Neonatal Intensive Care Nurse Exam Neonatal Pharmacology 2 — Questions and Answers
Question 1: Dopamine at low doses (1–5 mcg/kg/min) in neonates primarily causes:
- Renal and mesenteric vasodilation (Correct answer)
- Systemic vasoconstriction
- Decreased heart rate
- Bronchodilation
Correct answer: Renal and mesenteric vasodilation
Low-dose dopamine acts on dopaminergic receptors to cause renal and mesenteric vasodilation, increasing organ perfusion.
Question 2: A neonate is receiving a prostaglandin E1 (PGE1) infusion. The nurse should monitor for which adverse effect?
- Apnea (Correct answer)
- Hypertension
- Hypoglycemia
- Bradycardia
Correct answer: Apnea
PGE1 commonly causes apnea in neonates, requiring respiratory support and monitoring for all infants receiving this medication.
Question 3: Which statement about neonatal drug dosing is correct?
- Neonates have reduced protein binding, increasing free drug availability (Correct answer)
- Neonates metabolize drugs faster than adults
- Renal clearance is higher in neonates than adults
- IM absorption is always more reliable than IV in neonates
Correct answer: Neonates have reduced protein binding, increasing free drug availability
Neonates have lower albumin levels and fetal albumin with reduced binding affinity, resulting in more free (active) drug.
Question 4: Dextrose 10% (D10W) is the standard IV fluid for neonates because:
- It provides glucose to meet high neonatal metabolic demands and prevent hypoglycemia (Correct answer)
- It is isotonic and safe for peripheral veins
- It contains electrolytes needed for neonatal homeostasis
- It is the only fluid approved for umbilical lines
Correct answer: It provides glucose to meet high neonatal metabolic demands and prevent hypoglycemia
Neonates have limited glycogen stores and high glucose requirements, making D10W the standard maintenance fluid to prevent hypoglycemia.
Question 5: Which medication is used as an antidote for neonatal opioid toxicity?
- Naloxone (Correct answer)
- Flumazenil
- Atropine
- Epinephrine
Correct answer: Naloxone
Naloxone is a pure opioid receptor antagonist used to reverse respiratory depression caused by maternal or neonatal opioid exposure.
Question 6: Furosemide is used in the NICU to manage:
- Fluid overload and pulmonary edema (Correct answer)
- Hypoglycemia
- Neonatal abstinence syndrome
- Hyperbilirubinemia
Correct answer: Fluid overload and pulmonary edema
Furosemide is a loop diuretic that promotes sodium and water excretion to manage fluid overload, edema, and chronic lung disease.
Neonatal Intensive Care Nurse Exam Neonatal Pharmacology 2
Dopamine at low doses (1–5 mcg/kg/min) in neonates primarily causes: