Neonatal Intensive Care Pharm Test 50 Questions with Verified Answers
A mother with mild pregnancy induced hypertension in preterm labor got IV mag
... [Show More] sulfate two days prior to giving birth. She delivered at 31 week female with no apparent distress. It is important to monitor her for:
a. hyperglycemia
b. hypotonia
c. hypocalcemia - CORRECT ANSWER b. hypotonia
NICU is called to a delivery of a 24 weeker with evidence of abruption. the baby presents with cyanosis and no respiratory effort. After intubation, PPV and chest compressions, the baby's heart rate is <60. What intervention is next
a. Na Bicarb
b. Atropine
c. Epinephrine - CORRECT ANSWER c. epinephrine
In light of the abruption in the above patient, what other resuscitative measures might the provider consider
a. 10 ml/kg normal saline bolus
b. Ca gluconate 200mg bolus
c. 2 ml/kg D10W - CORRECT ANSWER a. 10 ml/kg normal saline bolus
A 24 weeker is being admitted into the NICU. His exam shows that the eyes are fused. Erythromycin ointment is ordered. How do you handle this?
a. give it when the babys eyes are able to open
b. force the eyes open to administer
c. apply ointment to fused junctures - CORRECT ANSWER c. apply ointment over fused
eye prophylaxis with a single use dose of sterile ophthalmic ointment containing 0.5% erythromycin is usually administered to prevent which of the following conditions?
a. congenital herpetic ophthalmia
b. human immuno ophthalmia
c. gonococcal ophthalmia neonatorum - CORRECT ANSWER c. gonococcal ophthalmia neonatorum
a drug used to treat apnea is the preterm infant is:
a. indocin
b. surfactant
c. caffeine - CORRECT ANSWER c. caffeine
you're caring for an infant with apnea on caffeine. you assess the patient and notice a HR of 190 while the infant is in a quiet sleep state. What should you do?
a. give the caffeine as ordered
b. sub aminophylline for the caffeine
c. hold the dose for resting HR >180 and notify MD - CORRECT ANSWER c. hold the dose for resting HR >180 and notify MD
at what age do you anticipate caffeine will be discontinued?
a. by 44 weeks, caffeine has diminished effect
b. by 34 weeks, most infants outgrow apnea of prematurity
c. at one year of age - CORRECT ANSWER b. by 34 weeks, most infants outgrow apnea of prematurity
surfactant is a treatment for respiratory distress syndrome because it:
a. sedates the infant
b. keeps alveoli open
c. decreases lung expansion - CORRECT ANSWER b. keeps alveoli open
after the neonate received surfactant, the nurse should observe for which of the following conditions?
a. hypertension
b. seizures
c. need for a decrease in vent support - CORRECT ANSWER c. need for a decrease in vent support
many infants with the diagnosis of PPHN will have pharmacologic support. Identify the medication that is a direct-acting vasodilator and acts by relaxing pulmonary vessel muscles
a. nitric oxide
b. dopamine
c. dobutamine - CORRECT ANSWER a. nitric oxide
the most significant role is surfactant in neonatal lung development is to:
a. decrease risk of pulmonary infection
b. maintain alveolar stability in decreasing surface tension
c. prevent alveolar lipid adhesion and surface film formation - CORRECT ANSWER bmaintain alveolar stability in decreasing surface tension
your patient has been difficult to wean off the ventilator. the nicu team and family meet to discuss the use of steroids. why is the team being cautious with dexamethasone?
a. increased susceptibility to infection
b. growth restriction and long term developmental implications
c. all of the above - CORRECT ANSWER c. all of the above
the best medication to ensure continued patency of the ductus arteriosus in the neonate is:
a. ibuprofen
b. indomethacin
c. prostaglandin E1 - CORRECT ANSWER c. prostaglandin E1
the least effective management strategy for treatment if chf in the preterm neonate is:
a. digoxin therapy
b. diuretic therapy
c. fluid restriction - CORRECT ANSWER a. digoxin therapy
Indomethacin use would be contraindicated in all of the following situations except:
a. platelet count of 45,000
b. urine output of 0.5-1 ml/kg/hr
c. infant with neurological deficit - CORRECT ANSWER c. infant with neurological deficit
in a symptomatic bradycardia, which of the following could be used to increase the heart rate?
a. inderal
b. digoxin
c. atropine - CORRECT ANSWER c. atropine
your patient is in SVT. the provider orders adenosine. what must the team take in to consideration when preparing and administering adenosine?
a. effective for atrial flutter as well as SVT
b. administered over one hour via syringe pump
c. may momentarily lose heart rate (asystole) after rapid IV push - CORRECT ANSWER c. may momentarily lose heart rate (asystole) after rapid IV push
a 2 day old preterm infant who has group b strep sepsis is presenting with symptoms of shock. his urinary output has dropped to less than 1 ml/kg/hr over the last shift. Which dopamine protocol will improve his symptoms?
a. dopa 5mcg/kg/min
b. dopa 10mcg/kg/min
c. dopa 20mcg/kg/min - CORRECT ANSWER b. dopa 10mcg/kg/min
depending on the amount of weight loss, electrolyte values, and markers of renal function, fluid is usually administered in the first 48 hours of like?
a. 40-60 ml/kg/day
b. 70-80 ml/kg/day
c. 100-120 ml/kg/day - CORRECT ANSWER c. 100-120 ml/kg/day
special care should be exercised when administering iv dopamine because:
a. infiltration leads to tissue necrosis
b. high doses may lead to profound bradycardia
c. precipitation may occur when used in dextrose solution - CORRECT ANSWER a. infiltration leads to tissue necrosis
full term infant admitted with hypoglycemia is requiring increase in glucose infusion rate. this can be accomplished by:
a. increasing iv rate
b. increasing the percent of glucose in the solution
c. both a & b - CORRECT ANSWER c. both a & b
when caring for a newborn on an insulin infusion, the glucose levels should be monitored how often during initial titration of the drip?
a. q 5 minutes
b. q 10 minutes
c. q 15 minutes - CORRECT ANSWER c. q 15 minutes
vitamin K is essential for activating which clotting factors?
a. I, II, III, and IV
b. II, VII, IX, and X
c. V, VIII, and X - CORRECT ANSWER b. II, VII, IX, and X
IV gent should be given over:
a. 1 hour
b. 30 mins
c. 10 mins - CORRECT ANSWER b. 30 mins
a trough level is ordered before the 3rd dose of gent and the dose is withheld pending the results. why?
a. at high levels, gent is associated with nephro and oto toxicity
b. efficacy is assured at any dose range
c. at high levels, gent is associated with thrombocytopenia - CORRECT ANSWER a. at high levels, gent is associated with nephro and oto toxicity
which of the following medication orders for a 27 week gestation 1kg infant would you require that the nurse question the provider regarding the dosage?
a. gent 5mg/kg IV q48 hours
b. gent 4mg/kg IV q24 hours
c. amp 100mg/kg IV q12 hours - CORRECT ANSWER b. gent 4mg/kg IV q24 hours
Your patient has a picc and is suspected of having an infection. How should the antibiotics be administered?
a. antibiotics can and should be given through picc until culture results are available
b. picc should be pulled and piv should be placed
c. antibiotics should be given po - CORRECT ANSWER a. antibiotics can and should be given through picc until culture results are available
what is the lowest efficacious concentration of heparin identified in the literature to maintain patency of central lines?
a. 10 units/ml
b. 1 unit/ml
c. 0.5 units/ml - CORRECT ANSWER c. 0.5 units/ml
a low birth weight infant is getting gent. which blood value should you pay attention to?
a. hgb
b. bun
c. blood sugars - CORRECT ANSWER b. bun
the initial antibiotics choice for infants with suspected meningitis:
a. amp and 3rd gen cephalosporin
b. amp and fluoroquinolone
c. high dose amp alone - CORRECT ANSWER a. amp and 3rd gen cephalosporin
your patient is receiving amphotericin-b. all statements are true except:
a. drug thats given fast over 15-20 minutes
b. often used as antifungal
c. IV solution needs to be protected from light - CORRECT ANSWER a. drug thats given fast over 15-20 minutes
which of the following treatments may be used to decrease exchange transfusion in the newborn in extreme hyperbilirubinemia
a. fresh frozen plasma
b. IVIG
c. phenobarbital - CORRECT ANSWER b. IVIG
which of the following doses of dopamine are most effective in treating a newborn with decreased renal perfusion
a. 2-5 mcg/kg/min
b. 5-10 mcg/kg/min
c. 10-20 mcg/kg/min - CORRECT ANSWER b. 5-10 mcg/kg/min
which of the following meds is commonly used to decrease gastric acid and inflammation in neonates with gerd
a. maalox
b. metoclopramide
c. omeprazole - CORRECT ANSWER c. omeprazole
initial pharmacological management of seizure disorder in infant:
a. dilantin load 30mg/kg IV over 15-30 mins
b. phenobarb load 20mg/kg IV over 10-15 mins
c. tegretol load 50mg/kg IV over 15-30 mins - CORRECT ANSWER b. phenobarb load 20mg/kg IV over 10-15 mins
when phenobarb is administered to treat major seizure disorder, the nurse should be ready to:
a. administer vitamin K
b. initiate bag and mask ventilation
c. support infusion - CORRECT ANSWER b. initiate bag and mask ventilation
which of the following protocols is used to treat a dobutamine extravasation?
a. admin 3 subq injections of hyaluronidase within 3 hours
b. admin 3 subq injections of phentolamine within 3 hours
c. admin 5 subq injections of phentolamine within 1 hour - CORRECT ANSWER c. admin 5 subq injections of phentolamine within 1 hour
if the neonate is symptomatic with a plasma glucose value of <40mg/dl and is not tolerating feeds, the nurse should request
a. IV bolus of 2ml/kg d10w and cont d10 at 80ml/kg/day
b. IV bolus of 2ml/kg d10w and cont d10 at 120ml/kg/day
c. IV bolus of 5ml/kg d10w and cont d10 at 80ml/kg/day - CORRECT ANSWER a. IV bolus of 2ml/kg d10w and cont d10 at 80ml/kg/day
most significant risk factor for opioid withdrawal?
a. choice of narcotic used
b. overall dose administered
c. route of admin - CORRECT ANSWER b. overall dose administered
babies born to mothers who use crack cocaine:
a. usually lethargic
b. fairly easy to comfort
c. exhibit hyper-irritability - CORRECT ANSWER c. exhibit hyper-irritability
baby with NAS is on methadone PO q6. the frequency is being changed q12 hours. what is the nurses responsibility?
a. hide dosage change from the mother
b. to save the excess methadone and keep it at the bedside for breakthrough
c. monitor abstinence scores in order to confirm if new dosing regimen is capturing withdrawal symptoms - CORRECT ANSWER c. monitor abstinence scores in order to confirm if new dosing regimen is capturing withdrawal symptoms
topical anesthetics are approved for use in newborn greater than
a. 32 weeks
b. 37 weeks
c. 40 weeks - CORRECT ANSWER c. 40 weeks
which of the following opioids cause less histamine release and may be more appropriate for newborns with hypovolemia or hemodynamic instability?
a. acetaminophen
b. fentanyl
c. morphine - CORRECT ANSWER b. fentanyl
what is the appropriate pain management strategy for a baby with a chest tube?
a. medicate if npass >3
b. around the clock analgesia
c. minimize analgesics to prevent development of tolerance - CORRECT ANSWER a. medicate if npass >3
extravasation injury is more common when IV solutions containing ___________ are infusing
a. calcium
b. magnesium
c. potassium - CORRECT ANSWER c. potassium
how many micrograms are in one milligram?
a. 10
b. 100
c. 1000 - CORRECT ANSWER c. 1000
which medication, when given as a bolus too rapidly, has the potential to cause chest wall rigidity?
a. fentanyl
b. phenobarb
c. versed - CORRECT ANSWER a. fentanyl
an infant is being treated for symptoms of withdrawal due to maternal narcotic use. he is receiving 0.15mg morphine PO q4. how much medication is drawn up from a unit dose container with the concentration of 10 mg per 5 ml?
a. 0.075 ml
b. 0.3 ml
c. 0.75 ml - CORRECT ANSWER a. 0.075 ml
the preferred site for IM injections in the neonate is:
a. thigh
b. butt
c. arm - CORRECT ANSWER a. thigh [Show Less]