, Silvestri: Saunders Comprehensive Review for the NCLEX- l8 l8 l8 l8 l8 l8
RN® Examination, 6th Edition l8 l8 l8
Pharmacology l8
Test Bank l8
MULTIPLE CHOICE l8
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that t
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
he client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication i
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
s prescribed for:
l8 l8
1. Pain relief l8
2. Increasing uterine contractions l8 l8
3. Decreasing uterine contractions l8 l8
4. Promoting fetal lung maturity l8 l8 l8
ANS: 1 l8l8
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for p
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and ―promoting fetal lun
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
g maturity‖ are not actions of this medication.
l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Re
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
member that this medication is used for pain relief. Review the action of this medication if you had diffic
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ulty with this question and are unfamiliar with this medication.
l8 l8 l8 l8 l8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ: Client Needs: Physiological Integrity l8 l8 l8
TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Planning
l 8 l8 l8 l8
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
administration following cesarean birth. If the client develops respiratory depression and requires
8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
naloxone (Narcan) as an antidote, the client may complain of which of the following?
8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
1. Increase in her pain level l8 l8 l8 l8
2. Decrease in her pain level l8 l8 l8 l8
3. Increase in the amount of itching from the opioid used in the epidural
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
4. Decrease in the amount of itching from the opioid used in the epidural
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
, ANS: 1 l8l8
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, wh
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ich reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
8Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid used in the ep
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
idural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖ are incorrect.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medica
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
tions used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote f
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
or an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question wa
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
s difficult.
l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ: Client Needs: Physiological Integrity l8 l8 l8
TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Assessment
l 8 l8 l8 l8
3. A client experiencing preterm labor at the twenty-
l8 l8 l8 l8 l8 l8 l8
ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betam
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ethasone (Celestone). The nurse understands that the medication will do which of the following?
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
1. Prevent spontaneous delivery. l8 l8
2. Stop the uterine contractions.l8 l8 l8
3. Promote maturation of the fetal lungs. l8 l8 l8 l8 l8
4. Accelerate the growth rate of the fetus. l8 l8 l8 l8 l8 l8
ANS: 3 l8l8
Rationale: Betamethasone (Celestone) is classified as an anti-
l8 l8 l8 l8 l8 l8 l8
inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which r
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
educes the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours aft
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
er administration of betamethasone to allow time for the lungs of the fetus to mature.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eli
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
minate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the strategic words ―tw
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
enty-
ninth week of gestation.‖ Specific knowledge about the medication and knowledge of the problems enco
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
untered by premature infants will assist in answering this question. Review the action of this medication
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
if this question was difficult.
8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal- l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
l8 l8 l8 l8 l8 l8 l8 l8 l8
, TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Planning
l 8 l8 l8 l8
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
which sign of magnesium toxicity?
l8 l8 l8 l8
1. Proteinuria
2. Hyperactive deep tendon reflexes l8 l8 l8
3. Respiratory rate of 10 breaths/min l8 l8 l8 l8
4. Serum magnesium level of 5 mEq/L l8 l8 l8 l8 l8
ANS: 3 l8l8
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of de
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood pressure.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can deve
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
lop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS d
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
epressant. Begin to answer this question by eliminating ―proteinuria‖ and ―hyperactive deep tendon refle
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
xes,‖ which are signs of preeclampsia. Select between the last two options using medication knowledge a
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
nd recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L. Review this medication a
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
nd the normal magnesium level if this question was difficult.
l8 l8 l8 l8 l8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Analyzing l8 l8 l8 l8
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby. l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ:
Client Needs: Physiological Integrity TOP: l8 l8 l8 l8
Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Assessment
l 8 l8 l8 l8
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
many weeks of gestation?
8 l8 l8 l8
1. 4
2. 14
3. 24
4. 34
ANS: 2 l8l8
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the medication. In
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
RN® Examination, 6th Edition l8 l8 l8
Pharmacology l8
Test Bank l8
MULTIPLE CHOICE l8
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that t
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
he client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication i
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
s prescribed for:
l8 l8
1. Pain relief l8
2. Increasing uterine contractions l8 l8
3. Decreasing uterine contractions l8 l8
4. Promoting fetal lung maturity l8 l8 l8
ANS: 1 l8l8
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for p
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and ―promoting fetal lun
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
g maturity‖ are not actions of this medication.
l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Re
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
member that this medication is used for pain relief. Review the action of this medication if you had diffic
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ulty with this question and are unfamiliar with this medication.
l8 l8 l8 l8 l8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ: Client Needs: Physiological Integrity l8 l8 l8
TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Planning
l 8 l8 l8 l8
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
administration following cesarean birth. If the client develops respiratory depression and requires
8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
naloxone (Narcan) as an antidote, the client may complain of which of the following?
8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
1. Increase in her pain level l8 l8 l8 l8
2. Decrease in her pain level l8 l8 l8 l8
3. Increase in the amount of itching from the opioid used in the epidural
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
4. Decrease in the amount of itching from the opioid used in the epidural
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
, ANS: 1 l8l8
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, wh
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ich reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
8Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid used in the ep
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
idural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖ are incorrect.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medica
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
tions used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote f
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
or an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question wa
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
s difficult.
l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ: Client Needs: Physiological Integrity l8 l8 l8
TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Assessment
l 8 l8 l8 l8
3. A client experiencing preterm labor at the twenty-
l8 l8 l8 l8 l8 l8 l8
ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betam
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ethasone (Celestone). The nurse understands that the medication will do which of the following?
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
1. Prevent spontaneous delivery. l8 l8
2. Stop the uterine contractions.l8 l8 l8
3. Promote maturation of the fetal lungs. l8 l8 l8 l8 l8
4. Accelerate the growth rate of the fetus. l8 l8 l8 l8 l8 l8
ANS: 3 l8l8
Rationale: Betamethasone (Celestone) is classified as an anti-
l8 l8 l8 l8 l8 l8 l8
inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which r
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
educes the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours aft
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
er administration of betamethasone to allow time for the lungs of the fetus to mature.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eli
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
minate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the strategic words ―tw
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
enty-
ninth week of gestation.‖ Specific knowledge about the medication and knowledge of the problems enco
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
untered by premature infants will assist in answering this question. Review the action of this medication
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
if this question was difficult.
8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Understanding l8 l8 l8 l8
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal- l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
l8 l8 l8 l8 l8 l8 l8 l8 l8
, TOP: Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Planning
l 8 l8 l8 l8
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
which sign of magnesium toxicity?
l8 l8 l8 l8
1. Proteinuria
2. Hyperactive deep tendon reflexes l8 l8 l8
3. Respiratory rate of 10 breaths/min l8 l8 l8 l8
4. Serum magnesium level of 5 mEq/L l8 l8 l8 l8 l8
ANS: 3 l8l8
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of de
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
ep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood pressure.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can deve
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
lop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
Test-
Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS d
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
epressant. Begin to answer this question by eliminating ―proteinuria‖ and ―hyperactive deep tendon refle
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
xes,‖ which are signs of preeclampsia. Select between the last two options using medication knowledge a
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
nd recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L. Review this medication a
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
nd the normal magnesium level if this question was difficult.
l8 l8 l8 l8 l8 l8 l8 l8 l8
PTS: 1
DIF: Level of Cognitive Ability: Analyzing l8 l8 l8 l8
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby. l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
OBJ:
Client Needs: Physiological Integrity TOP: l8 l8 l8 l8
Content Area: Pharmacology l8 l8
MSC: Integrated Process: Nursing Process—Assessment
l 8 l8 l8 l8
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l
many weeks of gestation?
8 l8 l8 l8
1. 4
2. 14
3. 24
4. 34
ANS: 2 l8l8
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the medication. In
l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8 l8
