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