Which of the following medications is not categorized as a tocolytic?
Oxytocin (Pitocin)
Magnesium Sulfate
Nifedipine (Procardia)
Indomethacin (Indocin)
The Correct Answer is A
Choice A rationale:
Oxytocin is a hormone that stimulates uterine contractions. It is not a tocolytic, which is a medication that inhibits uterine contractions. In fact, oxytocin is often used to induce labor or to augment labor that is progressing slowly.
It acts on the myofibrils in the uterine muscle, causing them to contract more forcefully and frequently. This leads to cervical dilation and effacement, and ultimately to the birth of the baby.
Oxytocin is typically administered as an intravenous (IV) infusion. The dosage is carefully titrated to achieve the desired effect on the uterus.
It is important to note that oxytocin can have serious side effects, including uterine hyperstimulation, fetal distress, and postpartum hemorrhage. Therefore, it should only be used under the close supervision of a healthcare provider.
Choice B rationale:
Magnesium sulfate is a tocolytic that is often used to prevent preterm labor. It works by relaxing the smooth muscle of the uterus.
It is typically administered as an IV infusion. The dosage is carefully monitored to ensure that the magnesium level in the blood does not become too high.
Side effects of magnesium sulfate can include flushing, nausea, vomiting, and headache. In rare cases, it can also cause serious complications such as respiratory depression and cardiac arrest.
Choice C rationale:
Nifedipine is a calcium channel blocker that is sometimes used as a tocolytic. It works by relaxing the smooth muscle of the uterus and blood vessels.
It is typically administered as an oral tablet. Side effects of nifedipine can include headache, dizziness, flushing, and low blood pressure.
Choice D rationale:
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is sometimes used as a tocolytic. It works by inhibiting the production of prostaglandins, which are substances that promote uterine contractions.
It is typically administered as an oral tablet or suppository. Side effects of indomethacin can include nausea, vomiting, heartburn, and diarrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:
Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.
Correct Answer is B
Explanation
Choice A rationale:
Increasing the amiodarone infusion rate would worsen the patient's bradycardia and hypotension. Amiodarone is a class III antiarrhythmic drug that works by prolonging the action potential duration in cardiac cells. This can lead to a decrease in heart rate and contractility.
Increasing the dose in this patient could lead to further hemodynamic compromise.
Choice B rationale:
Decreasing the amiodarone infusion rate is the most appropriate action in this situation. This will help to mitigate the drug's effects on the patient's heart rate and blood pressure.
A dose reduction may allow the heart rate to recover to a safer level while still maintaining the antiarrhythmic benefits of amiodarone.
Choice C rationale:
Continuing the amiodarone infusion at the current rate is not appropriate, as it is likely to worsen the patient's bradycardia and hypotension.
Maintaining the current dose could lead to further clinical deterioration.
Choice D rationale:
Discontinuing the amiodarone infusion entirely may not be necessary at this point. The patient's arrhythmia may still require treatment with amiodarone.
A dose reduction may be sufficient to address the patient's hemodynamic instability while still providing therapeutic benefits.
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