NARM Pharmacology and Medications 4

Question 1

A midwife is managing a postpartum hemorrhage unresponsive to oxytocin. Which second-line uterotonic is appropriate, but is CONTRAINDICATED in clients with hypertension?

Accepted Answer

Methylergonovine (Methergine) 0.2 mg IM

Answer

Misoprostol 800 mcg rectal

Answer

Carboprost tromethamine (Hemabate) 250 mcg IM

Answer

Tranexamic acid 1 g IV

Question 2

A client in preterm labor at 32 weeks is given betamethasone. What is the primary therapeutic goal of this medication?

Accepted Answer

Accelerate fetal lung maturation by stimulating surfactant production

Answer

Arrest uterine contractions to prolong pregnancy

Answer

Prevent intraventricular hemorrhage by reducing fetal heart rate variability

Answer

Reduce maternal fever that is triggering labor

Question 3

What is the recommended dose and route for misoprostol when used to treat postpartum hemorrhage after oxytocin failure?

Accepted Answer

600–800 mcg rectally or sublingually

Answer

200 mcg sublingual

Answer

400 mcg intravaginally

Answer

1000 mcg IV infusion

Question 4

A client at 36 weeks is prescribed nifedipine for tocolysis. Which side effect should the midwife anticipate and monitor?

Accepted Answer

Maternal hypotension and reflex tachycardia

Answer

Hyperkalemia and bradycardia

Answer

Pulmonary edema and fluid overload

Answer

Uterine hyperstimulation and fetal distress

Question 5

Iron supplementation is recommended during pregnancy. Which statement about iron absorption is correct?

Accepted Answer

Vitamin C (ascorbic acid) co-administration enhances iron absorption

Answer

Iron is best absorbed with milk to reduce GI irritation

Answer

Calcium supplements taken simultaneously increase iron bioavailability

Answer

Ferric (Fe3+) iron salts are more bioavailable than ferrous (Fe2+) salts

Question 6

Which medication used for nausea and vomiting of pregnancy (NVP) is classified as a combination antihistamine/Vitamin B6 product?

Accepted Answer

Doxylamine-pyridoxine (Diclegis/Bonjesta)

Answer

Ondansetron (Zofran)

Answer

Promethazine (Phenergan)

Answer

Metoclopramide (Reglan)

Question 7

A midwife administers carboprost (Hemabate) for uterine atony. Which condition is an absolute contraindication for this prostaglandin F2α analog?

Accepted Answer

Asthma

Answer

Hypertension

Answer

Renal insufficiency

Answer

Hepatic failure