Chapter 9: Drug Therapy During Pregnancy and Breast-Feeding

Chapter 9: Drug Therapy During Pregnancy and Breast-Feeding

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1. Based on physiological changes in the kidney during pregnancy, which adjustment would a nurse anticipate for a patient in her third trimester who has been taking a drug excreted only by the kidneys?

ANS:   B

By the third trimester, renal blood flow is doubled, causing a large increase in the glomerular filtration rate. As a result, there is accelerated clearance of drugs eliminated by glomerular filtration. To compensate for accelerated excretion, the dosage must be increased.

A decreased dosage is not indicated in this instance.

Rescheduling of the drug is not indicated in this instance.

With an increase in the glomerular filtration rate, the dosage must be increased, not left the same.

DIF:    Cognitive Level: Application             REF:    p. 85

TOP:    Nursing Process: Implementation

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

2. A pregnant patient is taking a medication that may produce toxicity if it is prolonged in her body. Which physiological change in the pregnant woman would be the most likely cause of an increased risk of toxicity?

ANS:   C

Prolonged transit means more time for drugs to be absorbed, and this could increase the levels of drugs for which absorption is normally poor; therefore, prolonged transit increases the possibility of toxicity.

An increased GFR would expedite the passage of drugs through the system and therefore would be least likely to produce toxicity.

Decreased renal blood flow does not occur in the third trimester of pregnancy, therefore it is not relevant to this situation.

Increased hepatic metabolism would not affect toxicity.

DIF:    Cognitive Level: Analysis                  REF:    p. 85

TOP:    Nursing Process: Diagnosis

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

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

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 being established.

No risk exists immediately prior to conception, unless the medication is a category X drug.

Teratogen exposure during the second and third trimesters usually disrupts function rather than gross anatomy.

DIF:    Cognitive Level: Application             REF:    p. 86

TOP:    Nursing Process: Implementation

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