NARM Pharmacology and Medications 2

Question 1

A client at 38 weeks gestation has a postpartum hemorrhage risk. Which medication is the FIRST-LINE uterotonic recommended by ACOG and used by CPMs within their scope?

Accepted Answer

Oxytocin 10 units IM

Answer

Misoprostol 600 mcg sublingual

Answer

Methylergonovine 0.2 mg IM

Answer

Carboprost 250 mcg IM

Question 2

When administering Vitamin K (phytonadione) to a newborn, what is the correct intramuscular dose?

Accepted Answer

1 mg

Answer

0.1 mg

Answer

0.5 mg

Answer

2 mg

Question 3

A client reports she took metformin throughout pregnancy for type 2 diabetes. Which neonatal complication should the midwife monitor for immediately after birth?

Accepted Answer

Hypoglycemia

Answer

Hypercalcemia

Answer

Respiratory alkalosis

Answer

Polycythemia

Question 4

Which antibiotic is the standard prophylaxis given to GBS-positive clients in labor when they have no penicillin allergy?

Accepted Answer

Penicillin G 5 million units IV then 2.5 million units q4h

Answer

Clindamycin 900 mg IV

Answer

Ampicillin 2 g IV then 1 g q4h

Answer

Cefazolin 2 g IV then 1 g q8h

Question 5

A midwife administers erythromycin ophthalmic ointment to a newborn. What is the primary purpose of this prophylaxis?

Accepted Answer

Prevention of chlamydial and gonococcal conjunctivitis

Answer

Treatment of herpes simplex keratitis

Answer

Prevention of cytomegalovirus retinitis

Answer

Treatment of chemical conjunctivitis

Question 6

A breastfeeding client asks if she can take ibuprofen for afterpains. Which statement reflects the best evidence-based guidance?

Accepted Answer

Ibuprofen is compatible with breastfeeding as minimal amounts transfer into breast milk

Answer

Ibuprofen is contraindicated in breastfeeding mothers

Answer

Ibuprofen should be replaced with aspirin for breastfeeding mothers

Answer

Ibuprofen use requires a 4-hour pump-and-discard period

Question 7

What is the mechanism of action of magnesium sulfate when used for eclampsia prophylaxis?

Accepted Answer

Stabilizes neuronal membranes by competing with calcium at receptor sites

Answer

Blocks calcium channels in smooth muscle, reducing blood pressure

Answer

Inhibits prostaglandin synthesis, reducing neuroinflammation

Answer

Enhances GABA activity to produce CNS sedation