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

Erythromycin ointment is applied prophylactically to prevent gonococcal ophthalmia neonatorum, which can cause blindness if untreated.

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

Diazoxide opens K-ATP channels in pancreatic beta cells, hyperpolarizing the membrane and inhibiting insulin secretion to treat hyperinsulinemic hypoglycemia.

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

Neonates have higher body water content (larger Vd), lower protein binding (more free drug), and immature organ clearance, requiring dose and interval adjustments.

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

Morphine causes dose-dependent respiratory depression and hypotension in neonates, requiring careful monitoring of respiratory rate and blood pressure.

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

When IV access is unavailable, NRP recommends 0.05-0.1 mg/kg epinephrine via ET tube, though IV/IO administration is preferred for reliability.

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Pharmacology and Medications 2