RNC-NIC Pharmacology & Therapeutic Management 4

Question 1

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?

Accepted Answer

Vancomycin

Answer

Vancomycin provides reliable gram-positive coverage including MRSA and is appropriate when penicillin allergy precludes ampicillin use in neonatal sepsis.

Question 2

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?

Accepted Answer

Precipitation of calcium phosphate salt

Answer

Calcium and phosphate can combine to form insoluble calcium phosphate precipitate in TPN solutions, which is dangerous if infused through a central line.

Question 3

A nurse notes that a preterm neonate on prolonged amphotericin B deoxycholate therapy has a rising serum creatinine. What is the priority nursing action?

Accepted Answer

Hold the dose and notify the physician

Answer

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.

Question 4

Which statement correctly describes the mechanism of action of bumetanide in neonates?

Accepted Answer

Blocks the Na-K-2Cl cotransporter in the thick ascending limb of Henle

Answer

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.

Question 5

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?

Accepted Answer

Hydrocortisone IV bolus

Answer

IV hydrocortisone is the treatment of choice for acute adrenal crisis because it provides both glucocorticoid and mineralocorticoid activity needed to stabilize the infant.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Pharmacology & Therapeutic Management 4