Chapter 09: Drug Therapy During Pregnancy and Breast-Feeding

Chapter 09: Drug Therapy During Pregnancy and Breast-Feeding

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is caring for a patient and her newborn immediately after delivery. The patient’s medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do?

a.	Administer opioids to the infant to prevent withdrawal syndrome.
b.	Monitor the infant’s respirations and prepare to administer naloxone if needed.
c.	Note a high-pitched cry and irritability in the infant and observe for seizures.
d.	Prepare the patient for motor delays in the infant caused by the alcohol use.

 

 

ANS:  B

Narcotics given for pain during labor cross the placenta and can cause respiratory depression in the infant. Nurses must be prepared to provide respiratory support and to give naloxone to reverse the narcotic effects if necessary. Exposure to opioids during labor is not sufficient to cause dependence, so withdrawal syndrome is not an issue. Infants withdrawing from drugs have a high-pitched cry and are irritable, which is not expected in this case. Any drug taken during the first weeks of pregnancy tends to have an “all or none” effect, meaning that they either cause death of the conceptus or, if sublethal, the conceptus recovers.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 82

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

2. A patient who has just learned she is pregnant has stopped using a prescription medication that she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell her?

a.	That asthma medications will not affect the fetus
b.	That her baby’s health is dependent on hers
c.	To avoid taking medications during her pregnancy
d.	To resume the medication in her second trimester

 

 

ANS:  B

Asthmatic women who fail to take medication have a doubled risk of stillbirth; therefore, the nurse should encourage the patient to use her medications. Because the health of the fetus depends on the health of the mother, all drugs must be considered in light of the benefits of treatment versus the risks to the fetus. Asthma medications may have effects on the fetus, but the risk of stillbirth presents a greater risk. In this case, the patient needs to take the medication to treat her asthma and not wait until the second trimester.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 81

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

3. A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time?

a.	Immediately before conception
b.	During the first trimester
c.	During the second trimester
d.	During the third trimester

 

 

ANS:  B

Gross malformations are caused by exposure to teratogens during the embryonic period, which is considered the first trimester. This is the time when the basic shape of internal organs and other structures is established. No risk exists immediately before conception unless the medication is a category X drug. Teratogen exposure during the second and third trimesters usually disrupts function rather than gross anatomy.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   p. 82

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and a physical assessment reveal that the patient is an active heroin addict. The nurse who cares for the neonate after delivery should anticipate which clinical manifestations?

a.	Passivity and flat affect
b.	Diarrhea and salivation
c.	A shrill cry and irritability
d.	Restless sleep and seizures

 

 

ANS:  C

The newborn of an active heroin addict experiences a withdrawal syndrome that includes shrill crying, vomiting, and extreme irritability. The newborn will not experience passivity or a flat affect, diarrhea, or salivation, or continuous restless sleep as a result of being born to an active heroin addict.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 82

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential