1
Q
What is the therapeutic intent of a spermicide like Nonoxynol-9 (N-9)?
A
It acts as a chemical barrier that destroys sperm by making the vaginal flora more acidic.
2
Q
How long before intercourse should spermicide be inserted to be effective?
A
It should be inserted 15 minutes before intercourse.
3
Q
What is the primary risk associated with using Nonoxynol-9 (N-9) spermicide more than twice daily?
A
It can cause lesions and increase the risk of HIV transmission.
4
Q
Combined Oral Contraceptives (COCs) contain Estrogen and Progestin to suppress ovulation, thicken cervical mucus, and _____ to prevent implantation.
A
alter uterine decidua
5
Q
What should a client do if they miss one Combined Oral Contraceptive (COC) pill?
A
They should take one pill as soon as possible.
6
Q
What are the five major health risks associated with Combined Oral Contraceptives (COCs)?
A
Thromboembolism, stroke, heart attack, hypertension, and gallbladder disease or liver tumor.
7
Q
Combined Oral Contraceptives (COCs) are contraindicated for clients over 35 years of age if they also have what habit?
A
Smoking.
8
Q
The effectiveness of both Combined Oral Contraceptives (COCs) and Progestin-only pills decreases when taken with medications that affect liver enzymes, such as _____ and some antibiotics.
A
anticonvulsants
9
Q
What is the most commonly reported adverse effect of Progestin-only pills (Minipill)?
A
Breakthrough or irregular vaginal bleeding.
10
Q
Within how many hours after unprotected coitus must an Emergency Oral Contraceptive be taken?
A
Within 72 hours.
11
Q
What medication might a provider recommend taking one hour prior to an Emergency Oral Contraceptive to counteract nausea?
A
An over-the-counter (OTC) antiemetic.
12
Q
An emergency oral contraceptive is contraindicated if a client is pregnant or has what undiagnosed condition?
A
Abnormal vaginal bleeding.
13
Q
How often is the Transdermal Contraceptive Patch replaced during its 4-week cycle?
A
It is replaced once a week for 3 weeks, with no application on the fourth week.
14
Q
The Transdermal Contraceptive Patch may be less effective in clients who weigh more than what amount?
A
198 lbs (90 kg).
15
Q
How often are Injectable Progestins (Medroxyprogesterone) administered?
A
Every 11 to 13 weeks via IM or subcutaneous injection.
16
Q
Why should a client receiving an injectable progestin (Medroxyprogesterone) maintain adequate calcium and vitamin D intake?
A
Because a potential adverse effect is decreased bone mineral density.
17
Q
The return to fertility after discontinuing injectable progestins can be delayed for up to how many months?
A
Up to 18 months.
18
Q
If a Contraceptive Vaginal Ring is removed for more than 4 hours, what is the recommended nursing action?
A
Replace it with a new ring and use a barrier method for 7 days.
19
Q
What is the most common adverse effect of an Implantable Progestin rod?
A
Irregular and unpredictable menstruation.
20
Q
If a pregnancy occurs while a client has an implantable progestin, there is an increased risk of what type of pregnancy?
A
Ectopic pregnancy.
21
Q
What is the classification of Nifedipine when used as a tocolytic?
A
Calcium channel blocker.
22
Q
Nifedipine should not be administered concurrently with what other tocolytic agent?
A
Magnesium sulfate.
23
Q
What is the therapeutic intent of administering Magnesium Sulfate to a client in preterm labor?
A
It relaxes smooth muscles to inhibit uterine activity.
24
Q
Magnesium sulfate provides fetal neuroprotection if birth is anticipated before _____ weeks’ gestation.
A
32
25
What is the antidote for Magnesium Sulfate toxicity?
Calcium gluconate or calcium chloride.
26
What are three key signs of Magnesium Sulfate toxicity that a nurse should monitor for?
Loss of deep tendon reflexes, respiratory rate less than 12/min, or urinary output less than 30 mL/hr.
27
What is the classification of Terbutaline when used as a tocolytic?
Beta-adrenergic agonist.
28
A provider should be notified if a client receiving Terbutaline has a heart rate greater than _____/min.
130
29
Terbutaline is contraindicated in clients with a history of cardiac disease, hyperthyroidism, or uncontrolled _____.
diabetes
30
What is the therapeutic intent of administering Betamethasone to a pregnant client?
To enhance fetal lung maturity and surfactant production in fetuses between 24 to 34 weeks gestation.
31
What is the standard administration schedule for Betamethasone for fetal lung maturity?
Administer 12 mg IM for two doses, 24 hours apart.
32
What potential maternal side effect should be monitored after administering Betamethasone?
Maternal hyperglycemia.
33
What antibiotics are most commonly prescribed for Group B Streptococcus (GBS) prophylaxis during labor?
Penicillin G or Ampicillin.
34
Besides a positive screen, name one condition that warrants GBS prophylaxis for a client with unknown status.
Maternal fever (≥38°C), rupture of membranes ≥18 hr, or delivering prematurely (<37 weeks).
35
Misoprostol (Prostaglandin E1) is a chemical agent used for what purpose in labor management?
To soften and thin the cervix (cervical ripening).
36
How long after the last dose of Misoprostol can Oxytocin be initiated?
No sooner than 4 hours after the last administration.
37
How long after the removal of a Dinoprostone insert can Oxytocin be initiated?
6 to 12 hours after the insert is removed.
38
Before administering Oxytocin for labor induction, the nurse must confirm the fetus is engaged at a minimum of what station?
Station 0.
39
Oxytocin infusion should be discontinued if uterine contractions have a frequency of more than _____ in 10 minutes.
5
40
If uterine tachysystole persists after discontinuing Oxytocin, what class of medication should be administered?
A tocolytic, such as Terbutaline.
41
In what phase of labor are sedatives like secobarbital typically used?
In the early or latent phase of labor.
42
Sedatives should not be administered for labor pain if birth is anticipated within how many hours?
Within 12 to 24 hours.
43
What medication should be readily available to reverse respiratory depression caused by opioid analgesics like fentanyl or meperidine?
Naloxone.
44
What is a primary adverse effect of administering opioid analgesics too close to the time of delivery?
Neonatal respiratory depression.
45
Besides controlling nausea and anxiety, what is Metoclopramide used for prior to general anesthesia?
To increase gastric emptying.
46
What is the primary advantage of using short-acting opioids like fentanyl in an epidural?
It provides rapid pain relief while allowing the client to sense contractions and bear down.
47
A pudendal block provides local anesthesia to which three areas during delivery?
The perineum, vulva, and rectal areas.
48
What is the primary nursing action to help offset maternal hypotension before an epidural block?
Administer a bolus of IV fluids.
49
If maternal hypotension persists after an IV fluid bolus for an epidural, what IV vasopressor should the nurse be prepared to administer?
Ephedrine.
50
What common adverse effect of an epidural block can lead to the need for catheterization?
Inability to feel the urge to void or urinary retention.
51
What medication is recommended late in the first trimester for preeclampsia prophylaxis in high-risk clients?
Low dose aspirin.
52
What two classes of antihypertensive medications should be avoided during pregnancy?
ACE inhibitors and angiotensin II receptor blockers.
53
What is the therapeutic intent of administering Oxytocin in the postpartum period?
To promote uterine contractions and prevent hemorrhage.
54
A nurse monitoring a client on postpartum Oxytocin should assess for signs of _____ intoxication, such as lightheadedness, nausea, and headache.
water
55
What is the primary contraindication for administering Methylergonovine for postpartum hemorrhage?
The client has hypertension.
56
What are common adverse effects of Carboprost tromethamine when used for postpartum hemorrhage?
Fever, hypertension, chills, headache, nausea, vomiting, and diarrhea.
57
Tranexamic acid, an antifibrinolytic, should be administered within _____ of birth for postpartum hemorrhage.
3 hours
58
Enemas and suppositories are contraindicated for postpartum clients who have what type of injury?
Third- or fourth-degree perineal lacerations.
59
What is the antidote for Heparin?
Protamine sulfate.
60
The therapeutic range for aPTT for a client on a continuous IV infusion of Heparin is _____ to _____ times the control level.
1.5 to 2.5
61
What is the antidote for Warfarin?
Phytonadione (Vitamin K).
62
Why must a client on Warfarin use reliable birth control?
Because Warfarin has teratogenic effects.
63
A client taking Warfarin or Heparin should be educated to avoid taking what two common over-the-counter pain relievers?
Aspirin or ibuprofen.
64
For how long should a client avoid pregnancy after receiving a Rubella or MMR vaccine?
For 4 weeks (28 days).
65
Rho(D) immune globulin is administered IM within 72 hours of birth to Rh-_____ clients who have an Rh-_____ newborn.
negative; positive
66
How long should a client avoid getting pregnant after receiving the Varicella vaccine?
For 1 month.
67
What is the purpose of administering Erythromycin ointment to a newborn?
It is mandatory prophylactic eye care to prevent ophthalmia neonatorum.
68
Where should the ribbon of Erythromycin ointment be applied on a newborn's eye?
To the lower conjunctival sac, from the inner to the outer canthus.
69
Why is Vitamin K (Phytonadione) administered to newborns?
To prevent hemorrhagic disorders, as Vitamin K is not produced in the newborn's GI tract until around day 7.
70
Into which muscle is the Vitamin K injection administered to a newborn?
The vastus lateralis muscle.
71
What is the critical rule regarding the administration sites for the Vitamin K and Hepatitis B injections in a newborn?
Do not give them in the same thigh.
72
If a newborn's parents are infected with Hepatitis B, what two things are given to the newborn within 12 hours of birth?
Hepatitis B immunoglobulin and the Hepatitis B vaccine.
73
What medication is used as a pharmacologic treatment to decrease CNS irritability and control seizures for newborns experiencing withdrawal?
Phenobarbital.
74
Lung surfactants like beractant are administered to premature newborns to restore surfactant and improve respiratory compliance in cases of _____.
Respiratory Distress Syndrome (RDS)
75
What is the therapeutic purpose of administering Zidovudine (ART) during pregnancy and to the newborn?
To decrease the transmission of HIV to the child.
76
During an intrapartum C-section, Zidovudine is administered IV _____ prior to the surgery until birth.
3 hours
77
What antibiotic is recommended as a single PO dose for Chlamydia during pregnancy?
Azithromycin.
78
What antibiotic is administered IM as the treatment for Syphilis during pregnancy?
Benzathine penicillin G.
79
A client taking Metronidazole should be educated to avoid _____ due to the risk of a disulfiram-like reaction.
alcohol
80
For treatment of genital warts during pregnancy, what treatment is considered safe?
Trichloroacetic acid (TCA) or bichloroacetic acid (BCA).
81
What type of antifungal therapy is recommended for Candidiasis during pregnancy?
Topical therapies (like Clotrimazole).
82
The use of ovarian stimulation medications like Clomiphene citrate can increase the risk of _____ by more than 25%.
multiple births
83
What medication is used to dissolve an unruptured ectopic pregnancy?
Methotrexate.
84
A client receiving Methotrexate for an ectopic pregnancy should be advised to avoid vitamins containing what substance?
Folic acid.
85
To increase absorption, ferrous sulfate supplements should be taken on an empty stomach with what type of beverage?
Orange juice (a source of vitamin C).
86
What two common substances interfere with the absorption of iron supplements?
Milk and caffeine.
87
What is the initial medication management for hyperemesis gravidarum?
Pyridoxine (Vitamin B6) and Doxylamine.
88
The Tocolytic Analogy: Tocolytics like Magnesium Sulfate are the '_____' used to slow down labor.
Brakes
89
The Oxytocic Analogy: Oxytocics like Oxytocin are the '_____' used to speed up postpartum recovery and prevent hemorrhage.
Accelerators
90
The Newborn Prophylaxis Analogy: Vitamin K and Erythromycin are immediate '_____' applied after birth to guard against threats.
Protective Seals
91
What is the therapeutic intent of a spermicide like Nonoxynol-9 (N-9)?
It acts as a chemical barrier that destroys sperm by making the vaginal flora more acidic.
92
How long before intercourse should spermicide be inserted to be effective?
It should be inserted 15 minutes before intercourse.
93
Using Nonoxynol-9 (N-9) more than twice daily can cause lesions and increase the risk of _____.
HIV
94
Combined Oral Contraceptives (COCs) contain which two hormones?
Estrogen and Progestin.
95
What are the three mechanisms by which Combined Oral Contraceptives (COCs) prevent pregnancy?
They suppress ovulation, thicken cervical mucus, and alter the uterine decidua to prevent implantation.
96
If a client taking COCs misses one pill, what is the correct action?
Take one pill as soon as possible.
97
What are the five major risks associated with Combined Oral Contraceptives (COCs)?
Thromboembolism, stroke, heart attack, hypertension, gallbladder disease, and liver tumor.
98
COCs are contraindicated for clients over the age of 35 who also have what habit?
Smoking.
99
The effectiveness of both COCs and progestin-only pills decreases when taken with medications that affect liver enzymes, such as _____ and some antibiotics.
anticonvulsants
100
What is the most common and frequently reported adverse effect of progestin-only pills (minipills)?
Breakthrough or irregular vaginal bleeding.
101
Within what timeframe must an Emergency Oral Contraceptive be taken after unprotected coitus?
Within 72 hours.
102
What medication might a provider recommend taking one hour prior to an Emergency Oral Contraceptive to counteract a common side effect?
An over-the-counter (OTC) antiemetic for nausea.
103
A transdermal contraceptive patch is applied once a week for 3 weeks, with no application during the _____ week.
fourth
104
The transdermal contraceptive patch may be less effective in clients weighing more than what amount?
198 lbs (90 kg).
105
How often are injectable progestins (Medroxyprogesterone) administered?
Every 11 to 13 weeks via IM or SC injection.
106
What is a major adverse effect of injectable progestins on the skeletal system?
Decreased bone mineral density.
107
Why should a client not massage the site after an IM injection of Medroxyprogesterone?
Massaging decreases the absorption and effectiveness of the medication.
108
A contraceptive vaginal ring is inserted and left in place for 3 weeks, then removed for a _____ day interval before a new ring is inserted.
seven
109
If a contraceptive vaginal ring is removed for more than 4 hours, what should the client do?
Replace it with a new ring and use a barrier method for 7 days.
110
What is the most common adverse effect of implantable progestin rods?
Irregular and unpredictable menstruation.
111
If a pregnancy occurs while an implantable progestin rod is in place, there is an increased risk of what type of pregnancy?
Ectopic pregnancy.
112
Which tocolytic agent is a calcium channel blocker that suppresses contractions by inhibiting calcium from entering smooth muscles?
Nifedipine.
113
Nifedipine should not be administered concurrently with which other tocolytic agent?
Magnesium sulfate.
114
What is the dual therapeutic intent of Magnesium Sulfate in labor management?
It relaxes smooth muscles to inhibit uterine activity (tocolytic) and provides fetal neuroprotection if birth is anticipated before 32 weeks.
115
What is the antidote for magnesium sulfate toxicity?
Calcium gluconate or calcium chloride.
116
List three clinical manifestations of magnesium sulfate toxicity.
Loss of deep tendon reflexes, respiratory rate <12/min, and urinary output <30 mL/hr.
117
What is the classification of Terbutaline when used as a tocolytic?
Beta-adrenergic agonist.
118
A nurse should notify the provider if a client receiving Terbutaline has a heart rate greater than _____/min.
130
119
What is the purpose of administering Betamethasone to a pregnant client between 24 to 34 weeks gestation?
To enhance fetal lung maturity and surfactant production.
120
How is Betamethasone administered for fetal lung maturity?
Two doses of 12 mg IM, administered 24 hours apart.
121
What is the primary medication class prescribed for Group B Streptococcus (GBS) prophylaxis during labor?
Penicillin G or Ampicillin.
122
Oxytocin should be initiated no sooner than _____ hours after the last dose of Misoprostol for cervical ripening.
4
123
What uterine stimulant is used for both labor induction/augmentation and to control postpartum hemorrhage?
Oxytocin.
124
What fetal station is the minimum requirement before administering oxytocin for labor induction?
Station 0 (engaged).
125
Uterine tachysystole is defined as having a contraction frequency of more than _____ contractions in 10 minutes.
five
126
What tocolytic medication should be administered if uterine tachysystole from oxytocin persists after discontinuation?
Terbutaline.
127
Sedatives like secobarbital or pentobarbital should not be administered if birth is anticipated within what timeframe?
Within 12 to 24 hours.
128
What is the primary risk to the neonate when sedatives or opioid analgesics are given too close to delivery?
Respiratory depression.
129
What is the opioid antagonist that should be readily available to reverse opioid-induced respiratory depression?
Naloxone.
130
What is the purpose of administering Metoclopramide as an adjunct with opioids during labor?
It controls nausea and anxiety.
131
A _____ provides local anesthesia to the perineum, vulva, and rectal areas during delivery and is administered transvaginally.
pudendal block
132
What is a common adverse effect of an epidural block that is managed by administering a bolus of IV fluids beforehand?
Maternal hypotension.
133
If maternal hypotension persists after an IV fluid bolus for an epidural, what IV vasopressor should be administered?
Ephedrine.
134
What three medications are used as premedication before general anesthesia to manage gastric contents?
An oral antacid, famotidine, and metoclopramide.
135
When is low-dose aspirin therapy initiated for prophylaxis against preeclampsia in high-risk clients?
Late in the first trimester.
136
Which uterine stimulant used for postpartum hemorrhage should not be administered to clients with hypertension?
Methylergonovine.
137
What is a potential serious adverse effect of Oxytocin when administered postpartum, related to fluid balance?
Water intoxication.
138
What are the common adverse effects of Carboprost tromethamine?
Fever, hypertension, chills, headache, nausea, vomiting, and diarrhea.
139
Tranexamic acid, an antifibrinolytic, should be administered within _____ of birth to be effective for postpartum hemorrhage.
3 hours
140
Enemas and suppositories are contraindicated for postpartum clients who have which type of injury?
Third- or fourth-degree perineal lacerations.
141
What is the antidote for heparin?
Protamine sulfate.
142
A client on heparin therapy should have an aPTT that is _____ times the control level.
1.5 to 2.5
143
What is the antidote for warfarin?
Phytonadione (Vitamin K).
144
Why must a client on warfarin use reliable birth control?
Warfarin has teratogenic effects, and oral contraceptives are contraindicated.
145
Clients on anticoagulants like heparin or warfarin should be educated to avoid taking which two common OTC pain relievers?
Aspirin or ibuprofen.
146
Following a rubella vaccine, a client should be advised not to get pregnant for how long?
For 4 weeks (28 days).
147
When is Rho(D) immune globulin administered to an Rh-negative client?
Within 72 hours of birth if their newborn is Rh-positive.
148
If a client does not have immunity to varicella, the vaccine is given postpartum with a second dose administered at _____ weeks.
4 to 8
149
What prophylactic medication is administered to newborns to prevent ophthalmia neonatorum?
Erythromycin ophthalmic ointment.
150
How is erythromycin ointment applied to a newborn's eyes?
A 1- to 2-cm ribbon is applied to the lower conjunctival sac, from the inner to the outer canthus.
151
Why is Vitamin K (Phytonadione) administered to newborns shortly after birth?
To prevent hemorrhagic disorders, as Vitamin K is not produced in the GI tract until around day 7.
152
Where is the intramuscular Vitamin K injection administered to a newborn?
Into the vastus lateralis muscle.
153
What is the protocol for administering the Vitamin K injection and the Hepatitis B vaccine regarding injection sites?
They should not be given in the same thigh.
154
If a newborn's parent is infected with Hepatitis B, what two treatments are given to the newborn within 12 hours of birth?
Hepatitis B immunoglobulin and the Hepatitis B vaccine.
155
What anticonvulsant is used to decrease CNS irritability and control seizures for newborns experiencing alcohol or opioid withdrawal?
Phenobarbital.
156
Lung surfactants like beractant or calfactant are administered to premature newborns to treat what condition?
Respiratory Distress Syndrome (RDS).
157
For how long should endotracheal tube suctioning be avoided after administering a lung surfactant to a newborn?
For 1 hour.
158
What antiretroviral therapy is administered to an HIV-positive mother and her newborn to decrease transmission?
Zidovudine.
159
Which two antibiotics are contraindicated during pregnancy for the treatment of Chlamydia?
Doxycycline and Levofloxacin.
160
What is the first-line treatment for Syphilis during pregnancy?
Benzathine penicillin G.
161
What severe reaction can occur if a client drinks alcohol while taking Metronidazole?
A disulfiram-like reaction (severe nausea and vomiting).
162
Which two treatments for genital warts are safe to use during pregnancy?
Trichloroacetic acid (TCA) or bichloroacetic acid (BCA).
163
What type of antifungal therapy is recommended for Candidiasis during pregnancy?
Topical therapies (e.g., Clotrimazole).
164
Ovarian stimulation medications like _____ and letrozole can increase the risk of multiple births by more than 25%.
Clomiphene citrate
165
What medication is used to dissolve an unruptured ectopic pregnancy?
Methotrexate.
166
Clients taking methotrexate for an ectopic pregnancy should be educated to avoid vitamins containing what substance?
Folic acid.
167
To increase absorption, ferrous sulfate supplements should be taken on an empty stomach with a source of vitamin C, such as _____.
orange juice
168
Which two common beverages interfere with the absorption of iron supplements?
Milk and caffeine.
169
Most oral hypoglycemic agents are contraindicated for Gestational Diabetes Mellitus (GDM), but _____ has limited use as an alternative to insulin.
Glyburide
170
What two medications are considered safe and effective for the initial management of hyperemesis gravidarum?
Pyridoxine (Vitamin B6) and Doxylamine.
171
What is the therapeutic intent of a spermicide like Nonoxynol-9?
It acts as a chemical barrier that destroys sperm by making the vaginal flora more acidic.
172
How long before intercourse should spermicide be inserted to be effective?
It should be inserted 15 minutes before intercourse.
173
Spermicide is effective for up to 1 hour after insertion, but should not be removed until at least _____ hours after intercourse.
6
174
Using Nonoxynol-9 (N-9) more than twice daily can cause lesions and increase the risk of what infection?
HIV.
175
What is the primary mechanism of action for Combined Oral Contraceptives (COCs)?
They suppress ovulation, thicken cervical mucus, and alter the uterine decidua to prevent implantation.
176
What should a client do if they miss one Combined Oral Contraceptive pill?
Take one pill as soon as possible.
177
A client taking COCs experiences nausea. What is a recommended nursing action to educate the client on?
Advise the client to take the pill at bedtime.
178
What are the most significant risks associated with Combined Oral Contraceptives (COCs)?
Thromboembolism, stroke, heart attack, and hypertension.
179
Combined Oral Contraceptives are contraindicated for clients over 35 who engage in what activity?
Smoking.
180
The effectiveness of COCs and progestin-only pills decreases when taken with medications that affect liver enzymes, such as _____ and some antibiotics.
anticonvulsants
181
What is the most commonly reported adverse effect of Progestin-only pills (Minipill)?
Breakthrough or irregular vaginal bleeding.
182
Progestin-only pills are contraindicated for clients with a history of bariatric surgery, lupus, severe cirrhosis, liver tumors, or what type of cancer?
Current or past breast cancer.
183
An Emergency Oral Contraceptive (morning-after pill) should be taken within how many hours of unprotected coitus?
Within 72 hours.
184
A client should be evaluated for pregnancy if menstruation does not begin within _____ days after taking an Emergency Oral Contraceptive.
21
185
The Transdermal Contraceptive Patch is replaced once a week for 3 weeks, with no application during which week?
The fourth week.
186
The Transdermal Contraceptive Patch may be less effective in clients who weigh more than what?
198 lb (90 kg).
187
How often are Injectable Progestins (Medroxyprogesterone) administered?
Every 11 to 13 weeks via IM or SC injection.
188
What is a significant adverse effect of Injectable Progestins on bone health?
Decreased bone mineral density.
189
After an IM injection of Medroxyprogesterone, why should the client be educated not to massage the site?
Massaging the site can decrease the absorption and effectiveness of the medication.
190
A contraceptive vaginal ring can be removed for up to how many hours without compromising its effectiveness?
Up to 3 hours.
191
If a contraceptive vaginal ring is removed for more than 4 hours, what should the client do?
Replace it with a new ring and use a barrier method for 7 days.
192
What is the most common adverse effect of an Implantable Progestin rod?
Irregular and unpredictable menstruation.
193
If pregnancy occurs with an Implantable Progestin in place, there is an increased risk of what type of pregnancy?
Ectopic pregnancy.
194
What is the classification of Nifedipine when used as a tocolytic?
Calcium channel blocker.
195
Nifedipine should not be administered concurrently with which other tocolytic agent?
Magnesium sulfate.
196
What is the therapeutic intent of administering Magnesium Sulfate to a client in preterm labor before 32 weeks' gestation?
It provides fetal neuroprotection, reducing the risk and severity of cerebral palsy.
197
What is the antidote for magnesium sulfate toxicity?
Calcium gluconate or calcium chloride.
198
A respiratory rate of less than _____ breaths/min is a manifestation of magnesium sulfate toxicity.
12
199
A urinary output of less than _____ mL/hr is a manifestation of magnesium sulfate toxicity.
30
200
What is the first sign of magnesium sulfate toxicity that a nurse should monitor for?
Loss of deep tendon reflexes.
201
What is the classification of Terbutaline when used as a tocolytic?
Beta-adrenergic agonist.
202
A provider should be notified if a client receiving Terbutaline has a heart rate greater than _____/min.
130
203
Terbutaline is contraindicated in clients with a history of cardiac disease, hyperthyroidism, or uncontrolled _____.
diabetes
204
What is the therapeutic purpose of administering Betamethasone to a pregnant client between 24 to 34 weeks' gestation?
To enhance fetal lung maturity and surfactant production.
205
What is the standard dosing schedule for Betamethasone for fetal lung maturity?
12 mg IM for two doses, administered 24 hours apart.
206
A nurse administering Betamethasone should monitor the mother for what metabolic adverse effect?
Maternal hyperglycemia.
207
For Group B Streptococcus (GBS) prophylaxis, Penicillin G is administered via an IV loading dose followed by intermittent IV boluses every _____ hours.
4
208
A client with unknown GBS status should receive prophylaxis if they have a maternal fever of ≥____ °C or rupture of membranes for ≥18 hours.
38
209
What is the classification of Misoprostol when used for cervical ripening?
Prostaglandin E1.
210
Oxytocin should be initiated no sooner than _____ hours after the last dose of Misoprostol.
4
211
Oxytocin should be initiated _____ to _____ hours after the administration of Dinoprostone gel or insert removal.
6 to 12
212
Before administering Oxytocin for labor induction, the nurse must confirm the fetus is engaged at a minimum of station _____.
0
213
Oxytocin administration should be discontinued if uterine contractions have a frequency of more than _____ in 10 minutes.
5
214
If uterine tachysystole persists after discontinuing oxytocin, what tocolytic medication is typically administered?
Terbutaline.
215
Sedatives like secobarbital or pentobarbital should not be administered for labor anxiety if birth is anticipated within _____ to _____ hours.
12 to 24
216
What is the primary risk to the neonate when sedatives (barbiturates) are administered to the mother during labor?
Neonatal respiratory depression.
217
What opioid antagonist should be readily available to reverse respiratory depression caused by opioid analgesics during labor?
Naloxone.
218
Opioid analgesics given during labor can cause decreased _____ variability.
FHR (Fetal Heart Rate)
219
Metoclopramide is used as an adjunct with opioids during labor to control _____ and anxiety.
nausea
220
A Pudendal block provides local anesthesia to which areas during delivery?
The perineum, vulva, and rectal areas.
221
What is a common adverse effect of an epidural or spinal block that can be offset by administering a bolus of IV fluids beforehand?
Maternal hypotension.
222
If maternal hypotension occurs after an epidural block, what IV vasopressor should the nurse be prepared to administer?
Ephedrine.
223
Low dose aspirin therapy is recommended late in the first trimester for prophylaxis against what condition in high-risk clients?
Preeclampsia.
224
What two classes of antihypertensive medications should be avoided during pregnancy?
ACE inhibitors and angiotensin II receptor blockers.
225
What is the primary therapeutic intent of administering Oxytocin in the postpartum period?
To promote uterine contractions and prevent or control postpartum hemorrhage.
226
When administering oxytocin postpartum, the nurse should monitor for signs of water intoxication, such as lightheadedness, nausea, vomiting, and _____.
headache
227
Methylergonovine is a uterine stimulant used to control postpartum hemorrhage but is contraindicated in clients who have _____.
hypertension
228
Common adverse effects of Carboprost tromethamine include fever, chills, headache, nausea, vomiting, and _____.
diarrhea
229
Tranexamic Acid, an antifibrinolytic, should be administered within how many hours of birth to be effective for postpartum hemorrhage?
Within 3 hours.
230
Enemas and suppositories are contraindicated for postpartum clients who have which type of perineal lacerations?
Third- or fourth-degree lacerations.
231
What is the antidote for heparin?
Protamine sulfate.
232
When a client is on a continuous IV infusion of Heparin, the nurse should monitor the aPTT, aiming for a level that is _____ to _____ times the control level.
1.5 to 2.5
233
What is the antidote for warfarin?
Phytonadione (Vitamin K).
234
A client taking warfarin must be educated to use birth control because the medication has _____ effects.
teratogenic
235
A client receiving the Rubella vaccine postpartum should be advised not to get pregnant for how long?
For 4 weeks (28 days).
236
Rho(D) immune globulin is administered IM within _____ hours of birth to Rh-negative clients who have an Rh-positive newborn.
72
237
A client receiving the Varicella vaccine postpartum should not get pregnant for how long following the immunization?
For 1 month.
238
What prophylactic medication is administered to newborns to prevent ophthalmia neonatorum?
Erythromycin ointment.
239
Erythromycin eye ointment application can be delayed for up to _____ hour after birth to facilitate bonding.
1
240
Why is Vitamin K (phytonadione) administered to newborns?
To prevent hemorrhagic disorders, as it is not produced in the GI tract until around day 7.
241
The Vitamin K injection should be administered intramuscularly into which muscle in the newborn?
The vastus lateralis.
242
The Hepatitis B vaccine and the Vitamin K injection should not be given in the _____.
same thigh
243
For a newborn whose parent is infected with hepatitis B, what is administered within 12 hours of birth?
Hepatitis B immunoglobulin and the Hepatitis B vaccine.
244
What medication is used to decrease CNS irritability and control seizures in newborns experiencing alcohol or opioid withdrawal?
Phenobarbital.
245
What is the therapeutic purpose of administering lung surfactants like beractant to premature newborns?
To restore surfactant and improve respiratory compliance in newborns with Respiratory Distress Syndrome (RDS).
246
After administering a lung surfactant, endotracheal tube suctioning should be avoided for how long?
For 1 hour.
247
To decrease the transmission of HIV to the fetus, what antiretroviral medication is administered to the mother during pregnancy and labor, and to the newborn for 6 weeks?
Zidovudine.
248
Which two antibiotics, often used to treat Chlamydia, are contraindicated during pregnancy?
Doxycycline and Levofloxacin.
249
What is the first-line treatment for Syphilis during pregnancy?
Benzathine penicillin G.
250
A client being treated with Metronidazole for Trichomoniasis or BV should be educated to avoid what substance to prevent a disulfiram-like reaction?
Alcohol.
251
Which treatments for genital warts are contraindicated during pregnancy?
Podophyllin, podofilox, sincatechins, and imiquimod.
252
For Candidiasis during pregnancy, _____ therapies are recommended over oral antifungals.
topical
253
What medication is used to dissolve an unruptured ectopic pregnancy by inhibiting cell division?
Methotrexate.
254
A client receiving Methotrexate for an ectopic pregnancy should be advised to avoid vitamins containing what substance?
Folic acid.
255
To increase absorption, ferrous sulfate supplements should be taken on an empty stomach with a source of Vitamin C, such as _____.
orange juice
256
What substances can interfere with the absorption of oral iron supplements?
Milk and caffeine.
257
Which oral hypoglycemic agent has limited use as an alternative to insulin for GDM?
Glyburide.
258
What combination of medications is considered a safe and effective initial treatment for hyperemesis gravidarum?
Pyridoxine (Vitamin B6) and Doxylamine.
OB Proctor Exam ATI
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