Pharmacotherapeutics for Advanced Practice 3rd Edition by Virginia Poole Arcangelo, Andrew M. Peterson - Test Bank

Pharmacotherapeutics for Advanced Practice 3rd Edition by Virginia Poole Arcangelo, Andrew M. Peterson – Test Bank

 

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Chapter 5. Principles of Pharmacotherapy in Pregnancy and Lactation

 

MULTIPLE CHOICE

 

1. The client has been prescribed Doxylamine (Unisom) for treatment of nausea and vomiting during pregnancy. What aspect of the client’s history will cause the nurse to contact the primary health care provider?

a.	Arthritis
b.	Depression
c.	Asthma
d.	Hyperglycemia

 

 

ANS:   C                     PTS:    1

 

2. The nurse is teaching a group of pregnant women the importance of adequate nutrition for the fetus. The nurse instructs the clients that folic acid deficiency during preconception and early in pregnancy can result in:

a.	skeletal defects.
b.	neural tube defects.
c.	intrauterine growth retardation.
d.	small-for-gestational-age infants.

 

 

ANS:   B                     PTS:    1

 

3. A client is ordered to receive iron and antacids. The nurse teaches the client that iron and antacids should be administered:

a.	at the same time.
b.	2 hours apart.
c.	with the antacid first.
d.	with the iron first.

 

 

ANS:   B                     PTS:    1

 

4. A client, 10 weeks pregnant, complains of severe nausea of pregnancy. Meclizine (Bonine) is prescribed. The client reports to the nurse that she has begun to experience dizziness. What is the highest priority nursing intervention?

a.	Contact the pharmacist; this indicates an overdosage of the medication.
b.	Contact the physician; this is an expected side effect of the medication.
c.	Contact the pharmacist; this indicates incorrect preparation of the medication.
d.	Contact the physician; this is an adverse reaction to the medication.

 

 

ANS:   B                     PTS:    1

 

5. A client complains of severe pregnancy-related nausea and is placed on Meclizine (Bonine). The nurse notes in the client history that the client is undergoing treatment for glaucoma. What is the highest priority nursing intervention?

a.	Recognize that one of the off-label uses for the drug is treatment of glaucoma.
b.	Contact the pharmacist; the dosage of the drug should be decreased when glaucoma is present.
c.	Recognize that use of the drug when glaucoma is present may result in a fatal reaction.
d.	Contact the physician; the drug should be used with caution when glaucoma is present.

 

 

ANS:   D                     PTS:    1

 

6. Betamethasone (Celestone) is ordered for a client in preterm labor. The client asks the nurse what the medication will do to help her. The nurse explains to the client that the medication will:

a.	help her to breathe more effectively during the labor process.
b.	prevent her infant from developing respiratory distress syndrome.
c.	help her infant to breathe more effectively during the labor process.
d.	prevent her from developing congestive heart failure during labor.

 

 

ANS:   B                     PTS:    1

 

7. A client is admitted to the labor and delivery unit and is being treated with terbutaline (Brethine). The nurse plans the client’s care with the knowledge that this medication is used to:

a.	induce labor.
b.	decrease uterine contractions.
c.	stimulate fetal heart rate.
d.	enhance placental blood flow.

 

 

ANS:   B                     PTS:    1

 

8. The client is being treated with hydralazine hydrochloride (Apresoline). What would be a positive outcome for the client as a result of treatment with this medication?

a.	Diastolic BP is maintained between 90 and 110 mm Hg.
b.	Diastolic BP is maintained between 70 and 90 mm Hg.
c.	Systolic BP is maintained between 100 and 120 mm Hg.
d.	Systolic BP is maintained between 90 and 110 mm Hg.

 

 

ANS:   A                     PTS:    1

 

9. A client diagnosed with pregnancy-induced hypertension (PIH) is treated with magnesium sulfate. The nurse tells the client that the purpose of this treatment is to:

a.	prolong labor.
b.	prevent seizures.
c.	increase blood pressure.
d.	stimulate urination.

 

 

ANS:   B                     PTS:    1

 

10. A prenatal client discloses that she takes high doses of vitamins. Which is the most accurate instruction that the nurse can provide in response to the client’s statement?

a.	“High levels of vitamins may cause harm to the fetus.”
b.	“Only water-soluble vitamins may be harmful during pregnancy.”
c.	“Megadoses of vitamins are associated with positive birth outcomes.”
d.	“Vitamin supplementation is not needed during pregnancy.”

 

 

ANS:   A                     PTS:    1

 

11. A pregnant woman experiences constipation. The nurse anticipates that which laxative may be used first after activity and dietary methods are unsuccessful?

a.	Mineral oil
b.	Psyllium (Metamucil)
c.	Lactulose
d.	Milk of magnesia

 

 

ANS:   B                     PTS:    1

 

12. The client is scheduled for treatment with betamethasone (Celestone). The nurse anticipates that this medication will be administered via the _____ route.

a.	oral
b.	intravenous
c.	intramuscular
d.	subcutaneous

 

 

ANS:   C                     PTS:    1

 

13. The client is scheduled for treatment with betamethasone (Celestone). The nurse anticipates that the medication will be administered to the client during which week _____ or before of her pregnancy.

a.	38
b.	36
c.	35
d.	33

 

 

ANS:   D                     PTS:    1

 

14. The healthcare provider orders hydroxyzine (Vistaril) for a client in labor. To achieve a positive outcome, the nurse plans to administer the drug via which route?

a.	Intradermally
b.	Intravenously
c.	Intramuscularly via Z-track technique
d.	Subcutaneously via Z-track technique

 

 

ANS:   C                     PTS:    1

 

15. An epidural block is ordered for a primipara client in labor. The nurse anticipates that this epidural block will be given when the cervix is dilated at _____ centimeters.

a.	2 to 3
b.	3 to 4
c.	4 to 5
d.	5 to 6

 

 

ANS:   D                     PTS:    1

 

16. A client is being treated with an ergot alkaloid medication. Which observation would cause the nurse to contact the primary healthcare provider?

a.	Hypertension
b.	Itching
c.	Jugular vein distention
d.	Seizure activity

 

 

ANS:   D                     PTS:    1

 

17. The client is scheduled for an epidural anesthetic as she delivers. What will be the highest priority nursing intervention?

a.	Administer 1 L of an isotonic IV solution and encourage use of a bedpan after spinal anesthesia.
b.	Administer 500 mL of a hypotonic IV solution and assess the level of consciousness because the patient is sedated.
c.	Administer 500 mL of a hypertonic IV solution and assess fetal heart rate and progress of labor as per pregnancy protocol.
d.	Administer 1 L of hypotonic IV solution and allow the client to ambulate during the spinal anesthesia.

 

 

ANS:   A                     PTS:    1

 

18. The best candidate for treatment with dinoprostone (Cervidil) is the woman who needs her:

a.	labor stopped.
b.	cervix ripened.
c.	labor stimulated.
d.	labor prolonged.

 

 

ANS:   B                     PTS:    1

 

19. Which will most likely be part of the nursing care of a woman postcaesarean section with spinal anesthesia?

a.	Early ambulation to avoid constipation
b.	Fluid restrictions to decrease blood volume
c.	Lying flat 6 to 8 hours to avoid spinal headache
d.	IV antibiotics to avoid postpartum infection

 

 

ANS:   C                     PTS:    1

 

20. The client is scheduled to be treated with Oxytocin by nasal spray. The nurse plans to administer the drug:

a.	2 to 3 minutes after the client nurses her baby.
b.	2 to 3 minutes before the client nurses her baby.
c.	after delivery of the placenta.
d.	as delivery of the placenta is imminent.

 

 

ANS:   B                     PTS:    1

 

MULTIPLE RESPONSE

 

1. A young women in labor, G1P0, is diagnosed with pregnancy-induced hypertension (PIH). She is ordered to receive magnesium sulfate. What are the other components of her nursing care? (Select all that apply.)

a.	Maintaining a quiet environment
b.	Assessing vital signs and fetal heart tones frequently
c.	Providing large amounts of PO and IV fluids to maintain fluid volume
d.	Allowing the woman to ambulate ad lib
e.	Assessing for clonus and deep tendon reflexes
f.	Monitoring urine hourly for protein

 

 

ANS:   A, B, E, F        PTS:    1