NARM Pharmacology and Medications 3

Question 1

A client at 41 weeks requires cervical ripening. Misoprostol (Cytotec) 25 mcg is placed vaginally. How frequently can doses be repeated if needed?

Accepted Answer

Every 3–4 hours

Answer

Vaginal misoprostol 25 mcg may be repeated every 3–4 hours per ACOG protocol, with reassessment of fetal status before each dose.

Question 2

Which finding indicates magnesium toxicity requiring immediate intervention?

Accepted Answer

Absent deep tendon reflexes

Answer

Loss of deep tendon reflexes is the earliest clinical sign of magnesium toxicity and indicates serum levels approaching the toxic range (>7 mEq/L).

Question 3

A newborn is born to a mother who received meperidine (Demerol) 2 hours before delivery. The neonate shows respiratory depression. What medication should be administered?

Accepted Answer

Naloxone 0.1 mg/kg IM or IV

Answer

Naloxone (Narcan) is the opioid antagonist used to reverse neonatal respiratory depression caused by maternal opioid administration.

Question 4

Which herbal supplement is CONTRAINDICATED in pregnancy due to its uterotonic properties?

Accepted Answer

Blue cohosh (Caulophyllum thalictroides)

Answer

Blue cohosh contains caulosaponin and caulophyllosaponin, which have uterotonic and vasoconstrictive effects and are associated with neonatal heart failure.

Question 5

A client has a penicillin allergy documented as 'anaphylaxis.' Which antibiotic should be used for GBS prophylaxis after confirming susceptibility?

Accepted Answer

Clindamycin 900 mg IV q8h

Answer

For clients with high-risk penicillin allergy (anaphylaxis, angioedema, urticaria), clindamycin is used if the GBS isolate is susceptible; cefazolin is used only for low-risk penicillin allergy.

(NARM) North American Registry of Midwives Practice Test

(NARM) North American Registry of Midwives Practice Test

NARM Pharmacology and Medications 3