CMA Medications & Pharmacology in Midwifery 2 — Questions and Answers
Question 1: Oxytocin augmentation during labor requires which type of monitoring?
- Maternal vital signs every 4 hours only
- Continuous electronic fetal monitoring (Correct answer)
- Intermittent auscultation every 30 minutes only
- Urine output monitoring only
Correct answer: Continuous electronic fetal monitoring
Continuous EFM is required during oxytocin augmentation to detect fetal intolerance (late decelerations, prolonged decelerations) from uterine hyperstimulation.
Question 2: Which analgesic crosses the placenta most readily and can cause neonatal respiratory depression if given close to delivery?
- Acetaminophen (Tylenol)
- Ibuprofen
- IV opioids (e.g., fentanyl, morphine) (Correct answer)
- Nitrous oxide
Correct answer: IV opioids (e.g., fentanyl, morphine)
IV opioids cross the placenta and can cause neonatal respiratory depression; their timing must be managed carefully to minimize neonatal exposure near delivery.
Question 3: Naloxone (Narcan) is administered to a newborn to reverse respiratory depression caused by:
- Maternal magnesium sulfate
- Maternal opioid analgesics given during labor (Correct answer)
- Epidural anesthesia
- Maternal GBS prophylaxis antibiotics
Correct answer: Maternal opioid analgesics given during labor
Naloxone reverses opioid-induced neonatal respiratory depression by competitively blocking opioid receptors in the newborn.
Question 4: Betamethasone (Celestone) is given to pregnant women threatened with preterm labor between 24–34 weeks to promote:
- Cervical ripening
- Fetal lung maturity (Correct answer)
- Uterine quiescence
- Placental growth
Correct answer: Fetal lung maturity
Antenatal corticosteroids such as betamethasone accelerate fetal lung surfactant production, significantly reducing respiratory distress syndrome in preterm newborns.
Question 5: Misoprostol (Cytotec) used for cervical ripening is administered via which route?
- Intravenous infusion
- Intramuscular injection
- Buccal, sublingual, or intravaginal routes (Correct answer)
- Oral tablet only
Correct answer: Buccal, sublingual, or intravaginal routes
Misoprostol can be administered buccally, sublingually, vaginally, or orally depending on clinical indication and institutional protocol.
Question 6: Which antidote is given for magnesium sulfate toxicity?
- Naloxone
- Calcium gluconate (Correct answer)
- Vitamin K
- Protamine sulfate
Correct answer: Calcium gluconate
Calcium gluconate 1 g IV is the antidote for magnesium sulfate toxicity, restoring normal neuromuscular function.
CMA Medications & Pharmacology in Midwifery 2
Oxytocin augmentation during labor requires which type of monitoring?