CH 6 Drugs for Pregnant or Lactating Women (E5)
A pregnant woman states that she has been constipated since becoming pregnant. Which medication is most appropriate for preventing constipation related to pregnancy? A) psyllium B) mineral oil C) saline cathartic D) stimulant cathartic
A
A pregnant woman is discussing immunizations recommended during pregnancy with her provider. Which of the following vaccines is recommended during each pregnancy? A) tetanus-diphtheria-pertussis B) tetanus-diphtheria C) live attenuated influenza vaccine D) measles, mumps, and rubella
A
A pregnant woman is experiencing nausea and vomiting in her first trimester of pregnancy. Which herbal agent that has traditionally been used as an antiemetic could the nurse discuss with the client? A) ginger B) garlic C) Ginkgo biloba D) green tea
A
A woman has been diagnosed with gestational diabetes. What effect does maternal hyperglycemia have on the fetus? A) It results in fetal hyperinsulinemia. B) It produces seizures in the newborn. C) It increases the mother's risk of preterm labor. D) It decreases the birth weight.
A
A woman is admitted to labor and delivery for labor induction due to postterm pregnancy. Labor has not begun on its own, and the cervix is unfavorable. Which of the following medications promotes cervical ripening? A) dinoprostone B) nifedipine C) naproxen sodium D) oxytocin
A
A woman was administered misoprostol in an effort to induce labor, but the care team is unsatisfied with the results. Consequently, oxytocin will be used. Prior to administering oxytocin, what must occur? A) Four hours must elapse after the last dose of misoprostol. B) The woman must have a type and cross-match performed. C) The woman must receive a bolus of 500 mL normal saline. D) The woman must have her electrolytes measured.
A
A woman who is in the first trimester of her pregnancy has told the nurse, "I've stopped taking my blood pressure pill because I know it could harm the baby. Instead, I've started taking natural and herbal remedies." What nursing diagnosis is suggested by the woman's statement? A) deficient knowledge related to drug and herbal effects during pregnancy B) health-seeking behaviors related to protection of fetal health C) acute confusion related to the potential teratogenic effects of herbs D) effective therapeutic regimen management related to use of herbs rather than drugs
A
A woman with a seizure disorder has been taking phenytoin since she was 6 years old. She has recently married and wants to start a family. She understands the risk related to the use of phenytoin during pregnancy. What should the nurse advise the woman about pregnancy? A) She should discuss her concerns with her gynecologist and neurologist. B) She should stop the phenytoin and take folic acid. C) She should begin to take prenatal vitamins. D) She should consult a genetic counselor about her seizure disorder.
A
A couple have been trying unsuccessfully for nearly a year to become pregnant and have now sought fertility counseling. The nurse should be aware of what potential etiological factors related to infertility? SELECT ALL THAT APPLY. A) absence of sperm B) endometriosis C) vaginitis D) blocked fallopian tubes E) fibromyalgia
A, B, D
A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? SELECT ALL THAT APPLY. A) Deepening voice B) Weight gain C) Low blood pressure D) Dry mouth E) Facial hair
A, B, E
A woman is to receive indomethacin for treatment of preterm labor. The nurse understands the teaching was successful when the woman states which of the following as adverse fetal effects? SELECT ALL THAT APPLY. A) ductus arteriosus constriction B) polyhydramnios C) oligohydramnios D) ductus venosus constriction
A, C
A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? SELECT ALL THAT APPLY. A) Thickening the cervical mucus B) Inducing maturation of ovarian follicle C) Increasing development of the corpus luteum D) Altering the endometrial lining E) Inhibiting ovulation
A, D, E
A client is receiving oxytocin. Which is a maternal focused adverse effect of the medication? A) acute confusion B) hypertension C) edema D) inverted T wave
B
A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil? A) Aspirin B) Isosorbide C) Clopidogrel D) Atorvastatin
B
A nurse is providing prenatal teaching in the obstetric clinic. Which of the following herbal supplements helps in the prevention of nausea and vomiting? A) St. John's wort B) ginger C) black cohosh D) garlic
B
A pregnant woman asks why she needs to take a folic acid supplement. What is the nurse's best explanation for the administration of folic acid? A) "Folic acid prevents the development of contractions." B) "Folic acid prevents neural tube birth defects." C) "Folic acid builds strong fetal bones." D) "Folic acid will decrease nausea and vomiting."
B
A woman in labor is being treated with magnesium sulfate intravenously and is beginning to show signs and symptoms of hypermagnesemia. The infusion has been discontinued, and the nurse should anticipate administration of what drug? A) metoprolol B) calcium gluconate C) potassium chloride D) furosemide
B
A woman is admitted to the labor and delivery unit in preterm labor. The woman was diagnosed with hyperthyroidism 3 years ago. Which tocolytic is contraindicated? A) magnesium sulfate B) terbutaline sulfate C) nifedipine D) indomethacin
B
When administering magnesium sulfate, for what should the nurse assess the client? A) dry, pale skin B) respiratory depression C) agitation D) tachycardia
B
A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy? A) during the second half of her third trimester B) in the 7 to 10 days after conception C) in the first trimester during organogenesis D) during 30 to 34 weeks of gestation
C
A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication? A) Bradycardia B) Edema C) Hypotension D) Tremor
C
A nurse knows that teaching was successful when expectant parents give which of the following rationales for administering folic acid supplements? A) prevent hydrocele B) increase absorption C) prevent neural tube deformity D) decrease blood glucose
C
A woman diagnosed with anovulation receives a prescription for menotropin to be administered subcutaneously. When providing education about medication administration, the nurse should teach the woman to: A) massage the area prior to administering the drug B) administer the drug at a 90-degree angle C) alternate the sides of the abdomen for the injection sites D) take human chorionic gonadotropin before the menotropin
C
A woman experiencing preterm labor receives terbutaline sulfate. Which of the following adverse effects should the nurse tell her to expect? A) headache B) edema C) hand tremors D) shortness of breath
C
A woman has been unable to conceive for many months and will soon begin treatment with clomiphene. What health education should the nurse provide to this client? A) Avoid drinking alcohol while taking clomiphene. B) Perform daily OTC pregnancy tests beginning the day after taking clomiphene. C) Take basal temperature between 5 and 10 days after taking clomiphene. D) Report any numbness or tingling in hands or lips to the care provider.
C
A woman is being administered IV magnesium sulfate. What is a desired outcome related to the administration of magnesium sulfate? A) increased contractions B) respiratory rate above 18 C) decreased blood pressure D) increased uterine tone
C
A woman prescribed the highly active antiretroviral therapy (HAART) for HIV/AIDS has become pregnant. What is the effect the woman's pregnancy is expected to have on her drug regimen? A) She must discontinue HAART due to the risk of teratogenic effects. B) Her dosages of HAART must be increased to reduce the risk of in utero transmission. C) She can continue her HAART unchanged as long as recommended doses are prescribed. D) Some components of her HAART must be replaced or discontinued.
C
A woman who began labor several hours ago is now prescribed oxytocin. What is the goal of oxytocin therapy? A) prevent postpartum bleeding B) decrease fetal hyperactivity C) augment weak or irregular contractions D) diminish periods of uterine relaxation
C
A woman who is 7 months pregnant is waking up at night experiencing gastroesophageal reflux. Which medication is most highly recommended? A) terbutaline B) diphenoxylate C) ranitidine D) chlorothiazide
C
The certified nurse midwife administers misoprostol in the woman's vagina to increase cervical ripening. The cervix ripens, but the contractions are not significant for the fetus to pass through the birth canal, and oxytocin is ordered. Which of the following is most important with regard to the administration of oxytocin? A) Begin the oxytocin immediately. B) Begin the oxytocin in 2 hours. C) Begin the oxytocin in 4 hours. D) Begin the oxytocin in 8 hours.
C
The nurse is providing immunization education to a pregnant woman. She should receive which of the following vaccines during cooler seasonal temperatures? A) rubella B) mumps C) influenza D) tetanus
C
A client is being administered magnesium sulfate for preterm labor. The client's serum magnesium level is elevated at 11 mg/dL. With what sign or symptom will the client likely present? A) tachypnea B) muscle rigidity C) tachycardia D) depressed deep tendon reflexes
D
A client is being treated for preterm labor. Which beta-adrenergic medication is administered orally to decrease uterine contractions? A) magnesium sulfate B) oxytocin C) nifedipine D) terbutaline
D
A couple has been trying to conceive for the past 8 months without success. Which of the following medications is the first drug of choice? A) leuprolide B) human chorionic gonadotropin C) follitropin beta D) clomiphene citrate
D
A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions? A) Atrophic vaginitis B) Dysfunctional uterine bleeding C) Osteoporosis D) Thrombophlebitis
D
A primiparous woman was vigilant in avoiding medications and herbs during her pregnancy and states that she is similarly committed to protecting her baby's health now that she is breast-feeding. What principle should guide the woman's use of herbs while breast-feeding? A) Very few herbs are explicitly contraindicated while breast-feeding. B) It is generally safer to use herbs rather than medications while breast-feeding. C) Most women can resume their prepregnancy herbal regimen after delivery. D) Not all herbs are safe while a woman is breast-feeding.
D
A woman in preterm labor has been administered terbutaline sulfate. For what potential adverse effects should the nurse assess the client? A) pruritus (itching) and copious diaphoresis B) joint pain and numbness in her extremities C) headache and visual disturbances D) palpitations and shortness of breath
D
A woman is at 42 weeks of gestation. Which medication will be administered to promote cervical ripening? A) calcium gluconate B) magnesium sulfate C) terbutaline D) dinoprostone
D
A woman is receiving intravenous (IV) magnesium sulfate to control symptoms of preeclampsia. Which of the following signs or symptoms indicates a need for the administration of IV calcium gluconate? A) urine ketosis B) respiratory rate of 36 breaths/min C) anuria D) loss of deep tendon reflexes
D