malformations in the neonates? a. Methotrexate b. Nitrofurantoin c. Carbamazepine d. Cyclophosphamide

a. Methotrexate When taken during pregnancy, methotrexate may cause limb malformations. Nitrofurantoin is not an immunosuppressant; it may cause abnormally small eyes or absent eyes in fetuses. Carbamazepine is an antiepileptic drug that may cause neural tube defects. Cyclophosphamide may cause central nervous system malformations and secondary cancers.

Which medication with the nurse identify as one that can be prescribed for the elective termination of a pregnancy? a. Mifeprex b. Raloxifene c. Methylergonovine d. Clomiphene

a. Mifeprex Mifeprex helps stimulate uterine contractions; this medication can be used for the elective termination of a pregnancy. Raloxifene may be used to prevent postmenopausal osteoporosis. Methylergonovine may be used to reduce postpartum uterine hemorrhage. Clomiphene may induce ovulation.

Which birth control agent requires administration once every three months? A. Progestin-only pills B. Intramuscular progestin C. Combination biphasic forms D. Combination monophasic forms

b. intramuscular progestin Intramuscular progestin requires the administration of a single injection every three months. Progressed-only oral contraceptive pills should be taken on a daily basis because of a higher incidence of ovulatory cycles. Combination biphasic and monophasic forms are administered as either a 21 or 28 day course.

Which would the nurse identify as the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone? a. Misoprostol b. Mifepristone c. Dinoprostone d. Methylergonovine

a. Misoprostol Misoprostol is the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone because it is relatively affordable. Mifepristone is used to induce labor. Dinoprostone is used for cervical ripening but is not an off-label medication for cervical ripening. Methylergonovine is used to enhance myometrial tone but is not used to augment labor.

Shortly after birth the nurse instills erythromycin ophthalmic ointment in the newborn's eyes. The father asks why an antibiotic is needed. The nurse explains it is routinely administered to prevent which type of infection? a. gonorrhea b. toxoplasmosis c. rubella d. cytomegalovirus

a. gonorrhea The antibiotic ointment is administered prophylactically to prevent the development of ophthalmia neonatorum, which may be contracted during a vaginal birth to a mother with gonorrhea, chlamydia, or both infections Cytomegalovirus, toxoplasmosis, and rubella are contracted by the fetus in utero during various stages of pregnancy, not during birth. Erythromycin ophthalmic ointment would be an ineffective treatment for these conditions.

Which medication is available in an injectable form? a. pitocin b. meclizine c. misoprostol d. dinoprostone

a. pitocin Pitocin is available in an injectable form. Meclizine and misoprostol are available as oral medications. dinoprostone is available as a topical gel for self-administration in the vagina

Which medication treatment in the client during her gestation may cause a single-load brain and neural tube defects? a. simvastatin b. isotretinoin c. carbamazepine d. cyclophosphamide

a. simvastatin Neural tube defects and single-lobed brains are teratogenic effects in a newborn associated with simvastatin, an HMG-CoA reductase inhibitor. Isotretinoin may cause CNS defects Carbamazepine exposure may cause neural tube defects. Cyclophosphamide may cause CNS malformation as a teratogenic effect

a client with endometriosis asks the nurse which side effects to expect from leuprolide. Which would the nurse include in the response? a. weight gain b. increased libido c. frequent urination d. heavy menstrual bleeding

a. weight gain SE of leuprolide: edema which causes weight gain, decreased libido - clients who take leuprolide do not experience menstrual periods because follicle-stimulating hormone and luteinizing hormone are suppressed

Which adverse effects of fertility medications are consequences of their extended action? (select all that apply) a. tachycardia b. hypovolemia c. multiple pregnancies d. deep vent thrombosis e. ovarian hyperstimulation

c. multiple pregnancies, d. ovarian hyperstimulation fertility medications stimulate the development of ovarian follicles and ovulation to attain conception. Adverse effects include multiple pregnancies and ovarian hyper-stimulation. Tachycardia, hypovolemia, and deep vein thrombosis are CV adverse effects that are not associated with extended action of fertility medications.

a client who has a habit of smoking is on estrogen therapy. Which condition is the client at most risk of developing? a. thrombosis b. gastrointestinal upset c. risk of developing cancer d. decreased effectiveness of estrogen

a. thrombosis smoking along with estrogen therapy may increase the risk of thrombosis. Estrogen taken on an empty stomach may cause GI upset. Estrogen is not prescribed to clients with endometrial or breast CA. the effectiveness of estrogen decreases with the use of anticoagulants, rifampicin, and St. John wort.

A client is taking fertility medications for the first time. Which adverse effect of the medication with the nurse inform the client about? a. vaginitis b. constipation c. joint swelling d. deep vein thrombosis

b. constipation Constipation as seen in the clients who are treated with fertility medications for the first time. Fertility medications do not cause vaginitis or swelling of joints. Deep vein thrombosis is an adverse effect of prolonged use of fertility medications

Which hypothalamic hormone would the nurse identify as helping treat postpartum uterine atony and hemorrhage? a. Oxytocin b. Indomethacin c. Dinoprostone d. Methylergonovine

a. Oxytocin Oxytocin is a hypothalamus secretory hormone that helps treat postpartum uterine atony and hemorrhage. Indomethacin helps maintain pregnancy and preterm labor. Dinoprostone causes ripening of the cervix during labor. Methylergonovine is an ergot alkaloid that helps treat postpartum uterine atony and hemorrhage

The nurse understands which antihypertensive medication is contraindicated in lactating women? a. atenolol b. labetalol c. metoprolol d. propranolol

a. atenolol Atenolol is contraindicated in lactating women because it enters the breastmilk and may cause adverse effects to the neonate. Labetalol and propanolol are safe to administer during lactation. Metoprolol is considered a safe medication to be taken during lactation

which is the most appropriate time for the nurse to administer an intravenous opioid analgesic to a client in active labor? a. between contractions b. when a contraction starts c. at the peak of a contraction d. just before the end of a contraction

b when a contraction starts when an analgesic is administered at the beginning of a contraction, uterine muscle tension increases resistance to the absorption of the medication, thereby slowing its passage through the placenta to the fetus. Between contractions is when the uterine muscle is at its most relaxed, and giving analgesic at this time thereby increases the rate of the opioid's passage through the placenta to the fetus.

Which medication would the nurse identify as being used to induce abortion? a. Oxytocin b. Mifepristone c. Dinoprostone d. Indomethacin

b. Mifepristone Mifepristone is used to induce abortion. Oxytocin is used to induce labor at full-term gestation. Oxytocin also enhances labor when uterine contractions are weak and ineffective, which is inappropriate for abortion. Dinoprostone is a uterine stimulant that produces labor by softening the cervix and ______ uterine muscle tone. Indomethacin is a tocolytic medication.

In which week of gestation would the nurse anticipate administering Rho(D) immune globulin to an Rh-negative client? a. 12 weeks b. 28 weeks c. 36 weeks d. 40 weeks

b. 28 weeks Rho(D) immune globulin (RhoGAM) administered during the 28th week of gestation reduces an active antibody response in an Rh-negative individual exposed to Rh-positive blood. It is difficult to determine whether Rh sensitization has occurred at 12 weeks in pregnancy. RhoGAM is given earlier than 36 weeks in the pregnancy; it is a preventative measure, not a treatment for a woman who is already sensitized. 40 weeks is around the time of birth; if the client has not been sensitized, she will receive RhoGAM within 72 hours of birth

Which medication is it teratogen that may cause masculinization of a female fetus? a. Lithium b. Danazol c. nitrofuantoin d. carbamazepine

b. Danazol Danazol is a teratogen that may cause masculinization of a female fetus. Lithium may cause cardiac defects. Nitrofurantoin may cause cleft lips with cleft palates. Carbamazepine may cause neural tube defects.

the nurse is teaching a group of student nurses about teratogenicity. Which statement by a student indicates that teaching was effective? (select all that apply) a. "negative animal studies indicate that the medication is safe to use in pregnant clients" b. "counseling must be provided to a sexually active client while using a known teratogen" c. "pregnant clients can continue to take anticancer medications if they cannot be avoided" d. "to wean a neonate from drug dependency, he or she should be given smaller doses of the drug" e. "functional defects in the newborn are the result of exposure of the fetus to teratogens in the later stages of pregnancy"

b, d, e

Which medication is used to prevent preterm labor? a. Oxytocin b. Nifedipine c. Raloxifene d. Clomiphene

b. Nifedipine Nifedipine is used to prevent preterm labor because it inhibits myometrial activity by blocking the influx of calcium. Oxytocin may be used to induce labor. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used to cause ovulation.

Which intrauterine medication exposure may lead to a child being born with a cleft lip? a. Phenytoin b. Multivitamin c. Methotrexate d. Nitrofurantoin

d. Nitrofurantoin Nitrofurantoin should not be administered during pregnancy because this medication may cause abnormally small or absent eyes, heart defects, or a cleft lip with a cleft palate. Phenytoin, multivitamins, and methotrexate do not cause a cleft lip

Which drug is contraindicated during pregnancy but can be safely used by lactating mothers?A. Tetracycline B. Lithium C. Carbamazepine D. Diethylstilbestrol

c. Carbamazepine Carbamazepine may cause neural tube defects when used during pregnancy but can be safely used by a lactating mother. Lithium and tetracycline should not be given to either a pregnant or lactating mother. Diethylstilbestrol cannot be given for pregnant clients and lactating mothers because it may cause vaginal carcinoma, and its level in the breast milk may be high.

the clinic nurse is planning care for a client with chlamydia. Which treatment would the nurse anticipate implementing? a. administration of 250mg of acyclovir orally in a single dose b. administration f 1g of azithromycin orally in a single dose c. administration of 250mg of ceftriaxone intramuscularly in a single dose d. administration of 2.4 million units of benzathine penicillin G intramuscularly in a single dose

b. 1g of azithromycin orally in a single dose acyclovir may be prescribed in a 7 day course for genital herpes 250mg ceftriaxone IM in a single dose is recommended for gonorrhea Benzathine penicillin G given IM as a single 2.4 million unit dose is treatment for primary, secondary, and early latent syphilis

Which teratogenic effect is seen because of lithium? a. stillbirth b. shortened limbs c. Ebstein anomaly d. neural tube defects

c. Ebstein anomaly Ebstein anomaly (cardiac defects) in the newborn occurs because of taking lithium during pregnancy. Stillbirth may occur because of alcohol use. Shortened limbs may occur because of thalidomide. Neural tube defects are due to anti seizure medications.

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor? a. Nifedipine b. Indomethacin c. Calcium gluconate d. Magnesium sulfate

b. indomethacin Indomethacin is a nonsteroidal antiinflammatory agent that may cause gastric irritation so sucralfate is administered along with this drug. Nifidipine is a calcium channel blocker used to manage preterm labor. Calcium gluconate is used to reverse magnesium sulfate toxicity. Magnesium sulfate is used to manage preterm labor and pregnancy-induced hypertension.

which medication identified by the nurse has an effect opposite to that of misoprostol? a. nifedipine b. mifepristone c. indomethacin d. dinoprostone

c. indomethacin misoprostol is a prostaglandin derivative that is used to induce uterine contractions and promos abortion. Indomethacin is used to maintain a pregnancy in preterm labor by inhibiting prostaglandin activity, which is the converse of misoprostol's effects. Nifedipine is a calcium channel blocker used to maintain a pregnancy in preterm labor. Mifepristone is a progesterone antagonist used along with misoprostol to induce abortion. Dinoprostone is a prostaglandin derivative used to dilate the opening of the cervix

which type of medication would the nurse identify as readily crossing the placenta? a. polar medications b. ionized medications c. lipid-soluble medications d. protein-bound medications

c. lipid-soluble medications Medications that are lipid soluble penetrate the placenta in higher concentrations. Polar medications are not transferred in higher concentrations through the placenta. Nonionized medications are more likely to be transferred through the placenta than ionized medications. Protein-bound medications remain in the maternal plasma because the molecules are too large to cross the placenta.

The nurse administers 2 serial intramuscular injections of betamethasone to a woman at 32 weeks' gestation admitted for preterm labor. The nurse explains to the client the medication is given to accomplish which purpose? a. stop the process of labor b. increase placental perfusion c. stimulate surfactant production d. reduce intensity of contractions

c. stimulate surfactant production corticosteroids stimulate surfactant production; they also have been shown to reduce the incidence of intraventricular hemorrhage. Betamethasone does not affect the labor process, increase placental perfusion, or affect the intensity of contractions

A nurse is caring for a client who was admitted with the diagnosis of severe preeclampsia and is now receiving an intravenous infusion of magnesium sulfate. What is the classification of this medication? a. Diuretic b. Oxytocic c. Antihypertensive agent d. Central nervous system depressant

d. CNS depressant Magnesium sulfate is a CNS depressant; it eases cerebral irritability, thus preventing seizures. Magnesium sulfate is not a diuretic; however, adequate kidney function is necessary to promote its excretion. Otherwise toxicity will result. Magnesium sulfate is not an oxytocic; oxytocin is used to promote uterine contractions and can cause an increase BP. Magnesium sulfate is not an antihypertensive; however, it may cause a transient decrease in blood pressure because of its peripheral dilating effect

Which effect with the nurse identify as seen when the fetus is exposed to a teratogen during embryonic period? a. delay in growth b. gross malformations c. death of the conceptus d. disruption of brain development

b. gross malformations Gross malformations occur if there is exposure to a teratogen during the embryonic period or the first trimester. During the fetal period, exposure to a teratogen causes delays in growth and development of the fetus. Death of the conceptus occurs if exposed to a lethal dose of teratogen during the pre-implantation period. Exposure to a teratogen during the fetal period (second or third trimester) causes disruption of brain development.

Which medication would the nurse identify as a potential cause for the formation of abnormally small eyes in the newborn if used during pregnancy? a. estrogens b. nitrofurantoin c. methotrexate d. valproic acid

b. nitrofurantoin Nitrofurantoin, an antimicrobial medication, causes formation of abnormally small eyes in the newborn. Sex hormone supplements, such as estrogens, may cause congenital defects of female reproductive organs. Methotrexate can cause congenital abnormalities (central nervous system and limbs malformations) and fetal death. Valproic acid is high teratogenic and cause neural tube defects, atrial septal defect, cleft palate, hypospadias, polydactyly, and craniosynostosis.

which medication for depression would be safe to use with a breast-feeding mother who wishes to continue breast-feeding the newborn? a. fluoxetine b. paroxetine c. valproic acid d. methotrexate

b. paroxetine Paroxetine can be safely given during breast-feeing. Fluoxetine can easily enter breast milk; therefore this medication would be used only when the respective serotonin reuptake inhibitors are ineffective. Valproic acid is an anti epileptic medication that can be given safely to breast-feeding women. Methotrexate is an anticancer medication that cannot be given during breast-feeding because it enters the breast milk and can cause adverse effects on the baby

Which ovulation stimulant with the nurse identify as being derived from the urine of postmenopausal woman? a. Oxytocin b. Clomiphene c. Menotropins d. Dinoprostone

c. Menotropins Menotropins are a standardized mixture of follicle-stimulating hormones and luteinizing hormones. These chemicals are derived from the urine of postmenopausal women. Clomiphene is a synthetic ovulation stimulant. Oxytocin and dinoprostone are synthetic uterine stimulants.

A client in active labor who is 90% effaced, 7 cm dilated with a vertex presenting at 2+ station, complains of pain and ask for medication. Which medication with the nurse anticipate causing respiratory depression in the newborn? a. Naloxone b. Lorazepam c. Meperidine d. Promethazine

c. Meperidine Meperidine is an opioid that can cause respiratory depression in the neonate if administered less than 4 hours before birth. Naloxone is an opioid antagonist that reverses the effects of respiratory depression in the newborn. Lorazepam is a sedative; it does not cause respiratory depression in the newborn, but it does not relieve pain by itself. Promethazine is a tranquilizer; it does not cause respiratory depression in the newborn, but does not receive pain by itself

Which medication is responsible for neonatal hypoglycemia? a. Warfarin b. Simvastatin c. Tolbutamide d. Methimazole

c. Tolbutamide Tolbutamide is an oral hypoglycemic agent used to treat DMT2. Has effects such as neonatal hypoglycemia Warfarin, a common blood thinner, may cause teratogenic effects such as skeletal and central nervous system defects. Simvastatin, an HMG-CoA reductase inhibitor used for the treatment of high cholesterol, may cause teratogenic effects such as facial malformations and severe central nervous system anomalies. Methimazole, an antithyroid medication administered for the treatment of maternal hyperthyroidism, may cause teratogenic effects such as neonatal goiter, cretinism, and hypothyroidism.

a client undergoing treatment for a medical condition gave birth to a baby with renal failure as a result of the teratogenic effect of the medications. The nurse would identify which treatment received by the mother during pregnancy as a potential cause of this teratogenic effect? a. cancer b. epilepsy c. hypertension d. microbial infection

c. hypertension Angiotensin-converting enzyme inhibitors used for treating hypertension may cause renal failure as a teratogenic effect. Treatment of cancer may cause central nervous system malformations. Treatment of epilepsy may cause growth delay. Antimicrobial may cause heart defects

the nurse is caring for a pregnant client who has contracted a trichomonal infection; for which oral medication would the nurse anticipate preparing to provide education? a. Penicillin G b. Acyclovir c. Nystatin d. Metronidazole

d. Metronidazole Metronidazole is a potent amebicide that is safe in pregnancy. It is effective in eradicating the protozoan Trichomonal vaginalis. Penicillin is administered for its effect on bacterial, not protozoal, infections. Acyclovir is an antiviral medication; therefore it would not be effective in treating protozoal infections such as trichomonal. Nystatin is an anti fungal for infections caused by Candida albicans

The nurse prepares to administer vitamin K to a newborn. Which rationale explains why newborns are deficient in this vitamin? a. Alterations in blood coagulation interfere with vitamin K production b. A newborn's liver does not produce it immediately after birth c. increased bilirubin levels interfere with vitamin K synthesis during the neonatal period d. a newborn's intestinal tract does not synthesize it for several days after birth

d. a newborn's intestinal tract does not synthesize it for several days after birth Because the infant's intestine is sterile at birth, it lacks the flora to synthesize vitamin K, which activates coagulation factors and prevents hemorrhage in the newborn. The liver does not produce vitamin K; vitamin K catalyzes the synthesis of prothrombin in the liver. Hyperbilirubinemia may develop because of complex factors; however, this does not inhibit vitamin K synthesis. Vitamin K alters blood coagulation, not vice versa.