NCLEX OB-Women's Health and Maternity/Newborn Drugs

A nurse is administering 5,000 units of heparin to a prenatal client on prolonged bed rest. The label indicates that there are 20,000 units of heparin in each milliliter of solution. How much solution should the nurse give the client? Record your answer using two decimal places and include a leading zero if applicable. Do not include units in your answer. ___ mL

0.25

The order reads: "Give calcitonin 50 international units subcutaneous daily." The medication is available in a vial that contains 200 international units/mL. How many milliliters will the nurse draw up in the syringe for this dose? Include a leading zero if applicable. Record your answer using two decimal places. _____mL

0.25

Vitamin K 0.5 mg is prescribed for a newborn. The vial on hand is labeled "1 mL = 2 mg." How many milliliters should the nurse administer? Include a leading zero if applicable and record your answer using two decimal places. _____ mL

0.25

A woman in premature labor is prescribed betamethasone to enhance fetal lung maturity. The prescription reads: "Administer betamethasone 12 mg IM daily for 3 days." The betamethasone comes in a vial labeled "6 mg/mL." How many milliliters should the nurse administer each day? Record your answer using a whole number. ___ mL

2

Arrange in sequential order the mechanism of action in clomiphene. 1. Stimulation of pituitary gland 2. Maturation of follicles and ovulation 3. Secretion of gonadotropin hormone 4. Stimulation of ovarian follicles

3. Secretion of gonadotropin hormone 1. Stimulation of pituitary gland 4. Stimulation of ovarian follicles 2. Maturation of follicles and ovulation

A 28-year-old woman seeks advice about oral contraceptives from the nurse in her company health office. What should the nurse tell her if she is a smoker? A. "Oral contraceptives can cause thrombophlebitis." B. "Oral contraceptives must be used with other methods." C. "Some oral contraceptives can be used without concern." D. "Some oral contraceptives are safe, but others are not safe."

A. "Oral contraceptives can cause thrombophlebitis."

A nurse is caring for a primigravida during labor. At 7 cm of dilation a prescribed pain medication is administered. Which medication requires monitoring of the newborn for the side effect of respiratory depression? A. Butorphanol B. Hydroxyzine C. Promethazine D. Diphenhydramine

A. Butorphanol

Which category of drugs carries fetal risk in humans? A. Category X B. Category A C. Category C D. Category B

A. Category X

At 6 weeks' gestation a client is found to have gonorrhea. What medication does a nurse expect the primary healthcare provider to prescribe? A. Ceftriaxone B. Levofloxacin C. Sulfasalazine D. Trimethoprim/sulfamethoxazole

A. Ceftriaxone

What is the first line drug used to manage intrauterine fetal death? A. Dinoprostone B. Misoprostol C. Mifepristone D. Methylergonovine

A. Dinoprostone

An infusion of oxytocin is administered to a client for induction of labor. After several minutes the uterine monitor indicates contractions lasting 100 seconds with a frequency of 130 seconds. What is the next nursing action? A. Discontinuing the infusion B. Checking the fetal heart rate C. Slowing the oxytocin flow rate D. Turning the client on her left side

A. Discontinuing the infusion

A client at 30 weeks' gestation is admitted in preterm labor. An intravenous solution of the tocolytic agent ritodrine is started. The client asks why the drug is being administered. How will the nurse respond? A. Enhances uterine relaxation B. Prevents fetal hypoglycemia C. Stimulates fetal lung maturity D. Counteracts adverse reactions of other drugs

A. Enhances uterine relaxation

Which hormone causes skin discoloration? A. Estrogen B. Progesterone C. Pituitary hormone D. Follicle-stimulating hormone

A. Estrogen

Which drug may cause Ebstein anomaly as a teratogenic effect and is also contraindicated in breast-feeding clients? A. Lithium B. Ibuprofen C. Vitamin A D. Nitrofurantoin

A. Lithium

Which drug can be prescribed for the elective termination of a pregnancy? A. Mifeprex B. Raloxifene C. Methylergonovine D. Clomiphene

A. Mifeprex

Which adverse effect of heparin may be seen during pregnancy? A. Osteoporosis B. Severe bleeding C. Abnormal uterine contractions D. Suppression of uterine contractions

A. Osteoporosis

A pregnant woman with cervical stenosis has been admitted to the hospital for a labor induction. Which drug should be administered? A. Oxytocin B. Misoprostol C. Dinoprostone D. Ergot alkaloids

A. Oxytocin

Which drug is used to induce spontaneous abortions? A. Oxytocin B. Estradiol C. Progestins D. Clomiphene

A. Oxytocin

Which oxytocic drug may help to control uterine bleeding post-delivery and promote milk ejection? A. Oxytocin B. Mifepristone C. Dinoprostone D. Ergot alkaloids

A. Oxytocin

What are the actions of oxytocin? Select all that apply. A. Promotes milk ejection during lactation B. Controls uterine bleeding after delivery C. Induces labor when uterine contractions are weak D. Prevents uterine fibrosis in women of reproductive age E. Prevents high-risk intrauterine fetal positions before delivery

A. Promotes milk ejection during lactation B. Controls uterine bleeding after delivery C. Induces labor when uterine contractions are weak

Immediately after the third stage of labor a nurse administers the prescribed oxytocin infusion. Why is this medication administered? A. To help the uterus contract B. To decrease uterine discomfort C. To aid in the separation of the placenta D. For the stimulation of breast milk production

A. To help the uterus contract

During a prenatal visit a nurse explains to a client who is Rh negative when Rho(D) immune globulin will be administered to her. When is the best time to administer Rho(D) immune globulin? A. Within 72 hours of birth if the infant is Rh positive B. Weekly during the ninth month if the mother is a multipara C. Immediately after birth if the infant's Coombs test result is positive D. Always during the second trimester

A. Within 72 hours of birth if the infant is Rh positive

The nurse knows that when a magnesium sulfate infusion is given to a client with preeclampsia, it can build to a toxic level. Which assessment finding should prompt the nurse to withhold the medication and notify the primary healthcare provider? A. Respirations of 14 breaths/min B. Absence of deep tendon reflexes C. Urine output of 30 mL/hr D. Blood pressure of 140/100 mm Hg

B. Absence of deep tendon reflexes

The clinic nurse is planning care for a client found to have chlamydia. Which treatment should the nurse plan to implement? A. Administration of 250 mg of acyclovir orally in a single dose B. Administration of 1 g of azithromycin orally in a single dose C. Administration of 250 mg of ceftriaxone intramuscularly in a single dose Incorrect D. Administration of 2.4 million units of benzathine penicillin G intramuscularly in a single dose

B. Administration of 1 g of azithromycin orally in a single dose

Which drug is used as an ovulation stimulant but may cause multiple pregnancies? A. Oxytocin B. Clomiphene C. Dinoprostone D. Methylergonovine

B. Clomiphene

A client is taking fertility drugs for the first time. Which adverse effect of the drug should the nurse inform the client about? A. Vaginitis B. Constipation C. Joint swelling D. Deep vein thrombosis

B. Constipation

Which statement related to breast-feeding is correct? A. Protein soluble drugs can enter breast milk. B. Drugs with a long half-life should be avoided. C. Mothers should take drugs prior to breast-feeding. D. Drug usage during lactation is safe because the drugs will not harm the baby.

B. Drugs with a long half-life should be avoided.

What step should a nurse take when preparing to administer Rho(D) immune globulin to a postpartum client? A. Start a primary intravenous (IV) line so that the drug may be administered via IV piggyback. B. Ensure that the client is Rh negative and the neonate is Rh positive. C. Obtain a syringe and needle appropriate for the subcutaneous injection. D. Determine that the client has not eaten since midnight of the previous night.

B. Ensure that the client is Rh negative and the neonate is Rh positive.

Which effect is seen when the fetus is exposed to a teratogen during the embryonic period? A. Delay in growth B. Gross malformations C. Death of the conceptus D. Disruption of brain development

B. Gross malformations

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor? A. Nifidipine B. Indomethacin C. Calcium gluconate D. Magnesium sulfate

B. Indomethacin

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

A client is prescribed dinoprostone for the termination of a pregnancy. What is the route of administration of the drug? A. Oral route B. Intravaginal route C. Intramuscular route D. Intravenous route

B. Intravaginal route

A client was treated with methotrexate for cancer during the 6th month of her pregnancy. Which teratogenic effect may be seen in the child? A. Stillbirth B. Mental retardation C. Holoprosencephaly D. Normal development of the child

B. Mental retardation

Which drug is used to prevent preterm labor? A. Oxytocin B. Nifedipine C. Raloxifene D. Clomiphene

B. Nifedipine

A breastfeeding mother requires treatment for depression. Which drug would be safe to use if the mother wishes to continue breastfeeding the newborn? A. Fluoxetine B. Paroxetine C. Valproic acid D. Methotrexate

B. Paroxetine

During which period of pregnancy do teratogens act in an "all-or-nothing" fashion? A. Fetal period B. Presomite period C. Embryonic period D. 32nd week of the gestational period

B. Presomite period

Which statement regarding a teratogenic drug is incorrect? A. Teratogenic drugs cause characteristic malformation. B. Teratogenic drugs act during all periods of gestation. C. An increase in the dosage of teratogenic drugs increases the incidence of malformation. D. An increase in the duration of exposure to teratogenic drugs increases the incidence of malformation.

B. Teratogenic drugs act during all periods of gestation.

Which statements relate to preterm labor? Select all that apply. A. A premature baby has good cognitive development. B. The treatment for preterm labor includes bed rest and hydration. C. Preterm labor before the 20th week is indicative of a nonviable fetus. D. It is not desirable to stop the delivery in the case of preterm labor. E. Preterm labor refers to uterine contractions progressing to delivery before the 27th week of pregnancy.

B. The treatment for preterm labor includes bed rest and hydration. C. Preterm labor before the 20th week is indicative of a nonviable fetus.

A client is admitted for induction of labor. An intravenous infusion of oxytocin is started. When the client's contractions begin they are 1.5 to 2 minutes in duration. While the nurse is in the room, one contraction lasts 3 minutes. What should the nurse do first? A. Give oxygen by nasal cannula. B. Turn off the oxytocin infusion. C. Reposition the monitoring belts. D. Place a call light next to the client.

B. Turn off the oxytocin infusion.

A client is receiving an oxytocin infusion for induction of labor. The uterine graph on the electronic monitor indicates no rest period between contractions, and this is confirmed on palpation. What should the nurse do first? A. Evaluate the fetal heart rate. B. Turn the oxytocin infusion off. C. Place the client in the left-lateral position. D. Prepare the client for an emergency birth.

B. Turn the oxytocin infusion off.

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

C. Carbamazepine

Which drug may cause photophobia as an adverse effect? A. Nifedipine B. Aldenorate C. Clomiphene D. Indomethacin

C. Clomiphene

A pregnant client at 30 weeks' gestation begins to experience contractions every 5 to 7 minutes. She is admitted with a diagnosis of preterm labor. Although the client is being given tocolytic therapy, her cervix continues to dilate, and it is determined that a preterm birth is inevitable. Which medication does the nurse expect the primary healthcare provider to prescribe? A. Norgestrel B. Aminophylline C. Dexamethasone D. Magnesium sulfate

C. Dexamethasone

Which drug may cause fetal facial malformations when taken by a pregnant client? A. Antimicrobials B. Antiseizure drugs C. HMG-CoA reductase inhibitors D. Nonsteroidal antiinflammatory drugs

C. HMG-CoA reductase inhibitors

Which situation is an indication for an oxytocin infusion? A. Hypertonic uterus B. Pelvic inflammatory disease C. Induction of labor at full-term D. Cervical stenosis in a client who is in labor

C. Induction of labor at full-term

Which type of drug readily enters the breast milk? A. Water-soluble drugs B. Ionized drugs C. Lipid-soluble drugs D. Protein-bound drugs

C. Lipid-soluble drugs

A nurse instills an antibiotic ophthalmic ointment into a newborn's eyes. What condition does this medication prevent? A. Herpetic ophthalmia B. Retinopathy of prematurity C. Ophthalmia neonatorum D. Hemorrhagic conjunctivitis

C. Ophthalmia neonatorum

The nurse is caring for a client whose labor is to be induced. What is the nurse's responsibility when a client's labor is being stimulated with an oxytocin infusion? A. Flushing the intravenous (IV) tubing if the flow slows B. Checking the fetal heart rate every 2 hours C. Stopping the infusion if contractions become hypertonic D. Decreasing the infusion rate if hypertonic contractions continue for 15 minutes

C. Stopping the infusion if contractions become hypertonic

Which cardiovascular adverse effect is associated with the use of clomiphene? A. Ischemia B. Chest pain C. Tachycardia D. Hypertension

C. Tachycardia

A postpartum client who was receiving an intravenous infusion of oxytocin to stimulate labor asks the nurse why it is not being discontinued now that the baby is born. How should the nurse respond? A. "The oxytocin promotes the flow of lochia." B. "The oxytocin eases the discomfort of involution." C. "The oxytocin enhances the healing of tissue in the uterus." D. "The contractions prevent excessive bleeding."

D. "The contractions prevent excessive bleeding."

Which drug helps to achieve sufficient maturation of the ovarian follicles? A. Oxytocin B. Mifepristone C. Methylergonovine D. Choriogonadotropin alfa

D. Choriogonadotropin alfa

Which hormone may cause vaginal carcinoma in a female child after birth? A. Estrogen B. Progesterone C. Androgens D. Diethylstilbestrol

D. Diethylstilbestrol

Which anomaly may be observed when a fetus is exposed to a teratogen during the embryonic development? A. Death of the fetus B. Normal growth of the fetus C. Improper functioning of the fetus D. Improper development of the organs

D. Improper development of the organs

Which drug is administered to women after delivery to prevent postpartum uterine atony and hemorrhage but is not given to augment labor? A. Dinopristone B. Mifepristone C. Indomethacine D. Methylergonovine

D. Methylergonovine

A primigravida has just given birth. The nurse is aware that the client has type AB Rh-negative blood. Her newborn's blood type is B positive. What should the plan of care include? A. Determining the father's blood type B. Preparing for a maternal blood transfusion C. Observing the newborn for signs of ABO incompatibility D. Obtaining a prescription to administer Rho(D) immune globulin to the mother

D. Obtaining a prescription to administer Rho(D) immune globulin to the mother

A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. With what drink is iron absorption most efficient? A. Water B. A strawberry milkshake C. Skim milk D. Orange juice

D. Orange juice

Which chemical may be responsible for Braxton Hicks contractions occurring during the final weeks of pregnancy? A. Estrogen B. Oxytocin C. Progesterone D. Prostaglandins

D. Prostaglandins

While receiving betamimetic (tocolytic) therapy for preterm labor the client begins to experience muscle tremors and exhibit signs of nervousness. She reports, "My heart is racing." The nurse identifies that the client's pulse rate is 110 beats/min and regular. What should the nurse do next? A. Discontinue the medication as per protocol. B. Notify the primary healthcare provider that preterm labor has restarted. C. Obtain the client's laboratory results for electrolyte levels. D. Reassure the client that these are expected side effects of the medication.

D. Reassure the client that these are expected side effects of the medication.

A nurse administers the prescribed intravenous dose of magnesium sulfate to a client with severe preeclampsia. What adverse effect should the nurse address when evaluating the client's response to the medication? A. Blurred vision B. Epigastric pain C. Fetal tachycardia D. Respiratory depression

D. Respiratory depression

Which risk is associated with estrogen therapy in a client who smokes? A. Hypocalcemia B. Vaginal bleeding C. Multiple pregnancies D. Thromboembolic disorders

D. Thromboembolic disorders