Neonatal Nurse Practitioner Exam Pharmacology and Medications 2

Question 1

Why is erythromycin eye ointment applied to neonates at birth in the US?

Accepted Answer

Prophylaxis against Neisseria gonorrhoeae ophthalmia neonatorum

Answer

Prevention of herpes simplex ophthalmia

Answer

Treatment of chlamydial conjunctivitis

Answer

Prevention of bacterial endophthalmitis

Question 2

A neonate develops hypoglycemia despite feeding. Diazoxide is started. What is its mechanism of action?

Accepted Answer

Inhibits insulin secretion by opening ATP-sensitive potassium channels

Answer

Stimulates insulin secretion from pancreatic beta cells

Answer

Increases glucagon release

Answer

Blocks gluconeogenesis

Question 3

What is the most important pharmacokinetic difference in neonates compared to adults when dosing medications?

Accepted Answer

Larger volume of distribution, lower protein binding, and immature renal/hepatic clearance

Answer

Faster hepatic metabolism

Answer

Smaller volume of distribution and rapid renal clearance

Answer

Higher albumin concentrations

Question 4

Morphine is used for analgesia/sedation in ventilated neonates. Which adverse effect requires the most monitoring?

Accepted Answer

Respiratory depression and hypotension

Answer

Hypertension

Answer

Hyperglycemia

Answer

Increased bowel motility

Question 5

What is the recommended dose of epinephrine for neonatal cardiac resuscitation via endotracheal tube per NRP guidelines?

Accepted Answer

0.05-0.1 mg/kg ET

Answer

0.01-0.03 mg/kg IV

Answer

0.5 mg/kg IV

Answer

0.001 mg/kg IV

Question 6

Furosemide is used in neonates with fluid overload. What electrolyte abnormality must be monitored closely?

Accepted Answer

Hypokalemia and hypocalcemia

Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hyperphosphatemia