Chapter 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs

Chapter 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a woman who is in early labor. The woman wants to avoid pain medications as long as possible. What will the nurse tell her?

a.	“I can give you a sedative-hypnotic now to help you relax.”
b.	“I can teach you some simple breathing exercises to help lessen discomfort.”
c.	“If you take fentanyl (Sublimaze) now, it will be more effective than if you wait.”
d.	“You may take ibuprofen, which won’t cause drowsiness.”

 

 

ANS:  B

Breathing and relaxation techniques are often used as nonpharmacologic measures to control pain during labor. Sedatives are often used to decrease maternal anxiety during false labor, latent labor, or with ruptured membranes without true labor. Fentanyl is generally not given until active labor. Ibuprofen can cause premature closure of the ductus arteriosis.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 801

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse administers meperidine (Demerol) to a woman who is in early labor. Immediately after the drug is given, the woman’s labor progresses quickly, and she delivers her infant. The nurse will monitor the infant closely for which condition?

a.	Opioid withdrawal syndrome
b.	Orthostatic hypotension
c.	Respiratory depression
d.	Tachycardia and poor perfusion

 

 

ANS:  C

Narcotic analgesics cause respiratory depression in the infant if given shortly before delivery. The nurse should monitor the infant closely and prepare to give naloxone (Narcan) if this occurs. Opioid withdrawal occurs with prolonged exposure to opioids.  Orthostatic hypotension and tachycardia are not common effects.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 802

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response. The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?

a.	Butorphanol tartrate (Stadol)
b.	Fentanyl (Sublimaze)
c.	Nalbuphine (Nubain)
d.	Secobarbital (Seconal)

 

 

ANS:  D

Sedative-hypnotic drugs, such as secobarbital, can cause neonatal respiratory depression, hypotonia, and a poor sucking response up to 4 days. Butorphanol tartrate, fentanyl, and nalbuphine do not have prolonged effects.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 802

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately. Her intravenous line has just infiltrated. The nurse will perform which action?

a.	Administer fentanyl intramuscularly.
b.	Contact the provider for an order for IM meperidine (Demerol).
c.	Give the woman promethazine (Phenergan)
d.	Request an order for hydroxyzine (Vistaril).

 

 

ANS:  B

Meperidine may be given IM and is the most commonly used opioid during labor.  Fentanyl is best given intravenously. Promethazine is given in combination with opioids during active labor to potentiate the analgesic action of the opioids and minimize emesis. Hydroxyzine is given for nausea.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 802

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies