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 suspected sepsis has a penicillin allergy documented in the chart. Which antibiotic is a safe first-line alternative for gram-positive coverage?
Answer: Vancomycin
Vancomycin provides reliable gram-positive coverage including MRSA and is appropriate when penicillin allergy precludes ampicillin use in neonatal sepsis.
A 30-week neonate is receiving total parenteral nutrition (TPN). Which TPN-associated drug interaction can occur with co-administration of calcium and phosphate in the same bag?
Answer: Precipitation of calcium phosphate salt
Calcium and phosphate can combine to form insoluble calcium phosphate precipitate in TPN solutions, which is dangerous if infused through a central line.
A nurse notes that a preterm neonate on prolonged amphotericin B deoxycholate therapy has a rising serum creatinine. What is the priority nursing action?
Answer: Hold the dose and notify the physician
Amphotericin B deoxycholate is nephrotoxic; a rising creatinine indicates renal impairment and the dose should be held while the prescriber is notified to reassess the regimen.
Which statement correctly describes the mechanism of action of bumetanide in neonates?
Answer: Blocks the Na-K-2Cl cotransporter in the thick ascending limb of Henle
Bumetanide, like furosemide, is a loop diuretic that inhibits the Na-K-2Cl cotransporter (NKCC2) in the thick ascending loop of Henle, producing potent diuresis.
A neonate with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is in adrenal crisis. What is the drug of choice for acute management?
Answer: Hydrocortisone IV bolus
IV hydrocortisone is the treatment of choice for acute adrenal crisis because it provides both glucocorticoid and mineralocorticoid activity needed to stabilize the infant.
A 3-day-old term neonate with seizures is found to have pyridoxine-dependent epilepsy. Which intervention is diagnostic and therapeutic simultaneously?
Answer: IV pyridoxine 100 mg while monitoring EEG
IV pyridoxine (vitamin B6) administered during EEG monitoring is both diagnostic and therapeutic—cessation of electrical seizure activity within minutes confirms pyridoxine-dependent epilepsy.
A NICU nurse is preparing to administer intravenous immunoglobulin (IVIG) for Rh hemolytic disease. Which infusion-related adverse effect should she monitor for most closely?
Answer: Hypotension, tachycardia, and chills
Anaphylactoid infusion reactions including hypotension, tachycardia, fever, and chills can occur with IVIG, especially with rapid infusion rates.