NCLEX Maternity Pharmacology Study Guide 2025/2026 – 100 Verified Questions and Answers with Rationales

This expertly curated maternity pharmacology guide features 100 of the most essential and up-to-date NCLEX-style questions and answers for the 2025/2026 exam cycle. Each question includes accurate answers and rationales focused on critical medications used in maternal and newborn care. Covering drug indications, contraindications, side effects, nursing interventions, and antidotes, this resource is a must-have for nursing students preparing for exams or clinical practice. Topics include: RhoGAM, Tocolytics, Magnesium Sulfate Opioids, Oxytocin, Ergot Alkaloids Corticosteroids like Betamethasone Newborn medications (Vitamin K, Hepatitis B, Eye Prophylaxis) Emergency pharmacologic interventions during labor & delivery Perfect for students aiming to pass the NCLEX-RN, NCLEX-PN, ATI, or HESI with confidence and deepen their understanding of high-risk obstetric pharmacology. example;;Rho GAM - Answer Prevention of anti RhoD antibody formation. Most successful if given at 28 weeks and 72 hours after delivery. To prevent isoimmunization in Rh neg clients who are exposed to Rh pos RBC in their baby Contraindications of RhoGAM - Answer Contraindicated for Rh positive clients Not given to newborns Tocolytics - Answer Medications that produce uterine relaxation and suppress uterine activity in an attempt to halt uterine contractions and prevent preterm birth Maternal CI of Tocolytics - Answer Severe preeclampsia Eclampsia Bleeding Tocolytics Classes - Answer Prostaglandin inhibitors = relax smooth muscle, indomethacin (Indocin) Mg sulfate = CNS depressant Ca Channel blocker = relax smooth muscle by blocking calcium entry, Nifedipine (Procardia, Adalat, Nifedical) B2 selective adrenergic agonist = relax smooth muscle by causing bronchodilation, terbutaline (Brethine) Mg Sulfate - Answer CNS depressant and anticonvulsant Causes smooth muscle relaxation Stops preterm labor to prevent preterm birth Prevent and control seizures in preeclamptic and eclamptic clients Antidote to Mg Sulfate - Answer Ca Gluconate Adverse Reactions to Mg Sulfate - Answer Can cause resp depression, depressed reflexes, flushing, hypotension, extreme muscle weakness, dec urine output, pulmonary edema, and elevated serum Mg levels Cont. infusion can cause mg toxicity in newborn Interventions for Mg Sulfate - Answer Monitor VS especially resp Monitor Mg levels Give via infusion pump Keep Ca gluconate on hand Check reflexes hourly (see if depressed) Patellar reflex and resp rate 16 before giving another IV dose Betamethasone and Dexamethasone - Answer Corticosteroids that inc production of surfactant to accelerate fetal lung maturity and reduce the incidence or severity of RDS For client in preterm labor 28 - 32 weeks whose labor can be inhibited for 48 hours without jeopardizing Opioid Analgesics - Answer Used to relieve moderate to severe pain associated with labor Administered IM or IV Regular use during pregnancy may produce withdrawal symptoms in fetus Antidote for Opioids - Answer Naloxone (Narcan) - rapidly reverses opioid toxicity, most preferred Nalmefene (Revex) - long acting opioid antagonist that does not require repeat doses Examples of Opioids - Answer Meperidine hydrochloride (Demerol) hydromorphone hydrochloride (Dilaudid) Fentanyl (Sublimaze) sufentanil (Sufenta) Butorphanol tartrate (Stadol) nalbuphine (Nubain) Prostaglandins - Answer Ripen cervix making it softer causing it to begin to dilate and efface, stimulate uterine contractions. Administered vaginally. Induces labor! Have client void before admin and then have her maintain a supine with lateral tilt or side lying position for 30 to 60 minutes (gel) or up to 2 hours (insert) after admin Treatment discontinued when bishop score is 8 or more or effective contraction pattern established Example of Prostaglandins - Answer Dinoprostone (Cervidil vaginal insert, Prepidil gel) Uterine Stimulants - Oxytocin (Pitocin) - Answer Stimulates smooth muscle of uterus and inc force, frequency and duration of contractions For induction of labor, controls postpartum bleeding, facilitates breastfeeding, manages incomplete abortion Adverse reactions - Answer Can produce uterine hypertonicity, high doses can cause hypotension Postpartum hemorrhage Shouldn't be used for client who can't deliver vaginally Interventions - Answer Piggybacked at port nearest point of venous insertion Give O2 if prescribed If hypertonic contractions, stop infusion, turn client on side, inc flow rate of IV, give O2 8 - 10 L, assess vital signs, FHR Ergot alkaloids - Answer Directly stimulating uterine muscle, inc force and frequency of contractions and produce a firm tetanic contraction of uterus Not administered before delivery of placenta! Used to control postpartum hemorrhage and postabortal hemorrhage from atony or involution Can produce arterial vasoconstriction and vasospasm of coronary arteries so important to assess circulation Examples of Ergot alkaloids - Answer methylergonovine maleate (Methergine)