Question 1

A nurse is caring for a woman during the perinatal and postnatal period. To stop postpartum hemorrhage, how will the nurse administer oxytocin [Pitocin] to this patient?

Accepted Answer

A)   20 units in 1000 mL of IV solution after delivery of the placenta
B)   20 units intramuscularly prior to delivery of the placenta
C)   40 units intramuscularly after delivery of the placenta
D)   60 units per rectum prior to delivery of the placenta A

Question 2

A pregnant patient is being induced with oxytocin, which has been infusing for 1 hour. The initial rate was 6 milliunits/min, and the rate now is 18 milliunits/min. The nurse notes regular contractions occurring every 3 minutes, each lasting 35 seconds. The nurse will:

Accepted Answer

A)   increase the rate of infusion by 1 to 2 milliunits/min every 15 to 40 minutes.
B)   increase the rate of infusion by 3 to 6 milliunits/min every 15 to 40 minutes.
C)   interrupt the infusion and continue to monitor the patient before restarting.
D)   interrupt the infusion and notify the provider of potential oxytocin toxicity. B

Question 3

A nurse provides teaching to a woman who is taking tranexamic acid [Lysteda] for menorrhagia. Which statement by the patient indicates a need for further teaching?

Accepted Answer

A)   "I may experience back pain or muscle cramps while taking this drug."
B)   "I may take two tablets 3 times daily for up to 5 days with each period."
C)   "I should take an oral contraceptive to prevent pregnancy while taking this drug."
D)   "I should take this medication with food to improve absorption of the drug." C

Question 4

A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin [Pitocin]. The patient is having increased frequency, duration, and intensity of contractions. The nurse will interrupt the oxytocin infusion if what occurs?

Accepted Answer

A)   Contractions occur every 2 to 3 minutes.
B)   Individual contractions last 2 minutes.
C)   Mild to moderate pain occurs with uterine contractions.
D)   Resting intrauterine pressure is greater than 10 to 15 mm Hg.

Question 5

A postpartum patient is receiving methylergonovine to prevent hemorrhage. The nurse assesses the patient and notes a heart rate of 76 beats per minute, a respiratory rate of 16 breaths per minute, and a blood pressure of 120/80 mm Hg. The patient's uterus is firm. The patient complains of mild to moderate cramping. Bleeding is minimal. What will the nurse do?

Accepted Answer

A)   Continue to monitor and tell the patient to report increased cramping.
B)   Notify the provider of possible uterine hypertonicity.
C)   Notify the provider of the patient's blood pressure.
D)   Request an order to administer the methylergonovine intravenously.

Question 6

A patient is admitted to the obstetric unit in preterm labor at 36 weeks' gestation. The prescriber orders a tocolytic agent. When teaching the patient about this medication, the nurse will tell her that tocolytics:

Accepted Answer

A)   are given until term to reduce fetal mortality.
B)   are used to help the fetal lungs mature.
C)   help delay delivery while glucocorticoids are given.
D)   help treat the infections that cause preterm labor.

Question 7

A patient who has experienced preterm births with her previous two pregnancies will begin receiving hydroxyprogesterone caproate [Makena] to prevent preterm delivery with her current pregnancy. Which statement by the patient indicates a need for further teaching about this drug?

Accepted Answer

A)   "I should report any calf pain immediately."
B)   "I will eventually learn to administer the injections of this drug myself."
C)   "This drug may cause fluid retention and glucose intolerance."
D)   "This medication must be given once a week until 37 weeks' gestation."

Question 8

Which are indications for early induction of labor?

Accepted Answer

A)   Abruptio placentae
B)   Active genital herpes infection
C)   Gestational hypertension
D)   Premature rupture of the membranes
E)   Umbilical cord prolapse

Question 9

A patient has received two doses of dinoprostone [Prepidil] to initiate labor. It has been 6 hours since the last dose. The nurse assesses the patient and notes that the cervix is ripe and dilated to 4 cm, but contractions are diminishing in intensity and frequency. What will the nurse expect to do?

Accepted Answer

A)   Administer oxytocin.
B)   Monitor urine output.
C)   Prepare for a cesarean section.
D)   Watch closely for fetal distress.

Question 10

Which drugs are useful for preventing preterm labor?

Accepted Answer

A)   Antibiotics
B)   Hydroxyprogesterone
C)   Indomethacin
D)   Magnesium sulfate
E)   Terbutaline

Question 11

A pregnant patient is 1 week post-term and will receive intravenous oxytocin. Which will the nurse evaluate before starting the infusion?

Accepted Answer

A)   Cervical ripening
B)   Fetal monitoring
C)   Renal function
D)   Respiratory function
E)   Uterine activity

Question 12

A patient is in preterm labor, and the prescriber orders magnesium sulfate for its neuroprotective effect on the fetus. The order calls for 4 gm given as an intravenous bolus over 20 minutes, followed by a maintenance infusion of 2 gm/hr. What will the nurse do?

Accepted Answer

A)   Administer the drug as ordered.
B)   Question the bolus amount.
C)   Question the bolus rate.
D)   Question the maintenance amount.

Exam 64: Drugs That Affect Uterine Function