CMA Medications & Pharmacology in Midwifery 1 — Questions and Answers
Question 1: Which medication is the first-line treatment for postpartum hemorrhage caused by uterine atony?
- Misoprostol
- Oxytocin (Pitocin) (Correct answer)
- Methylergonovine (Methergine)
- Carboprost (Hemabate)
Correct answer: Oxytocin (Pitocin)
Oxytocin administered IV or IM immediately after delivery of the placenta is the first-line uterotonic for preventing and treating uterine atony.
Question 2: Methylergonovine (Methergine) is contraindicated in patients with:
- Anemia
- Hypertension (Correct answer)
- Diabetes
- Hypothyroidism
Correct answer: Hypertension
Methergine causes vasoconstriction and is absolutely contraindicated in hypertensive patients due to the risk of severe blood pressure elevation.
Question 3: Vitamin K is administered to newborns shortly after birth to prevent:
- Neonatal jaundice
- Hemorrhagic disease of the newborn (VKDB) (Correct answer)
- Group B Strep infection
- Respiratory distress syndrome
Correct answer: Hemorrhagic disease of the newborn (VKDB)
Newborns have low vitamin K stores and immature gut flora; intramuscular vitamin K prevents vitamin K deficiency bleeding (VKDB).
Question 4: Which tocolytic medication works by blocking calcium channels to inhibit uterine contractions?
- Magnesium sulfate
- Nifedipine (Correct answer)
- Terbutaline
- Indomethacin
Correct answer: Nifedipine
Nifedipine, a calcium channel blocker, reduces uterine contractility by preventing calcium influx into myometrial cells.
Question 5: The recommended dose of folic acid supplementation to reduce neural tube defect risk in pregnancy is:
- 200 mcg/day
- 400 mcg/day (Correct answer)
- 800 mcg/day
- 1000 mcg/day
Correct answer: 400 mcg/day
The CDC recommends 400 mcg of folic acid daily beginning at least one month before conception and throughout the first trimester.
Question 6: Magnesium sulfate is used in obstetrics for which two indications?
- Labor induction and postpartum hemorrhage
- Seizure prophylaxis in preeclampsia and fetal neuroprotection in preterm birth (Correct answer)
- Cervical ripening and GBS prophylaxis
- Tocolysis only and neonatal resuscitation
Correct answer: Seizure prophylaxis in preeclampsia and fetal neuroprotection in preterm birth
Magnesium sulfate is used to prevent eclamptic seizures in preeclampsia and to provide fetal neuroprotection when preterm birth is imminent before 32 weeks.
CMA Medications & Pharmacology in Midwifery 1
Which medication is the first-line treatment for postpartum hemorrhage caused by uterine atony?