Chapter 39 Drugs Used in Obstetrics

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Chapter 39  Drugs Used in Obstetrics

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Which drug will the health care provider prescribe to soften the cervix of a woman who is at 42 weeks of gestation?
a.
Methylergonovine (Methergine)
b.
Dinoprostone (Prepidil)
c.
Betamethasone (Celestone)
d.
Terbutaline (Brethine)

ANS: B
Dinoprostone is a natural chemical in the body that causes uterine and gastrointestinal smooth muscle stimulation. It plays a role in cervical softening and dilation unrelated to uterine muscle stimulation. It is used to start and continue cervical ripening at term. Methergine is used to treat postpartum bleeding. Betamethasone is used to enhance fetal lung development. Terbutaline is used to treat premature labor.

DIF: Cognitive Level: Comprehension REF: Page 607 OBJ: N/A
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Reproduction

2. For which reason will betamethasone IM be administered to the mother in premature labor?
a.
To stop uterine contractions
b.
To prevent precipitous labor
c.
To stimulate lung maturity in the fetus
d.
To stimulate prolactin to enhance breastfeeding

ANS: C
Glucocorticoids may be administered IM to accelerate fetal lung maturation to minimize respiratory distress syndrome. Tocolytic drugs are given to stop uterine contractions. Prolactin production and release are triggered by pituitary hormone, estrogen, and progesterone.

DIF: Cognitive Level: Application REF: Page 600 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Reproduction; Safety; Gas Exchange

3. A 26-year-old patient with preeclampsia is receiving IV magnesium sulfate. The 1400 assessment includes blood pressure, 100/70 mm Hg; respiration, 10; fetal heart tone, 100/min; urine output, 20 mL/hr; and absent patellar reflex. Which is the priority nursing action?
a.
Decrease IV magnesium sulfate to half the dose and reassess the patient and fetus in 15 minutes.
b.
Stop the IV magnesium sulfate and contact the health care provider.
c.
Place the patient on her left side and administer oxygen.
d.
Stop the IV magnesium sulfate and administer calcium gluconate 5 mEq IV over 3 minutes.

ANS: D
The patient is exhibiting signs of magnesium sulfate toxicity, including respiratory depression. The infusion should be stopped at once. The antidote, calcium gluconate, should be administered.

DIF: Cognitive Level: Application REF: Page 611 OBJ: 2
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Reproduction; Safety; Gas Exchange; Perfusion

4. Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered?
a.
Oxytocin (Pitocin)
b.
Magnesium sulfate
c.
Vitamin K
d.
Dopamine

ANS: A
Uterine stimulants, primarily oxytocin, given in low-dose infusions after delivery of the fetus and placenta, help stimulate firm uterine contractions to reduce the risk of postpartum hemorrhage from an atonic uterus. Magnesium sulfate is given to treat eclampsia and preeclampsia. Vitamin K is given to prevent hemorrhage. Dopamine is given to treat hypotension.

DIF: Cognitive Level: Comprehension REF: Page 609 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Reproduction; Safety

5. A 36-week primigravida patient has been admitted to the unit with a blood pressure of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order?
a.
Nifedipine (Procardia)
b.
Furosemide (Lasix)
c.
Magnesium sulfate
d.
Terbutaline (Brethine)

ANS: C
Magnesium sulfate depresses the central nervous system and blocks peripheral nerve transmission, which produces anticonvulsant effects and smooth muscle relaxation. In cases of preeclampsia or eclampsia, magnesium sulfate is used to control seizure activity. Hypertension, headache, and edema are signs of preeclampsia in a pregnant woman. Calcium channel blockers, such as nifedipine, are sometimes given as tocolytic agents. Furosemide is given for diuresis; it may be used in the treatment of hypertension, but not eclampsia. Terbutaline is given as a tocolytic agent.

DIF: Cognitive Level: Application REF: Page 611 OBJ: 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Reproduction; Perfusion; Safety

 

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