, Silvestri: Saunders Comprehensive Review for the NCLEX-
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RN® Examination, 6th Edition
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Pharmacology w#
Test Bank w#
MULTIPLE CHOICE w#
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
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that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
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medication is prescribed for: w# w# w#
1. Pain relief w#
2. Increasing uterine contractions w# w#
3. Decreasing uterine contractions w# w#
4. Promoting fetal lung maturity w# w# w#
ANS: w#w# 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up t
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o 2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be pre
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scribed for pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “pro
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moting fetal lung maturity” are not actions of this medication.
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Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this questio
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n. Remember that this medication is used for pain relief. Review the action of this medication if yo
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u had difficulty with this question and are unfamiliar with this medication.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding w# w# w# w#
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saund
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ers. OBJ: w# Client Needs: Physiological Integrity w# w# w#
TOP: Content Area: Pharmacology w# w#
MSC: Integrated Process: Nursing Process—Planning
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2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid ana
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lgesic administration following cesarean birth. If the client develops respiratory depression an
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d requires naloxone (Narcan) as an antidote, the client may complain of which of the follo
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wing?
1. Increase in her pain level w# w# w# w#
2. Decrease in her pain level w# w# w# w#
3. Increase in the amount of itching from the opioid used in the epidural
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4. Decrease in the amount of itching from the opioid used in the epidural
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, ANS: w#w# 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonis
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t, which reverses the effects of opioids. If it is given, the client may complain of an increase in he
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r pain level. Therefore “decrease in her pain level,” “increase in the amount of itching from the op
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ioid used in the epidural,” and “decrease in the amount of itching from the opioid used in the epid
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ural” are incorrect.w# w#
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the m
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edications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
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antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if t
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his question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding w# w# w# w#
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saund
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ers. OBJ: Client Needs: Physiological Integrity
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TOP: Content Area: Pharmacology w# w#
MSC: Integrated Process: Nursing Process—Assessment
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3. A client experiencing preterm labor at the twenty-
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ninth week of gestation has been admitted to the hospital. The client has a prescription to receive
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betamethasone (Celestone). The nurse understands that the medication will do which of the follow
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ing?
1. Prevent spontaneous delivery. w# w#
2. Stop the uterine contractions.
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3. Promote maturation of the fetal lungs. w# w# w# w# w#
4. Accelerate the growth rate of the fetus. w# w# w# w# w# w#
ANS: w#w# 3
Rationale: Betamethasone (Celestone) is classified as an anti-
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inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, wh
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ich reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48
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hours after administration of betamethasone to allow time for the lungs of the fetus to mature.
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Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mi
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nd, eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic
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words “twenty-
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ninth week of gestation.” Specific knowledge about the medication and knowledge of the problems
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encountered by premature infants will assist in answering this question. Review the action of this
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medication if this question was difficult. w# w# w# w# w#
PTS: 1
DIF: Level of Cognitive Ability: Understanding
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, REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-
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child nursing (3rd ed.). St. Louis: Saunders.
w# w# w# w# w# OBJ: Client Needs: Physiological Integrity
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w# w# w# w# w# w#
RN® Examination, 6th Edition
w# w# w#
Pharmacology w#
Test Bank w#
MULTIPLE CHOICE w#
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
medication is prescribed for: w# w# w#
1. Pain relief w#
2. Increasing uterine contractions w# w#
3. Decreasing uterine contractions w# w#
4. Promoting fetal lung maturity w# w# w#
ANS: w#w# 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up t
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
o 2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be pre
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
scribed for pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “pro
w# w# w# w# w# w# w# w# w# w# w#
moting fetal lung maturity” are not actions of this medication.
w# w# w# w# w# w# w# w# w#
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this questio
w# w# w# w# w# w# w# w# w# w# w# w# w# w#
n. Remember that this medication is used for pain relief. Review the action of this medication if yo
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
u had difficulty with this question and are unfamiliar with this medication.
w# w# w# w# w# w# w# w# w# w# w#
PTS: 1
DIF: Level of Cognitive Ability: Understanding w# w# w# w#
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saund
w# w# w# w# w# w# w# w# w# w# w#
ers. OBJ: w# Client Needs: Physiological Integrity w# w# w#
TOP: Content Area: Pharmacology w# w#
MSC: Integrated Process: Nursing Process—Planning
w # w# w# w#
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid ana
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
lgesic administration following cesarean birth. If the client develops respiratory depression an
w# w# w# w# w# w# w# w# w# w# w#
d requires naloxone (Narcan) as an antidote, the client may complain of which of the follo
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
wing?
1. Increase in her pain level w# w# w# w#
2. Decrease in her pain level w# w# w# w#
3. Increase in the amount of itching from the opioid used in the epidural
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4. Decrease in the amount of itching from the opioid used in the epidural
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, ANS: w#w# 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonis
w# w# w# w# w# w# w# w# w# w# w# w# w#
t, which reverses the effects of opioids. If it is given, the client may complain of an increase in he
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
r pain level. Therefore “decrease in her pain level,” “increase in the amount of itching from the op
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
ioid used in the epidural,” and “decrease in the amount of itching from the opioid used in the epid
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
ural” are incorrect.w# w#
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the m
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
edications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w
antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if t
# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
his question was difficult.
w# w# w#
PTS: 1
DIF: Level of Cognitive Ability: Understanding w# w# w# w#
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saund
w# w# w# w# w# w# w# w# w# w# w#
ers. OBJ: Client Needs: Physiological Integrity
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TOP: Content Area: Pharmacology w# w#
MSC: Integrated Process: Nursing Process—Assessment
w # w# w# w#
3. A client experiencing preterm labor at the twenty-
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ninth week of gestation has been admitted to the hospital. The client has a prescription to receive
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
betamethasone (Celestone). The nurse understands that the medication will do which of the follow
w# w# w# w# w# w# w# w# w# w# w# w# w#
ing?
1. Prevent spontaneous delivery. w# w#
2. Stop the uterine contractions.
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3. Promote maturation of the fetal lungs. w# w# w# w# w#
4. Accelerate the growth rate of the fetus. w# w# w# w# w# w#
ANS: w#w# 3
Rationale: Betamethasone (Celestone) is classified as an anti-
w# w# w# w# w# w# w#
inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, wh
w# w# w# w# w# w# w# w# w# w# w# w# w# w#
ich reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
hours after administration of betamethasone to allow time for the lungs of the fetus to mature.
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mi
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
nd, eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic
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words “twenty-
# w#
ninth week of gestation.” Specific knowledge about the medication and knowledge of the problems
w# w# w# w# w# w# w# w# w# w# w# w# w# w#
encountered by premature infants will assist in answering this question. Review the action of this
w# w# w# w# w# w# w# w# w# w# w# w# w# w# w#
medication if this question was difficult. w# w# w# w# w#
PTS: 1
DIF: Level of Cognitive Ability: Understanding
w# w# w# w#
, REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-
w# w# w# w# w# w# w# w# w# w#
child nursing (3rd ed.). St. Louis: Saunders.
w# w# w# w# w# OBJ: Client Needs: Physiological Integrity
w# w# w# w#
