Neonatal Intensive Care Nurse Exam Neonatal Pharmacology 1 — Questions and Answers
Question 1: When administering gentamicin to a neonate, the nurse should monitor which laboratory value most closely?
- Serum creatinine and BUN (Correct answer)
- Serum glucose
- Bilirubin level
- Platelet count
Correct answer: Serum creatinine and BUN
Gentamicin is nephrotoxic and ototoxic; serum creatinine and BUN must be monitored to detect aminoglycoside-induced renal injury.
Question 2: Indomethacin is used in the NICU to treat which condition?
- Patent ductus arteriosus (Correct answer)
- Neonatal seizures
- Hyperglycemia
- Hyperbilirubinemia
Correct answer: Patent ductus arteriosus
Indomethacin is a COX inhibitor that promotes ductal closure by blocking prostaglandin synthesis, which keeps the PDA open.
Question 3: A neonate receives phenobarbital for seizures. Which side effect requires close monitoring?
- Respiratory depression and sedation (Correct answer)
- Hypertension
- Hyperglycemia
- Thrombocytopenia
Correct answer: Respiratory depression and sedation
Phenobarbital causes CNS and respiratory depression, requiring continuous monitoring of respiratory rate and oxygen saturation.
Question 4: Which route of administration is preferred for emergency medications in neonates when IV access is unavailable?
- Intraosseous (IO) (Correct answer)
- Intramuscular
- Subcutaneous
- Oral
Correct answer: Intraosseous (IO)
Intraosseous access provides rapid vascular access for emergency drug administration when IV access cannot be quickly established.
Question 5: Vitamin K is administered to all newborns at birth to prevent:
- Hemorrhagic disease of the newborn (Correct answer)
- Neonatal jaundice
- Group B Streptococcus infection
- Transient tachypnea
Correct answer: Hemorrhagic disease of the newborn
Neonates have low vitamin K stores and immature gut flora, placing them at risk for vitamin K deficiency bleeding (VKDB).
Question 6: The nurse is preparing to administer IV vancomycin to a 28-week neonate. The most important pre-administration assessment is:
- Renal function (serum creatinine) and trough level (Correct answer)
- Blood pressure
- Temperature
- Fontanelle assessment
Correct answer: Renal function (serum creatinine) and trough level
Vancomycin is renally cleared and nephrotoxic; trough levels guide dosing intervals and prevent toxicity in preterm neonates.
Neonatal Intensive Care Nurse Exam Neonatal Pharmacology 1
When administering gentamicin to a neonate, the nurse should monitor which laboratory value most closely?