Obstetric Nurse Test Obstetric Nurse Pharmacology in Obstetrics 2 — Questions and Answers
Question 1: A patient with preterm labor at 30 weeks is receiving magnesium sulfate tocolysis. Which finding requires the nurse to withhold the next dose?
- Respiratory rate of 10 breaths/min (Correct answer)
- Urine output of 35 mL/hr
- Deep tendon reflexes 2+
- Serum magnesium level of 5 mEq/L
Correct answer: Respiratory rate of 10 breaths/min
A respiratory rate below 12 breaths/min indicates magnesium toxicity and the infusion must be stopped immediately.
Question 2: Betamethasone is administered to a pregnant patient at 28 weeks gestation. What is the primary purpose of this medication?
- Reduce maternal infection risk
- Accelerate fetal lung maturity (Correct answer)
- Prevent preterm labor contractions
- Lower maternal blood pressure
Correct answer: Accelerate fetal lung maturity
Betamethasone stimulates fetal surfactant production to reduce the risk of neonatal respiratory distress syndrome.
Question 3: A patient is receiving IV oxytocin augmentation. Uterine contractions are occurring every 90 seconds. What is the nurse's priority action?
- Increase the oxytocin rate per protocol
- Discontinue the oxytocin infusion (Correct answer)
- Administer IV fluid bolus
- Notify the provider and continue monitoring
Correct answer: Discontinue the oxytocin infusion
Tachysystole (contractions more frequent than every 2 minutes) requires immediate discontinuation of oxytocin to prevent fetal hypoxia.
Question 4: Which antidote should be immediately available at the bedside of a patient receiving magnesium sulfate?
- Naloxone (Narcan)
- Calcium gluconate (Correct answer)
- Protamine sulfate
- Flumazenil
Correct answer: Calcium gluconate
Calcium gluconate reverses magnesium toxicity by competing with magnesium at neuromuscular junctions.
Question 5: A postpartum patient has received methylergonovine (Methergine) for uterine atony. Which vital sign finding indicates a serious adverse effect?
- Blood pressure 170/110 mmHg (Correct answer)
- Heart rate 88 bpm
- Temperature 37.8°C
- Respiratory rate 18 breaths/min
Correct answer: Blood pressure 170/110 mmHg
Methylergonovine causes vasoconstriction and is contraindicated in hypertension because it can cause severe hypertensive crisis.
Question 6: A nurse is preparing to administer carboprost tromethamine (Hemabate) for postpartum hemorrhage. Which patient condition is a contraindication?
- Active asthma (Correct answer)
- Type 2 diabetes
- Hypothyroidism
- Iron deficiency anemia
Correct answer: Active asthma
Carboprost is contraindicated in patients with asthma because it causes bronchoconstriction via prostaglandin F2α activity.
Question 7: Which route of administration is recommended for misoprostol when used to treat postpartum hemorrhage if the patient is actively vomiting?
- Oral
- Sublingual
- Rectal (Correct answer)
- Intranasal
Correct answer: Rectal
Rectal administration of misoprostol bypasses the gastrointestinal tract and is effective when oral or sublingual routes are not feasible due to vomiting.
Obstetric Nurse Test Obstetric Nurse Pharmacology in Obstetrics 2
A patient with preterm labor at 30 weeks is receiving magnesium sulfate tocolysis.
Which finding requires the nurse to withhold the next dose?