Pharmacology & Therapeutic Management Flashcards
7 cards from real RNC-NIC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pharmacology & Therapeutic Management flashcards as text
A neonate with persistent pulmonary hypertension (PPHN) is started on inhaled nitric oxide (iNO). Which parameter most directly indicates a therapeutic response?
Answer: Improved oxygenation index (OI)
A decrease in the oxygenation index (OI = FiO2 × mean airway pressure × 100 / PaO2) indicates improved gas exchange and pulmonary vasodilation in response to iNO.
A 28-week neonate requires caffeine citrate therapy. What is the recommended IV loading dose?
Answer: 20 mg/kg
The standard caffeine citrate loading dose is 20 mg/kg IV, followed by a maintenance dose of 5–10 mg/kg/day.
Which electrolyte abnormality is most commonly associated with prolonged furosemide therapy in neonates?
Answer: Hypokalemia
Furosemide causes urinary wasting of potassium, sodium, and chloride, making hypokalemia the most common electrolyte imbalance with chronic use.
A NICU nurse prepares to administer indomethacin to close a hemodynamically significant PDA. Which finding is an absolute contraindication?
Answer: Serum creatinine of 1.2 mg/dL
Serum creatinine ≥1.8 mg/dL (or significant renal dysfunction) is a contraindication; a creatinine of 1.2 mg/dL warrants caution but is not an absolute cutoff—however, active renal impairment (oliguria <0.6 mL/kg/hr or elevated creatinine) contraindicates use.
Vancomycin is prescribed for a neonate with culture-proven MRSA bacteremia. Which monitoring parameter is most important to guide dosing?
Answer: AUC/MIC ratio
Current guidelines recommend AUC/MIC-guided dosing (target AUC 400–600 mg·h/L) rather than trough-only monitoring to optimize efficacy and minimize nephrotoxicity.
A term neonate with hypoxic-ischemic encephalopathy (HIE) is undergoing therapeutic hypothermia. Phenobarbital is ordered for seizures. How does hypothermia affect phenobarbital metabolism?
Answer: Decreases hepatic clearance, increasing drug levels
Therapeutic hypothermia reduces hepatic enzyme activity and drug clearance, leading to higher phenobarbital levels and potential toxicity at standard doses.
A nurse is administering a continuous morphine infusion to a ventilated preterm neonate. Which adverse effect requires immediate intervention?
Answer: Blood pressure of 48/26 mmHg
Morphine causes histamine release and vasodilation, which can lead to hypotension; a low BP in a preterm neonate on morphine infusion requires prompt assessment and possible dose reduction or fluid bolus.