HESI Maternity/Pediatric Remediation Exam - Questions, Answers and Rationales An Rh-negative client has a spontaneous abortion at the end of the second
... [Show More] trimester and is prescribed Rho(D) immune globulin. The client asks the nurse, "Why do I need this medication?" Which information would the nurse consider before answering the client's question? A. It will expand the woman's antibody pool. B. It will prevent the woman from producing antibodies. C. The woman's production of immune bodies will be accelerated. D. The activity of the mother's Rh-negative antibodies will be suppressed. Rho(D) immune globulin attacks fetal red cells that have gained access to the maternal bloodstream at the time of birth; it prevents antibody formation. Antibody formation is undesirable; it sensitizes the woman and contributes to fetal red cell destruction in future pregnancies. There is no production of immune bodies. Rho(D) immune globulin prevents the woman's immune system from responding to the fetal Rh-positive blood. Which medications would the nurse identify as being used to induce labor in pregnant clients? Select all that apply. One, some, or all responses may be correct. A. Oxytocin B. Ergonovine C. Carboprost D. Misoprostol E. Dinoprostol Oxytocin is an oxytocic that triggers or augments uterine contractions; it is used for labor induction. Misoprostol is a prostaglandin used for cervical ripening and labor induction. Dinoprostone is used for cervical ripening to induce labor. Ergonovine is an oxytocic used for postpartum or postabortion hemorrhage. Carboprost is a prostaglandin used to treat postpartum hemorrhage. The nurse identifies which medication as impairing fertility when administered along with fertility medications? A. Clomiphene B. Menotropins C. Promethazine D. Choriogonadotropin When taken with fertility medications, promethazine increases prolactin concentration, which may impair fertility. Clomiphene and menotropins are ovulation stimulants given to induce ovulation in infertile women. Choriogonadotropin alfa is a recombinant form of human gonadotropin hormone; this medication is an ovulation stimulant. In which week of gestation would the nurse anticipate administering Rho(D) immune globulin to an Rh-negative client? A. 12 weeks B. 28 weeks C. 36 weeks D. 40 weeks Rho(D) immune globulin (RhoGAM) administered during the 28th week of gestation reduces an active antibody response in an Rh-negative individual exposed to Rh-positive blood. It is difficult to determine whether Rh sensitization has occurred at 12 weeks in pregnancy. RhoGAM is given earlier than 36 weeks in the pregnancy; it is a preventive measure, not a treatment for a woman who is already sensitized. Forty weeks is around the time of birth; if the client has not been sensitized, she will receive RhoGAM within 72 hours of birth. The nurse identifies which antimicrobial medications as safe during breast-feeding? A. Penicillins B. Macrolides C. Tetracycline D. Cephlasporins E. Chloramphenicol Penicillins, macrolides, and cephalosporins are considered safe medications during breast-feeding as they are least likely to affect the infant. Tetracycline and chloramphenicol should be avoided during breast-feeding. A medication is administered to a client in her third trimester of pregnancy. Which statement regarding the medication administration is correct? A. The dose of medication should be increased for pregnant clients B. No medication should be administered to the pregnant client C. Medication dosages should not be altered for a pregnant client D. Medication dosage may need to be decreased for pregnant clients During pregnancy, a client's hepatic metabolism and glomerular filtration are increased. As a result, the excretion rate is faster. The dose of a medication should be increased for the medication action to be optimal. It is true that some medications should not be given to the pregnant client, because of potential teratogenic effects on the fetus. The client should see her health care provider if in doubt. The dose of a medication should be altered for a pregnant client depending on the trimester she is in. How a medication affects the fetus depends on the stage of development of the fetus and the dosage and strength of the medication administered. During the first 3 to 8 weeks after fertilization, the major organs are developing, and the dose of a medication should be decreased or withdrawn for pregnant clients. The nurse understands which medication taken by a pregnant woman may show a delayed teratogenic effect in the offspring? A. Aspirin B. Heparin C. Ethyl alcohol D. Diethylstilbestrol Diethylstilbestrol may cause vaginal cancer in a female child 18 or more years after birth. Aspirin suppresses contractions during labor and may cause bleeding in the mother. Heparin does not cause fetal harm but may cause osteoporosis in the mother. Ethyl alcohol causes drug dependence or alcohol withdrawal syndrome in neonates. A client is taking fertility medications for the first time. Which adverse effect of the medication would the nurse inform the client about? A. Vaginitis B. Constipation C. Joint swelling D. Deep vein thrombosis Constipation is seen in the clients who are treated with fertility medications for the first time. Fertility medications do not cause vaginitis or swelling of joints. Deep vein thrombosis is an adverse effect of prolonged use of fertility medications. The nurse instills an antibiotic ophthalmic ointment into a newborn's eyes. The nurse would explain to the mother that the medication prevents which condition? A. Ophthalmia neonatorum B. Herpetic ophthalmia C. Retinopathy of prematurity D. Hemorrhagic conjunctivitis Ophthalmia neonatorum is caused by gonorrheal and/or chlamydial infections present in the vaginal tract. It is preventable with the prophylactic use of an antibiotic ophthalmic ointment applied to the neonate's eyes. Herpes affects the neonate systemically. Retinopathy of prematurity (formerly retrolental fibroplasia) occurs as a result of prolonged exposure to a too-high oxygen concentration. Hemorrhagic conjunctivitis is usually caused by rapid expulsion of the fetus's head from the vagina. Which medication may cause photophobia as an adverse effect? [Show Less]