1. The nurse is administering terbutaline to a patient in preterm
labor. Which assessment finding requires the nurse to hold the
medication and notify the provider?
A. Maternal heart rate of 115 bpm
B. Fetal heart rate of 150 bpm
C. Blood pressure of 110/70 mmHg
D. Respiratory rate of 18 breaths per minute
Correct Answer: A. Maternal heart rate of 115 bpm
Rationale: Terbutaline can cause maternal tachycardia as a side effect. A
heart rate >120 bpm is concerning and warrants holding the medication
and notifying the provider.
2. A patient at 31 weeks gestation is receiving indomethacin for
preterm labor suppression. The nurse knows this medication should
be used for no more than:
A. 12 hours
B. 24 hours
C. 2-3 days
D. 7 days
Correct Answer: C. 2-3 days
Rationale: Indomethacin is an NSAID that suppresses prostaglandins,
which can close the fetal ductus arteriosus prematurely if used for too
long. It is limited to ≤2-3 days in pregnancies <32 weeks to reduce fetal
complications.
3. Which medication is used for pregnancy-induced hypertension
and also acts as a tocolytic?
A. Oxytocin
B. Nifedipine
C. Misoprostol
D. Betamethasone
Correct Answer: B. Nifedipine
Rationale: Nifedipine (Procardia) is a calcium channel blocker that
relaxes uterine smooth muscle (tocolytic) and is also used to manage
pregnancy-induced hypertension by reducing blood pressure.
,4. The nurse is about to administer methylergonovine (Methergine)
to a postpartum patient experiencing heavy bleeding. Which
assessment finding requires the nurse to hold the medication?
A. Blood pressure of 162/98 mmHg
B. Hemoglobin of 10 g/dL
C. Fundus firm and midline
D. Pulse of 88 bpm
Correct Answer: A. Blood pressure of 162/98 mmHg
Rationale: Methylergonovine increases blood pressure and should not
be given to hypertensive patients due to the risk of hypertensive crisis or
stroke.
5. A nurse is preparing to administer carboprost (Hemabate) to a
postpartum patient with uterine atony. The nurse should question
the order if the patient has which condition?
A. Asthma
B. Gestational diabetes
C. Hypotension
D. Iron-deficiency anemia
Correct Answer: A. Asthma
Rationale: Carboprost (Hemabate) can cause bronchospasm, making
it contraindicated in asthma patients due to the risk of respiratory
distress.
6. A laboring patient is receiving oxytocin (Pitocin) to induce labor.
Which assessment finding requires immediate intervention?
A. Contractions occurring every 3 minutes
B. FHR decelerations after contractions
C. Cervical dilation progressing at 1 cm per hour
D. Maternal blood pressure of 110/70 mmHg
Correct Answer: B. FHR decelerations after contractions
Rationale: Late decelerations indicate uteroplacental insufficiency,
which may be caused by excessive uterine contractions (tachysystole)
, from oxytocin. The nurse should discontinue oxytocin, reposition the
patient, and provide oxygen.
7. A preterm labor patient is prescribed betamethasone. What is the
primary purpose of this medication?
A. Decrease uterine contractions
B. Enhance fetal lung maturity
C. Prevent maternal infection
D. Reduce maternal blood pressure
Correct Answer: B. Enhance fetal lung maturity
Rationale: Betamethasone is a glucocorticoid given IM in two doses,
24 hours apart to stimulate fetal surfactant production, improving
lung function in preterm infants.
8. The nurse is administering magnesium sulfate for preeclampsia.
Which assessment finding suggests magnesium toxicity?
A. Deep tendon reflexes +3
B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hr
D. Blood pressure of 140/90 mmHg
Correct Answer: B. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity causes CNS depression, leading to
respiratory depression (<12/min), absent DTRs, and decreased urine
output (<30 mL/hr). Calcium gluconate is the antidote.
9. A newborn is scheduled to receive erythromycin ophthalmic
ointment. What is the purpose of this medication?
A. Prevent neonatal blindness caused by gonorrhea
B. Reduce the risk of newborn sepsis
C. Promote eye lubrication
D. Prevent chlamydia transmission
Correct Answer: A. Prevent neonatal blindness caused by gonorrhea
Rationale: Erythromycin ophthalmic ointment is applied to newborn
labor. Which assessment finding requires the nurse to hold the
medication and notify the provider?
A. Maternal heart rate of 115 bpm
B. Fetal heart rate of 150 bpm
C. Blood pressure of 110/70 mmHg
D. Respiratory rate of 18 breaths per minute
Correct Answer: A. Maternal heart rate of 115 bpm
Rationale: Terbutaline can cause maternal tachycardia as a side effect. A
heart rate >120 bpm is concerning and warrants holding the medication
and notifying the provider.
2. A patient at 31 weeks gestation is receiving indomethacin for
preterm labor suppression. The nurse knows this medication should
be used for no more than:
A. 12 hours
B. 24 hours
C. 2-3 days
D. 7 days
Correct Answer: C. 2-3 days
Rationale: Indomethacin is an NSAID that suppresses prostaglandins,
which can close the fetal ductus arteriosus prematurely if used for too
long. It is limited to ≤2-3 days in pregnancies <32 weeks to reduce fetal
complications.
3. Which medication is used for pregnancy-induced hypertension
and also acts as a tocolytic?
A. Oxytocin
B. Nifedipine
C. Misoprostol
D. Betamethasone
Correct Answer: B. Nifedipine
Rationale: Nifedipine (Procardia) is a calcium channel blocker that
relaxes uterine smooth muscle (tocolytic) and is also used to manage
pregnancy-induced hypertension by reducing blood pressure.
,4. The nurse is about to administer methylergonovine (Methergine)
to a postpartum patient experiencing heavy bleeding. Which
assessment finding requires the nurse to hold the medication?
A. Blood pressure of 162/98 mmHg
B. Hemoglobin of 10 g/dL
C. Fundus firm and midline
D. Pulse of 88 bpm
Correct Answer: A. Blood pressure of 162/98 mmHg
Rationale: Methylergonovine increases blood pressure and should not
be given to hypertensive patients due to the risk of hypertensive crisis or
stroke.
5. A nurse is preparing to administer carboprost (Hemabate) to a
postpartum patient with uterine atony. The nurse should question
the order if the patient has which condition?
A. Asthma
B. Gestational diabetes
C. Hypotension
D. Iron-deficiency anemia
Correct Answer: A. Asthma
Rationale: Carboprost (Hemabate) can cause bronchospasm, making
it contraindicated in asthma patients due to the risk of respiratory
distress.
6. A laboring patient is receiving oxytocin (Pitocin) to induce labor.
Which assessment finding requires immediate intervention?
A. Contractions occurring every 3 minutes
B. FHR decelerations after contractions
C. Cervical dilation progressing at 1 cm per hour
D. Maternal blood pressure of 110/70 mmHg
Correct Answer: B. FHR decelerations after contractions
Rationale: Late decelerations indicate uteroplacental insufficiency,
which may be caused by excessive uterine contractions (tachysystole)
, from oxytocin. The nurse should discontinue oxytocin, reposition the
patient, and provide oxygen.
7. A preterm labor patient is prescribed betamethasone. What is the
primary purpose of this medication?
A. Decrease uterine contractions
B. Enhance fetal lung maturity
C. Prevent maternal infection
D. Reduce maternal blood pressure
Correct Answer: B. Enhance fetal lung maturity
Rationale: Betamethasone is a glucocorticoid given IM in two doses,
24 hours apart to stimulate fetal surfactant production, improving
lung function in preterm infants.
8. The nurse is administering magnesium sulfate for preeclampsia.
Which assessment finding suggests magnesium toxicity?
A. Deep tendon reflexes +3
B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hr
D. Blood pressure of 140/90 mmHg
Correct Answer: B. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity causes CNS depression, leading to
respiratory depression (<12/min), absent DTRs, and decreased urine
output (<30 mL/hr). Calcium gluconate is the antidote.
9. A newborn is scheduled to receive erythromycin ophthalmic
ointment. What is the purpose of this medication?
A. Prevent neonatal blindness caused by gonorrhea
B. Reduce the risk of newborn sepsis
C. Promote eye lubrication
D. Prevent chlamydia transmission
Correct Answer: A. Prevent neonatal blindness caused by gonorrhea
Rationale: Erythromycin ophthalmic ointment is applied to newborn
