NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
Magnesium Sulfate -
correct answer ✅Central nervous system depressant, smooth
muscle relaxation, vasodilation
Given IVF over PUMP
Used for: Tocolytic - stop premature labor
Seizure prevention - preeclampsia/eclampsia
Antidote = calcium gluconate
Side effects: respiratory depression, pulmonary edema,
hypermagnesemia, depressed DTRs, muscle weakness, flushing,
hypotension, decreased UOP, cardiac arrest
Contraindications: heart block, kidney failure (must be able to
excrete the Mg to prevent toxicity!), myocardial damage
D/C 2hrs prior to delivery - may result in hypotonia/sleepiness in
newborn (sedative effect)
VS (esp RR) Q30-60mins, DTR hourly, UOP >25ml/hr minimum
Betamethasone (Dexamethasone) -
correct answer ✅Corticosteroids
Used for: fetal lung maturation/surfactant production (28-32 weeks
gestation)
,NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
IM injection x2 24 hours apart
Side effects - decreased immune response to infection, pulmonary
edema (retention of Na + H2O), elevated blood glucose
Hydromorphone hydrochloride (Dilaudid), meperidine
hydrochloride (Demerol), Fentanyl, sufentanil, butorphanol tartrate,
nalbuphine -
correct answer ✅Opioid analgesics
Used for: maternal pain control during labor
Route: IM, IV
Side effects: Respiratory suppression, nausea, vomiting, dizziness,
hypotension, urinary retention, sinusoidal-like fetal heart pattern,
fetal respiratory depression/sedation
Monitoring - VS, especially RR and BP. D/C 4 hrs prior to delivery to
prevent fetal sedation/resp depression. Monitor UOP for retention.
Have naloxone on hand for reversal!
Misoprostol, dinopronstone gel -
correct answer ✅Prostaglandins
Uses: cervical ripening, stimulate uterine contractions (decrease
risk of hemorrhage)
,NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
Route: vaginally (or rectally for miso)
Side effects: GI = n/v/d, cramps. Fever, chills, flushing, headache,
hypotension, uterine tachysystole, hyperstimulation of uterus, fetal
passage of meconium
Contraindications: active cardiac, liver or kidney disease, acute PID,
fetal malpresentation, expected c-section or hx of c/s,
nonreassuring fetal HRP, previa or unexplained vaginal bleeding,
maternal fever/infection
Monitor maternal vs and fetal HR, d/c when Bishop is 8+.
Oxytocin (pitocin) -
correct answer ✅Uterine stimulant
Uses: stimulate uterine contractions/induce labor, uterine
involution (tx of hemorrhage).
Route: IV or IM (post-partum)
Side effects: uterine hyperstimulation/tachysystole, hypotension,
uterine rupture
Monitor maternal VS Q15 mins (BP, HR, weight, I's&O's, LOC, lung
sounds), frequency/duration/strength of uterine contractions
Q15mins, fetal HR Q15 mins.
DO NOT LEAVE UNATTENDED WHILE RECEIVING OXYTOCIN
, NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
IF UTERIN HYPERSTIMULATION OCCURS OR NON-REASSURING FHR,
STOP INFUSION! turn client on side, turn up IV rate of NS or LR,
place oxygen mask on.
Nifedipine -
correct answer ✅Ca-channel blocker
Uses: tocolytic
relaxes smooth muscle by blocking calcium entry.
Side effects: tachycardia, hypotension, dizziness, headache,
flushing, fatigue, nausea, fetal hypotension
DO NOT USE WITH MAG SULFATE.
Methylergonovine -
correct answer ✅Post-partum hemorrhage management
Ergot alkaloid
Uses: tx of uterine atony or postpartum hemorrhage
Stimulates uterine muscle contractions, vasoconstriction of
arteries.
Exam Questions & Answers (Grade
A+)
Magnesium Sulfate -
correct answer ✅Central nervous system depressant, smooth
muscle relaxation, vasodilation
Given IVF over PUMP
Used for: Tocolytic - stop premature labor
Seizure prevention - preeclampsia/eclampsia
Antidote = calcium gluconate
Side effects: respiratory depression, pulmonary edema,
hypermagnesemia, depressed DTRs, muscle weakness, flushing,
hypotension, decreased UOP, cardiac arrest
Contraindications: heart block, kidney failure (must be able to
excrete the Mg to prevent toxicity!), myocardial damage
D/C 2hrs prior to delivery - may result in hypotonia/sleepiness in
newborn (sedative effect)
VS (esp RR) Q30-60mins, DTR hourly, UOP >25ml/hr minimum
Betamethasone (Dexamethasone) -
correct answer ✅Corticosteroids
Used for: fetal lung maturation/surfactant production (28-32 weeks
gestation)
,NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
IM injection x2 24 hours apart
Side effects - decreased immune response to infection, pulmonary
edema (retention of Na + H2O), elevated blood glucose
Hydromorphone hydrochloride (Dilaudid), meperidine
hydrochloride (Demerol), Fentanyl, sufentanil, butorphanol tartrate,
nalbuphine -
correct answer ✅Opioid analgesics
Used for: maternal pain control during labor
Route: IM, IV
Side effects: Respiratory suppression, nausea, vomiting, dizziness,
hypotension, urinary retention, sinusoidal-like fetal heart pattern,
fetal respiratory depression/sedation
Monitoring - VS, especially RR and BP. D/C 4 hrs prior to delivery to
prevent fetal sedation/resp depression. Monitor UOP for retention.
Have naloxone on hand for reversal!
Misoprostol, dinopronstone gel -
correct answer ✅Prostaglandins
Uses: cervical ripening, stimulate uterine contractions (decrease
risk of hemorrhage)
,NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
Route: vaginally (or rectally for miso)
Side effects: GI = n/v/d, cramps. Fever, chills, flushing, headache,
hypotension, uterine tachysystole, hyperstimulation of uterus, fetal
passage of meconium
Contraindications: active cardiac, liver or kidney disease, acute PID,
fetal malpresentation, expected c-section or hx of c/s,
nonreassuring fetal HRP, previa or unexplained vaginal bleeding,
maternal fever/infection
Monitor maternal vs and fetal HR, d/c when Bishop is 8+.
Oxytocin (pitocin) -
correct answer ✅Uterine stimulant
Uses: stimulate uterine contractions/induce labor, uterine
involution (tx of hemorrhage).
Route: IV or IM (post-partum)
Side effects: uterine hyperstimulation/tachysystole, hypotension,
uterine rupture
Monitor maternal VS Q15 mins (BP, HR, weight, I's&O's, LOC, lung
sounds), frequency/duration/strength of uterine contractions
Q15mins, fetal HR Q15 mins.
DO NOT LEAVE UNATTENDED WHILE RECEIVING OXYTOCIN
, NCLEX Pharmacology (Saunders)
Exam Questions & Answers (Grade
A+)
IF UTERIN HYPERSTIMULATION OCCURS OR NON-REASSURING FHR,
STOP INFUSION! turn client on side, turn up IV rate of NS or LR,
place oxygen mask on.
Nifedipine -
correct answer ✅Ca-channel blocker
Uses: tocolytic
relaxes smooth muscle by blocking calcium entry.
Side effects: tachycardia, hypotension, dizziness, headache,
flushing, fatigue, nausea, fetal hypotension
DO NOT USE WITH MAG SULFATE.
Methylergonovine -
correct answer ✅Post-partum hemorrhage management
Ergot alkaloid
Uses: tx of uterine atony or postpartum hemorrhage
Stimulates uterine muscle contractions, vasoconstriction of
arteries.
