prep u ch 6

A patient is pregnant and is at 7 weeks' gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby. The best response to the patient by the nurse would be a) "You will need to continue taking your insulin because hyperglycemia is thought to contribute to low birth weight." b) "Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta." c) "I will tell your physician that you are concerned about taking insulin during your pregnancy." d) "You will have to discontinue the insulin therapy during your pregnancy, but you will resume the medication after delivery."

"Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta."

Mrs. Allen develops a headache and asks the nurse if it is safe to take aspirin 1 hour before breast-feeding. What is an appropriate response? a) Your headache may interfere with letdown; take the aspirin. b) Aspirin is the drug of choice for pain during the lactation period. c) The aspirin will not be absorbed by the baby. d) Aspirin should be avoided during lactation; consult your physician.

Aspirin should be avoided during lactation; consult your physician.

Mrs. Smith is considering pregnancy; she is healthy and does not take prescription medications. She asks the nurse for advice. What should the nurse suggest this client do? a) Avoid over-the-counter medications before pregnancy b) Begin fertility drugs as soon as possible c) Double the dose of her multivitamins with minerals before pregnancy d) Avoid multivitamins with minerals before pregnancy

Avoid over-the-counter medications before pregnancy

The labor and delivery nurse is preparing to give pitocin to a patient to induce labor. Which of the following should be the most cause for concern for the nurse if the patient starts to exhibit it? a) Slight change in comfort level b) Big change in blood pressure c) Nausea without vomiting d) Statement by the patient that she just wants it to be over

Big change in blood pressure

Which of the U.S. FDA Pregnancy Categories should the nurse consider in assessing the risk vs. benefit of a drug for use in pregnant women before administration of the medication? (Select all that apply.) a) D b) C c) B d) X

D • C • X

One hour after delivery, Mrs. East is concerned that her child is listless. What would the nurse evaluate? a) Maternal nutrition b) Antibiotic administration to the mother before delivery c) The child's ability to breast-feed d) Drugs received by the mother during labor and delivery Submit your answer

Drugs received by the mother during labor and delivery

As part of a preconception class, the nurse stresses which time period the fetus is the most venerable to teratogenic agents? a) Second trimester b) Third trimester c) First trimester d) Entire gestational period

First trimester

Which would be safe to give during pregnancy? a) Phenytoin b) Flu vaccine c) MMR vaccine d) Varicella vaccine

Flu vaccine

The nurse is assessing a young pregnant woman at her first prenatal visit. When the nurse inquires if the client is using OTC or herbal preparations, the client names some herbs she uses. Which of the following should the nurse recognize as one to avoid? a) Chamomile b) Peppermint c) Ginseng d) Lavender

Ginseng

Heartburn and GERD can become more common in pregnant women for both mechanical and chemical reasons. Mechanically, the growing fetus increases abdominal pressure. What could be a chemical cause for increased heartburn and GERD? a) Hormones relax the upper esophageal sphincter. b) Hormones relax the lower esophageal sphincter. c) Hormones increase flatulence. d) Hormones increase acid production. Submit your answer

Hormones relax the lower esophageal sphincter.

The pregnant woman is at increased risk for toxicity with highly protein-bound drugs due to what physiologic change that occurs during pregnancy? a) Vasodilatation b) Increased levels of protein in the blood c) Increase in cell volume by 30% d) Increase in plasma volume by 50%

Increase in plasma volume by 50%

A patient having twin daugthers begins to have contractions and calls her physician, who tells her to go to the emergency department (ED) for examination. The patient is only 34 weeks' gestation. In the ED, the contractions continue. The patient is admitted. The nurse expects the physician to order which of the following for this patient? a) Magnesium b) Cytotec c) Pitocin d) Methergine

Magnesium

A pregnant client wants to know what drugs she can take safely during her pregnancy. Which of the following drugs should the nurse tell her is relatively safe during pregnancy? a) Dihydroergotamine mesylate b) Estazolam c) Magnesium sulfate d) Valproic acid

Magnesium sulfate

Ms. Harbor received parenteral opioid analgesics during labor and delivery of her first child. The nurse observes that the neonate is experiencing respiratory depression. What is the drug of choice in this case? a) Morphine sulfate b) Naloxone c) Terbutaline d) Magnesium sulfate

Naloxone

During a prenatal visit, the client mentions she has been drinking peppermint and ginger tea. The nurse should inquire if the client is having problems with which of the following? a) Diarrhea b) Bloating c) Constipation d) Nausea Submit your answer

Nausea

A client mentions at her prenatal visit that she has been using an OTC cough syrup with alcohol. The nurse is concerned and suggests an alternative therapy for which of the following reasons? a) No amount of alcohol is considered safe during pregnancy. b) Prescribed cough syrup is safer than OTC remedies for the mother and fetus. c) The cough syrup safety during pregnancy is uncertain. d) The cough syrup will be ineffective during pregnancy.

No amount of alcohol is considered safe during pregnancy.

The nursing instructor is teaching the student about drugs given to induce uterine contractions and promote labor. These drugs are classified as which of the following? a) Tocolytic b) Cytotoxic c) Ergots d) Oxytocic

Oxytocic

A 36-year-old patient comes to the clinic and tells the nurse that she suspects that she is pregnant. During the initial assessment, the nurse learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications? a) Insulin b) Phenytoin (Dilantin) c) Furosemide (Lasix) d) Ibuprofen (Advil)

Phenytoin (Dilantin)

A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered? a) Second stage of labor b) Postpartum c) Antepartum d) Pre-term labor

Pre-term labor

Mrs. Ames is started on terbutaline therapy. What would indicate that the therapy has been successful? a) There has been less or no bleeding in the delivery. b) The mother did not require any labor induction. c) The mother does not experience adverse effects. d) Premature birth is avoided for at least 24 hours.

Premature birth is avoided for at least 24 hours.

The client is showing signs of pre-eclampsia. The nurse realizes the client is at increased risk for preterm labor. The nurse discusses the potential use of which drug class with the client? a) Galactagogues b) Abortients c) Uterotonics d) Tocolytics

Tocolytics

Ms. Penn receives Duramorph through her epidural catheter after undergoing a cesarean section. For what should the nurse observe the client? a) Hypertension b) Dysrhythmia c) Urinary retention d) Diarrhea

Urinary retention

Which of the following is the term for the adverse reaction (fluid volume excess) that occurs sometimes when oxytocin is administered continuously IV while the patient is also receiving fluids by mouth? a) Water intoxication b) Loss of fluid c) Uterine hypertonicity d) Uterine atony

Water intoxication

On occasion, medications can be administered to a fetus through maternal ingestions. Which of these medications can be used for such treatment? a) Penicillin b) Levothyroxine c) All of these d) Digoxin

all of these

The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during a) the second trimester. b) the first 2 months of pregnancy. c) breast-feeding of the neonate. d) the two to 3 weeks prior to delivery. Submit your answer

the first 2 months of pregnancy. Correct

Terbutaline would be used to halt the contractions associated with preterm labor. a) True b) False

true

Which of the following is an adverse effect caused by all uterine stimulants because of their antidiuretic effect? (Choose one) a) Dehydration b) Water intoxication c) Hypotension d) Polydipsia

water intoxication