Chapter 55: Postpartum and Newborn Drugs Nursing School Test Banks

Chapter 55: Postpartum and Newborn Drugs
Test Bank

MULTIPLE CHOICE

1. The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant. She asks why she cannot use drugs to suppress lactation. Which response by the nurse is correct?
a. Hormonal drugs are not as effective as complementary therapies.
b. Hormonal drugs cause increased constipation.
c. Hormonal drugs increase the risk of blood clots.
d. Hormonal drugs promote uterine atony.
ANS: C
Estrogenic drug therapy is less common than in the past because of the increased risk of thrombophlebitis. They are more effective than complementary drugs. They do not increase constipation or promote uterine atony.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 838
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

2. The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation. What information will the nurse include when teaching this patient about this medication?
a. Crush the tablet if it is difficult to swallow.
b. Store this medication in a cool, dry place.
c. Take the tablet with a carbonated beverage.
d. Take with milk if gastrointestinal upset occurs.
ANS: B
Bisacodyl tablets should be stored in a cool, dry place. They should not be crushed. It is not necessary to give with a carbonated beverage. Bisacodyl tablets should not be taken within 1 to 2 hours of milk or antacid.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 832
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

3. When teaching a postpartal patient about the use of mineral oil as a laxative, the nurse will explain that mineral oil
a. does not have serious side effects.
b. is safe to take with other laxatives.
c. may be taken with food.
d. should be mixed with juice or soda.
ANS: D
Mineral oil should be given with fruit juice or soda to disguise the taste. It can be aspirated, causing aspiration pneumoniaa serious side effect. It should not be taken with food and should not be taken with other laxatives.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 832
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section. The mothers blood type is Rh-negative, and the infants blood type is Rh-positive. The provider has ordered human D immune globulin (RhoGAM). The nurse understands that this patient will need
a. less than the usual RhoGAM dose.
b. more than the usual RhoGAM dose.
c. no RhoGAM.
d. the usual RhoGAM dose.
ANS: B
For women with abruption, previa, caesarean births, or manual placental removal, more than 15 mL of fetal-maternal hemorrhage of Rh-positive red blood cells may have occurred, necessitating an increased dose of D immune globulin.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 835
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Immunizations

5. The nurse has just administered Rho(D) immune globulin (RhoGAM) to a postpartal woman. What information will the nurse include when teaching this patient?
a. Avoid live vaccines for 3 months.
b. There are no adverse reactions to this injection.
c. The immune globulin does not cross into breast milk.
d. You will not need to have the injection with future deliveries.
ANS: A
Patients receiving Rho(D) immune globulin should be cautioned to avoid live vaccines for 3 months. Patients can experience hypersensitivity reactions to the immune globulin, and Rho(D) immune globulin crosses into breast milk. Women will need to have the immune globulin with future deliveries if the infant is Rh-positive.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 836
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

6. A woman who has just delivered her infant observes the nurse administering ophthalmic ointment into her infants eyes, and she asks why this is being done. The nurse will explain that this ointment is given for which purpose?
a. To prevent chemical conjunctivitis
b. To prevent infection
c. To provide moisture
d. To treat infection
ANS: B
To prevent the risk of infection, infants are treated with erythromycin ophthalmic ointment. Chemical conjunctivitis may occur in 20% of infants as an adverse effect of the drug. It is not used as a moisturizer. It is given as prophylaxis not treatment.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 837
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse is caring for a newborn infant whose mother is HBsAg-negative. The nurse expects to give the infant
a. hepatitis B immune globulin.
b. hepatitis B immune globulin and hepatitis B vaccine 12 hours later.
c. no vaccine.
d. recombinant hepatitis B vaccine.
ANS: D
Infants whose mothers are HBsAg-negative will need to receive recombinant hepatitis B vaccine. Immune globulin is given to infants whose mothers status is unknown or who are positive. All infants receive the hepatitis B vaccine.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 838
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

8. The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative, rubella titer less than 1:8/1:10, Rh-negative with Rh-positive infant. Which injections will the nurse expect to be ordered?
a. Hepatitis B immune globulin and MMR today
b. MMR and Rho(D) immune globulin (RhoGAM) today
c. Rho(D) immune globulin (RhoGAM) and hepatitis B immune globulin today
d. Rho(D) immune globulin (RhoGAM) today and MMR in 3 months
ANS: D
The woman needs RhoGAM today and will need an MMR since her rubella titer is low. Because it is a live vaccine, the MMR should be given in 3 months. She does not need hepatitis B immune globulin.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 883
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

9. A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases. She has a 3-year-old and a 5-year-old child who have not been immunized. The nurse will counsel the patient to perform which action?
a. Delay obtaining the vaccines for her children and herself until after her baby is born.
b. Have her children vaccinated now and obtain the vaccine for herself after the baby is born.
c. Obtain the MMR vaccine for her children and herself when she is in her third trimester of pregnancy.
d. Obtain the MMR vaccine for her children and herself within the next few weeks.
ANS: B
Pregnant women should not receive MMR vaccine because it is a live virus and there is risk to the fetus. Her children should be vaccinated so they do not contract rubella and pass it to her.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 838
TOP: NURSING PROCESS: Assessment/Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

10. The nurse is instructing a nursing student who will administer erythromycin ophthalmic ointment and phytonadione (vitamin K) injection to a newborn infant. The nurse will instruct the student to perform which action?
a. Administer the ointment after giving the injection.
b. Apply a 1-cm ribbon of ointment to the infants eyes.
c. Apply the ointment along the lower border of the upper eyelids.
d. Warm the ointment in a warmer before applying.
ANS: B
Erythromycin ointment should be applied in a 1-cm ribbon along the lower lid. The ointment should be administered first, since the injection may cause the infant to cry. The ointment should not be placed in the warmer.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 838
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

11. The nurse tells a postpartal woman that her baby will need hepatitis B vaccine. The mother says she does not want her baby to have a shot and refuses to sign the consent. The nurse will
a. administer the vaccine without consent.
b. note the refusal in the mothers and babys chart.
c. tell her she will harm her baby if she does not consent.
d. tell the mother that it is required by law.
ANS: B
Although hepatitis B vaccine is recommended, patients have a right to refuse. The refusal should be documented in the mothers and babys chart. The nurse should never administer the vaccine without consent. Telling the mother that she will harm her baby if she does not consent is coercive. The vaccine is recommended and is required for admission to schools, but parents still have a right to refuse.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 838
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Health Promotion and Maintenance: Postpartal Care

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