ATI PN PHARMACOLOGY PROCTORED EXAM Version 24 QUESTIONS AND ANSWERS VERIFIED AND GRDED
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Course
Nursing pharmacology
Institution
Nursing Pharmacology
ATI PN PHARMACOLOGY PROCTORED EXAM Version 24 QUESTIONS AND ANSWERS VERIFIED AND GRDED
The nurse is monitoring a client who is
receiving oxytocin (Pitocin) to induce labor.
Which assessment finding would cause the
nurse to immediately discontinue the
oxytocin infusion?
1. Fatigue
2...
, SAUNDERS ATI PHARMACOLOGY STUDY GUIDE COMPLETE SOLUTION WITH RATIONALS
CHAPTERS 35 TO 77
Week 1: Chapter 35 “Maternity and Newborn Medications”
Questions Answers and Rationales
1. The nurse is monitoring a client who is 1. Fatigue
receiving oxytocin (Pitocin) to induce labor. 2. Drowsiness
Which assessment finding would cause the 3. Uterine hyperstimulation
nurse to immediately discontinue the 4. Early decelerations of the fetal heart rate
oxytocin infusion?
Rationale: Often used to induce labor. High doses are often used for
uterine hyperstimulation & C/S births. ADVERSE EFFECTS:
Hyperstimulation of uterine contractions & non-reassuring fetal HR→
DISCONTINUE
2. A pregnant client is receiving magnesium 1. Proteinuria of 3 +
sulfate for the management of 2. Respirations of 10 breaths/ minute
preeclampsia. The nurse determines that 3. Presence of deep tendon reflexes
the client is experiencing toxicity from the 4. Serum magnesium level of 6 mEq/ L
medication if which finding is noted on
assessment? Rationale: Mg TOXICITY→ RESP. DEPRESSION, LOSS OF TENDON
REFLEXES & SUDDEN DECLINE IN FETAL HR, MATERNAL HR, &
BP caused by Mg tx. Must remain within therapeutic serum levels 4–7.5
mEq/L. Proteinuria 3+ is expected in a pt w/ preeclampsia.
3. The nurse is monitoring a client in preterm 1. Flushing
labor who is receiving intravenous 2. Hypertension
magnesium sulfate. The nurse should 3. Increased urine output
monitor for which adverse effects of this 4. Depressed respirations
medication? Select all that apply. 5. Extreme muscle weakness deep
6. Hyperactive tendon reflexes
R ationale: Mg sulfate is a CNS depressant that relaxes smooth
m uscles like the uterus. It’s used to STOP preterm
c ontractions labor and for preeclampsia pts. to PREVENT
A DVERSE SEIZURES. EFFECTS:
• Flushing
Depressed respirations
Depressed deep tendon reflexes
• Hypotension
Extreme muscle weakness
Decreased urine output
Pulmonary Edema
Elevated Mg serum levels
4. 1. “I will flush the eyes after instilling the ointment?”
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, The nurse instructor asks a nursing student
to describe the procedure for administering 2.
erythromycin ointment to the eyes of a “I will clean the newborn’s eyes before instilling ointment.”
after
newborn. Which student statement 3.
indicates that further teaching is needed? “I need to administer the eye ointment within 1 hr.
delivery.” NB’s
4. conjunctiva
“I will instill the eye ointment into each of the sacs.”
Rationale: Eye prophylaxis protects the NB against Neisseria
gonorrhea & Chlamydia trachomatis. The eyes are NOT FLUSHED
AFTER INSTILLATION of med because the flush would WASH AWAY the
administered medication.
5. A client in preterm labor (31 weeks) 1. Nalbuphine (Nubain)
who is dilated to 4 cm has been started on 2. Betamethasone (Celestone)
magnesium sulfate and contractions have 3. Rho(D) immune globulin (RhoGAM)
stopped. If the client’s labor can be inhibited 4. Dinoprostone (Cervidil vaginal insert)
for the next 48 hours, the nurse anticipates a
prescription for which medication? Rationale: Betamethasone, a glucocorticoid increases the production
of surfactant to stimulate fetal lung maturation. It is administered to
clients in preterm labor at 28 to 32 weeks of gestation if the labor can
be inhibited for 48 hours.
Nalbuphine (Nubain) is an opioid analgesic.
Rho(D) immune globulin (RhoGAM) is given to Rh-negative clients to
prevent immunological condition aka Rh disease (hemolytic disease of
NB); it takes out the + cells that were transported from maternal
blood stream → fetal circulation.
Dinoprostone (Cervidil vaginal insert) is a prostaglandin given to ripen
and soften the cervix and to stimulate uterine contractions.
6. Methylergonovine (Methergine) is 1. Uterine tone
prescribed for a woman to treat postpartum 2. Blood pressure → ABC!!!
hemorrhage. Before administration of 3. Amount of lochia
methylergonovine, what is the priority nursing 4. Deep tendon reflexes
assessment?
Rationale: Methylergonovine is an ERGOT ALKALOID prevents or
controls postpartum hemorrhage by contracting the uterus. This med
→ continuous uterine contractions and can elevate BP→
CHECK BP → report to MD if HTN is present
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, 7. The nurse is preparing to administer 1. Intradermal
beractant (Survanta) to a premature infant 2. Intratracheal
who has respiratory distress syndrome. The 3. Subcutaneous
nurse plans to administer the medication by 4. Intramuscular
which route?
Rationale: Respiratory distress syndrome is a serious lung disorder
caused by immaturity and the inability to produce surfactant→
hypoxia and acidosis. It is common in premature infants and may be
due to lung immaturity as a result of surfactant deficiency. The
mainstay of tx=exogenous surfactant, which is administered by the
intratracheal route.
* Note relationship that question states “respiratory distress
syndrome”→ Intratracheal
8. An opioid analgesic is administered to a 1. Naloxone → Antidote!
client in labor. The nurse assigned to care for 2. Morphine sulfate
the client ensures that which medication is 3. Betamethasone(Celestone) hydrochloride
readily available if respiratory depression 4. Meperidine (Demerol)
occurs?
9. Rho(D) immune globulin (RhoGAM) is 1. Having Rh-positive blood
prescribed for a client after delivery and the 2. Developing a rubella infection
nurse provides information to the client about 3. Developing physiological jaundice
the purpose of the medication. The nurse 4. Being affected by Rh incompatibility
determines that the woman understands the
purpose if the woman states that it will protect Rationale: Rh incompatibility can occur when an Rh-negative mother
her next baby from which condition? becomes sensitized to Rh antigen. Sensitization may occur when an
Rh-negative woman becomes pregnant with a fetus who is positive→
maternal circulation→ mother’s immune system to form antibodies
against Rh+ blood. This medication prevents mothers from developing
antibodies against Rh+ blood by providing passive antibody protection
against Rh antigen.
10. Methylergonovine (Methergine) is 1. Hypotension
prescribed for a client with postpartum 2. Hypothyroidism
hemorrhage. Before administering the 3. Diabetes mellitus
medication, the nurse contacts the health care 4. Peripheral vascular disease
provider who prescribed the medication if
which condition is documented in the client’s Rationale: Ergot alkaloids are contraindicated in clients with significant
medical history? cardiovascular disease, peripheral vascular disease, hypertension,
preeclampsia, or eclampsia. The vasoconstrictive effects of the ergot
alkaloids worsen these conditions.
Chapter 49: “Pediatric Med. Administration and Calculations”
Questions Answers and Rationales
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