A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct?
“Clinical trials to assess this risk would put the fetus at risk.”
“The relatively new FDA study will allow testing of medications during pregnancy in the future.”
“Most women are reluctant to admit taking medications while they are pregnant.”
“It is safer to recommend that pregnant women avoid medications while pregnant.”
The Correct Answer is A
Choice A Reason:
Clinical trials to assess the teratogenic effects of medications during pregnancy are ethically challenging because they would involve exposing pregnant women and their fetuses to potential risks. The primary concern is the safety of the fetus, as many drugs can cross the placenta and potentially cause harm. Therefore, most of the data on teratogenic effects come from observational studies, case reports, and animal studies rather than controlled clinical trials.
Choice B Reason:
While the FDA has initiatives to improve the safety of medications during pregnancy, it is not accurate to say that a new study will allow testing of medications during pregnancy in the future. The ethical concerns surrounding the exposure of pregnant women to potential teratogens remain a significant barrier. Current efforts focus on improving post-marketing surveillance and encouraging the reporting of adverse effects to gather more data.
Choice C Reason:
Although some women may be reluctant to admit taking medications during pregnancy, this is not the primary reason for the lack of data on teratogenic effects. The main issue is the ethical and practical challenges of conducting clinical trials in pregnant women. Reluctance to report medication use can contribute to underreporting, but it is not the central factor.
Choice D Reason:
Recommending that pregnant women avoid medications is a general precaution, but it does not address the reason why more is not known about teratogenic effects. The avoidance of medications is advised to minimize potential risks, but the lack of data is primarily due to the ethical constraints of conducting clinical trials in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Administering the drug at intervals longer than the drug half-life is not typically recommended for medications with a narrow therapeutic range. These drugs require precise dosing to maintain therapeutic levels without reaching toxic levels. Extending the dosing interval could lead to subtherapeutic levels, reducing the drug’s effectiveness.
Choice B Reason:
Teaching the patient that maximum drug effects will occur within a short period is not specific to drugs with a narrow therapeutic range. While some medications may have rapid onset of action, the critical aspect of narrow therapeutic range drugs is maintaining consistent blood levels to avoid toxicity or subtherapeutic effects.
Choice C Reason:
Administering the medication intravenously is not a requirement for all drugs with a narrow therapeutic range. While IV administration can provide precise control over drug levels, many narrow therapeutic range drugs can be administered orally or through other routes. The key is monitoring and adjusting the dose based on blood levels.
Choice D Reason:
Ordering lab tests to check blood drug levels is essential for managing medications with a narrow therapeutic range. These drugs have a small margin between therapeutic and toxic doses, so regular monitoring of blood levels helps ensure the drug remains within the safe and effective range. This practice is known as therapeutic drug monitoring (TDM) and is crucial for drugs like warfarin, phenytoin, and digoxin.
Correct Answer is C
Explanation
Choice A Reason:
The sympathetic nervous system (SNS) is responsible for the “fight or flight” response, which prepares the body to respond to perceived threats. One of the primary effects of SNS activation is an increase in heart rate. This is achieved through the release of catecholamines like adrenaline, which stimulate the heart to pump more blood to vital organs and muscles.
Choice B Reason:
Another effect of SNS activation is an increase in blood glucose levels. This occurs because the body needs more energy to respond to stress. The SNS stimulates the liver to release glucose into the bloodstream, ensuring that muscles and other tissues have enough energy to function effectively during a stressful situation.
Choice C Reason:
The correct answer is that SNS activation does not increase GI motility and movement. In fact, it has the opposite effect. During a “fight or flight” response, the body prioritizes functions that are critical for immediate survival, such as increased heart rate and blood flow to muscles. As a result, non-essential functions like digestion are slowed down. The SNS decreases GI motility and movement to divert energy and blood flow to more critical areas.
Choice D Reason:
SNS activation also leads to an increase in blood pressure. This is achieved by constricting blood vessels and increasing the force of heart contractions. The purpose of this response is to ensure that enough blood and oxygen are delivered to essential organs and muscles during a stressful situation.
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