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Exam (elaborations)

HESI maternal Latest update October 2024

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Atenolol is contraindicated in lactating women because it enters the breastmilk and may cause adverse effects to the neonate. Labetalol and propanolol are safe to administer during lactation. Metoprolol is considered a safe medication to be taken during lactation Which hormone levels do not requir...

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  • October 14, 2024
  • 27
  • 2024/2025
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HESI maternal Latest
update October 2024



Atenolol is contraindicated in lactating women because it enters the breastmilk and may cause adverse
effects to the neonate. Labetalol and propanolol are safe to administer during lactation. Metoprolol is
considered a safe medication to be taken during lactation



Which hormone levels do not require monitoring during the ministration of menotropins for infertility?

a. estrogen

b. luteinizing hormone

c. follicle-stimulating hormone

d. gonadotropin-releasing hormone - Answer--d. gonadotropin-releasing hormone



Menotropins that are administered for infertility act at the pituitary level. Gonadotropin-releasing
hormones act at the hypothalamus level; therefore this hormone does not need to be monitored.
Menotropins is a standardized mixture of follicle-stimulating hormone and luteinizing; these hormones
should be monitored. Also, estrogen levels need to be monitored because the luteinizing hormone
directly stimulates the production of estrogen

Which effect with the nurse identify as seen when the fetus is exposed to a teratogen during embryonic
period?

a. delay in growth

b. gross malformations

c. death of the conceptus

d. disruption of brain development - Answer--b. gross malformations

,Gross malformations occur if there is exposure to a teratogen during the embryonic period or the first
trimester. During the fetal period, exposure to a teratogen causes delays in growth and development of
the fetus. Death of the conceptus occurs if exposed to a lethal dose of teratogen during the pre-
implantation period. Exposure to a teratogen during the fetal period (second or third trimester) causes
disruption of brain development.



Which medication may be used to treat postpartum hemorrhage?

a. clomiphene

b. menotropins

c. dinoprostone

d. methylergonovine - Answer--d. methylergonovine



Methylergonovine is a medication of choice used to treat postpartum hemorrhage. Clomiphene and
menotropins are ovulation stimulants given to induce ovulation in infertile women. Dinoprostone is
used to induce cervical ripening and cause termination of a pregnancy.

Which medication would the nurse identify as a potential cause for the formation of abnormally small
eyes in the newborn if used during pregnancy?

a. estrogens

b. nitrofurantoin

c. methotrexate

d. valproic acid - Answer--b. nitrofurantoin



Nitrofurantoin, an antimicrobial medication, causes formation of abnormally small eyes in the newborn.
Sex hormone supplements, such as estrogens, may cause congenital defects of female reproductive
organs. Methotrexate can cause congenital abnormalities (central nervous system and limbs
malformations) and fetal death. Valproic acid is high teratogenic and cause neural tube defects, atrial
septal defect, cleft palate, hypospadias, polydactyly, and craniosynostosis.



The nurse understands which antihypertensive medication is contraindicated in lactating women?

, a. atenolol

b. labetalol

c. metoprolol

d. propranolol - Answer--a. atenolol

Which teratogenic effect is seen because of lithium?

a. stillbirth

b. shortened limbs

c. Ebstein anomaly

d. neural tube defects - Answer--c. Ebstein anomaly



Ebstein anomaly (cardiac defects) in the newborn occurs because of taking lithium during pregnancy.
Stillbirth may occur because of alcohol use. Shortened limbs may occur because of thalidomide. Neural
tube defects are due to anti seizure medications.



Which medication may cause malformations of the male external genitalia?

a. Etretinate

b. Dutasteride

c. Methimazole

d. Propylthiouracil - Answer--b. Dutasteride



Dutasteride is a 5-alpha-reductase inhibitor that causes malformations of external genitalia in males.
Etretinate is a vitamin A derivative that may cause multiple CNS defects. Methimazole and
propylthiouracil are antithyroid medications that may cause goiters and hypothyroidism.



A client in active labor who is 90% effaced, 7 cm dilated with a vertex presenting at 2+ station,
complains of pain and ask for medication. Which medication with the nurse anticipate causing
respiratory depression in the newborn?

a. Naloxone

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