Practice Question
The nurse reviews a clients lab result and notes a positive pregnancy test. Which medication would be important for the nurse to question the provider about? Use the chart exhibit to answer the question.
Answer Choices:
Correct Answer:
Lisinopril 20mg po every day at 0900
Rationale:
💊 Lisinopril is an ACE inhibitor, a drug class known to be teratogenic in pregnancy, especially in the second and third trimesters.
💊 ACE inhibitors can cause fetal renal dysgenesis, oligohydramnios, skull hypoplasia, and neonatal renal failure, which makes them contraindicated once pregnancy is identified.
💊 Because this client now has a positive pregnancy test, the nurse must question the provider about continuing lisinopril and anticipate a safer alternative antihypertensive (such as labetalol or nifedipine).
💊 Recognizing medications that can harm fetal development is a critical aspect of safe medication management in pregnancy and demonstrates appropriate advocacy for maternal–fetal safety.
❌ Azithromycin 250 mg PO daily
💊 Azithromycin is a macrolide antibiotic that is generally considered relatively safe in pregnancy when clearly indicated.
💊 It is often used to treat respiratory, skin, or certain sexually transmitted infections in pregnant clients when benefits outweigh risks.
💊 While all medications in pregnancy should be evaluated carefully, azithromycin does not carry the specific, well-documented teratogenic renal risks associated with ACE inhibitors.
💊 Therefore, this medication would not be the first one the nurse needs to question based solely on a positive pregnancy test.
❌ Ascorbic acid 75 mg PO every day at 0900
💊 Ascorbic acid is vitamin C, and 75 mg is a standard daily supplemental dose that is generally safe in pregnancy.
💊 Vitamin C plays a role in collagen formation, immune function, and tissue repair, all of which are useful during pregnancy.
💊 At this dose, there is no evidence of harm to the fetus, and it may even support maternal nutritional status.
💊 As a result, this prescription would not typically be questioned after a positive pregnancy test.
❌ Acetaminophen 325 mg PO for pain
💊 Acetaminophen is considered the preferred analgesic/antipyretic in pregnancy when used at recommended doses.
💊 It does not carry the same teratogenic or fetal renal toxicity risks as NSAIDs or ACE inhibitors.
💊 Short-term use for pain or fever is generally accepted as safe for both mother and fetus, although prolonged or high-dose use should still be monitored.
💊 Therefore, acetaminophen is not the priority medication to question in response to a new pregnancy finding.
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This question is from Exam 3 Modules 5 and 6 which contains 73 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: General Exams
- Domain: Medical-surgical📚
- Answer Choices: 4