Pharmacology Test Bank 1
, Pharmacology Test Bank 2
Silvestri: Saunders Comprehensive Review for the
NCLEX-RN® Examination, 5th Edition
Pharmacology
Test Bank
MULTIPLE CHOICE
1. TheI!nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the
F F F F F F F F F F F F F F F F F F
client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medicationis
F F F F F F F F F F F F F F F
prescribed for: F
1. Pain relief F
2. Increasing uterine contractions F F
3. Decreasing uterine contractions F F
4. Promoting fetal lung maturity F F F
ANS: 1 F
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to3
F F F F F F F F F F F F F F F F F F F F F
hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain
F F F F F F F F F F F F F F F F
relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lung
F F F F F F F F F F F
maturity” are not actions of this medication.
F F F F F F
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question.
F F F F F F F F F F F F F F F
Remember that this medication is used for pain relief. Review the action of this medication ifyou had
F F F F F F F F F F F F F F F F F F
difficulty with this question and are unfamiliar with this medication.
F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding
F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Planning F F F
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
F F F F F F F F F F F F F F F F F
administration following cesarean birth. If the client develops respiratory depression and requires
F F F F F F F F F F F F
naloxone (Narcan) as an antidote, the client may complain of which of the following?
F F F F F F F F F F F F F
1. Increase in her pain level F F F F
2. Decrease in her pain level F F F F
3. Increase in the amount of itching from the opioid used in the epidural
F F F F F F F F F F F F
4. Decrease in the amount of itching from the opioid used in the epidural
F F F F F F F F F F F F
ANS: 1 F
, Pharmacology Test Bank 3
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which
F F F F F F F F F F F F F F F
reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
F F F F F F F F F F F F F F F F F F F F
Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in the
F F F F F F F F F F F F F F F F F F
epidural,” and “decrease in the amount of itching from the opioid used in the epidural” are incorrect.
F F F F F F F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
F F F F F F F F F F F F F F F
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote
F F F F F F F F F F F F F F F F
for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question was
F F F F F F F F F F F F F F F F F F
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Assessment F F F
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital.
F F F F F F F F F F F F F F F F F
The client has a prescription to receive betamethasone (Celestone). The nurse understands thatthe
F F F F F F F F F F F F F F
medication will do which of the following? F F F F F F
1. Prevent spontaneous delivery. F F
2. Stop the uterine contractions. F F F
3. Promote maturation of the fetal lungs. F F F F F
4. Accelerate the growth rate of the fetus. F F F F F F
ANS: 3 F
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It increases
F F F F F F F F F F F F
the surfactant level and lung maturity in the fetus, which reduces the incidence of respiratory distress
F F F F F F F F F F F F F F F F
syndrome. Delivery must be delayed for at least 48 hours after administration of betamethasoneto allow time
F F F F F F F F F F F F F F F F F
for the lungs of the fetus to mature.
F F F F F F F
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind,
F F F F F F F F F F F F F F F F F F
eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words
F F F F F F F F F F F F F
“twenty-ninth week of gestation.” Specific knowledge about the medication and knowledge of theproblems
F F F F F F F F F F F F F F
encountered by premature infants will assist in answering this question. Review the action of this medication
F F F F F F F F F F F F F F F F
if this question was difficult.
F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Planning
F F F F
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
F F F F F F F F F F F F F F F
which sign of magnesium toxicity?
F F F F
, Pharmacology Test Bank 4
1. Proteinuria
2. Hyperactive deep tendon reflexes F F F
3. Respiratory rate of 10 breaths/min F F F F
4. Serum magnesium level of 5 mEq/L F F F F F
ANS: 3 F
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
F F F F F F F F F F F F F F
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of deep
F F F F F F F F F F F F F F F
tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood pressure.
F F F F F F F F F F F F F F F
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity candevelop
F F F F F F F F F F F F F F F
very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
F F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS
F F F F F F F F F F F F F F F F
depressant. Begin to answer this question by eliminating “proteinuria” and “hyperactive deep tendon
F F F F F F F F F F F F F
reflexes,” which are signs of preeclampsia. Select between the last two options using medicationknowledge
F F F F F F F F F F F F F F F
and recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L. Review this medication and
F F F F F F F F F F F F F F F F F F
the normal magnesium level if this question was difficult.
F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Analyzing F F F F
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby. F F F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Assessment
F F F F
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
F F F F F F F F F F F F F F F F
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
F F F F F F F F F F F F F F F F F
many weeks of gestation?
F F F
1. 4
2. 14
3. 24
4. 34
ANS: 2 F
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth weekof
F F F F F F F F F F F F F F F F F
gestation. Before this time, the fetus is at risk because of the teratogenic effects of the medication. In
F F F F F F F F F F F F F F F F F
addition, a bolus of AZT is given intravenously during labor, and the neonate is treated for six weeksafter
F F F F F F F F F F F F F F F F F F F
birth.
Test-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological
F F F F F F F F F F F F F
therapy for clients who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of
F F F F F F F F F F F F F F F F F
medications and chemicals during the period of organogenesis will assist you in selecting the correct answer.
F F F F F F F F F F F F F F F F
Review treatment measures for the pregnant client with HIV infection if you had difficulty withthis question.
F F F F F F F F F F F F F F F F
PTS: 1
, Pharmacology Test Bank 5
DIF: Level of Cognitive Ability: Understanding F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Planning F F F
6. The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a
F F F F F F F F F F F F F F F F
newborn. The nurse plans to explain to the parents that the purpose of the medication is to:
F F F F F F F F F F F F F F F F
1. Help the newborn to see more clearly.
F F F F F F
2. Guard against infection acquired during intrauterine life.
F F F F F F
3. Ensure the sterility of the conjunctiva in the newborn.
F F F F F F F F
4. Protect the newborn from contracting an eye infection during birth.
F F F F F F F F F
ANS: 4 F
Rationale: The use of eye prophylaxis with an agent such as erythromycin protects the newborn from
F F F F F F F F F F F F F F F F
contracting a conjunctival infection during birth. This infection, called ophthalmia neonatorum, resultsfrom
F F F F F F F F F F F F F
maternal vaginal infection with chlamydia or gonorrhea. This prophylaxis is mandatory in the United States.
F F F F F F F F F F F F F F F
“Help the newborn to see more clearly,” “guard against infection acquired during intrauterine life,” and
F F F F F F F F F F F F F F F
“ensure the sterility of the conjunctiva in the newborn” do not describe the purposes of this medication.
F F F F F F F F F F F F F F F F
Test-Taking Strategy: Familiarity with the purpose of this medication is needed to answer this question.
F F F F F F F F F F F F F F F
Remember erythromycin protects the newborn from contracting a conjunctival infection during birth.
F F F F F F F F F F F
Review the purpose of this medication if you had difficulty with this question.
F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Health Promotion and Maintenance F F F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Teaching and Learning F F F F
7. The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the
F F F F F F F F F F F F F F F F
newborn. Before giving the medication, the nurse explains to the client that this medication will:
F F F F F F F F F F F F F F
1. Prevent clotting abnormalities in the newborn.
F F F F F
2. Stimulate the liver to produce vitamin K. F F F F F F
3. Prevent vitamin deficiency of fat-soluble vitamins.
F F F F F
4. Supplement the infant, because breast milk and formula are low in vitamin K.
F F F F F F F F F F F F
ANS: 1 F
Rationale: Vitamin K is given to the newborn to prevent clotting abnormalities. Vitamin K is usually
F F F F F F F F F F F F F F F F
produced by bacteria in the gastrointestinal tract, which is sterile in the newborn. The other options are
F F F F F F F F F F F F F F F F F
incorrect reasons for administering this medication to a newborn.
F F F F F F F F
Test-Taking Strategy: Use the process of elimination. Thinking about the action and purpose of vitaminK will
F F F F F F F F F F F F F F F F F
assist in answering correctly. Review the rationale for this newborn prophylaxis if this question was difficult.
F F F F F F F F F F F F F F F
, Pharmacology Test Bank 6
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ: F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Implementation
F F F F
8. The client who has developed atrial fibrillation is not responding to medication therapy and has been placed
F F F F F F F F F F F F F F F F F
on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nursewould tell
F F F F F F F F F F F F F F F F F
the client to avoid which of the following foods while taking this medication?
F F F F F F F F F F F F
1. Cherries
2. Potatoes
3. Broccoli
4. Spaghetti
ANS: 3 F
Rationale: Anticoagulant medications work by antagonizing the action of vitamin K, which is needed for
F F F F F F F F F F F F F F F
clotting. When a client is taking an anticoagulant, foods high in vitamin K are often omitted from thediet.
F F F F F F F F F F F F F F F F F F F
Vitamin K is found in large amounts in green leafy vegetables, such as broccoli, cabbage, turnip greens, and
F F F F F F F F F F F F F F F F F F
lettuce. The other options listed are foods that are lower in vitamin K.
F F F F F F F F F F F F
Test-Taking Strategy: Knowledge about the relationship between warfarin and vitamin K is needed toanswer
F F F F F F F F F F F F F F F
this question. Note the strategic word “avoid” in the question. This tells you that the correct option is a food
F F F F F F F F F F F F F F F F F F F F
that is high in vitamin K. If you had difficulty with this question, review foods high invitamin K.
F F F F F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Implementation F F F
9. A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The
F F F F F F F F F F F F F F F F F
nurse checks the medication to ensure that which medication is available as an antidote if needed?
F F F F F F F F F F F F F F F
1. Magnesium oxide F
2. Vitamin K F
3. Aluminum hydroxide F
4. Calcium gluconate F
ANS: 4 F
Rationale: The antidote for magnesium sulfate is calcium gluconate. This medication should be available if
F F F F F F F F F F F F F F F
the client experiences magnesium toxicity. The other options are incorrect. “Magnesiumoxide” and
F F F F F F F F F F F F F
“aluminum hydroxide” are antacids. Vitamin K is the antidote for warfarin (Coumadin).
F F F F F F F F F F F
, Pharmacology Test Bank 7
Test-Taking Strategy: Eliminate “magnesium oxide” and “aluminum hydroxide” first because they are
F F F F F F F F F F F F
comparable or alike and are antacids. For the remaining options, recall that vitamin K is the antidote for
F F F F F F F F F F F F F F F F F F
warfarin (Coumadin). Remember that the antidote for magnesium sulfate is calcium gluconate. If this
F F F F F F F F F F F F F F
question was difficult, review this medication and the relationship between magnesium and calcium.
F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ:F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Implementation
F F F F
10. The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following
F F F F F F F F F F F F F F F
delivery of an infant. The nurse determines that this medication had the intended effect after evaluatingfor
F F F F F F F F F F F F F F F F F
which of the following findings?
F F F F
1. Decreased pulse rate F F
2. Increased urine output F F
3. Improved uterine tone F F
4. Increased blood pressure F F
ANS: 3 F
Rationale: Methylergonovine is an ergot alkaloid that is given following delivery to treat postpartum
F F F F F F F F F F F F F F
hemorrhage. It acts by vasoconstricting arterioles and directly stimulating uterine muscle contractions.
F F F F F F F F F F F
Blood pressure may increase, but this is not the intended therapeutic effect. “Decreased pulse rate” and
F F F F F F F F F F F F F F F F
“increased urine output” are unrelated to the effects of this medication.
F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, recall the action of the medication and its usein the
F F F F F F F F F F F F F F F F F F
immediate postpartum period. Remember that this medication improves uterine tone. Review theaction of
F F F F F F F F F F F F F F
methylergonovine if you had difficulty with this question. F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ:F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
11. The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receivingthe
F F F F F F F F F F F F F F F F F F F F
medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates
F F F F F F F F F F F F F F F F F
that the physician will prescribe:
F F F F
1. Discontinuation of the medication F F F
2. A decrease of the dosage of the medication
F F F F F F F
3. An increase of the dosage of the medication
F F F F F F F
4. Continuation of the presently prescribed dosage F F F F F
ANS: 4 F
, Pharmacology Test Bank 8
Rationale: When carbamazepine is administered, blood levels need to be monitored periodically to check
F F F F F F F F F F F F F F
for the child’s absorption of the medication. The amount of the medication prescribed is based onthe blood
F F F F F F F F F F F F F F F F F F
level achieved. The therapeutic serum range of carbamazepine is 4 to 12 mcg/mL. The nurse would
F F F F F F F F F F F F F F F F
anticipate that the physician will continue the presently prescribed dosage.
F F F F F F F F F
Test-Taking Strategy: Knowing the therapeutic serum drug level of carbamazepine will direct you to the
F F F F F F F F F F F F F F F
correct option. Remember that the therapeutic serum range is 4 to 12 mcg/mL. If you had difficulty withthis
F F F F F F F F F F F F F F F F F F F
question, learn the therapeutic serum drug level of carbamazepine.
F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Planning
F F F F
12. The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the
F F F F F F F F F F F F F F F F F
application of topical cortisone cream to the affected skin sites. Which of the following statements, if made
F F F F F F F F F F F F F F F F F
by the mother, indicates an understanding of the use of this medication?
F F F F F F F F F F F
1. “I shouldn’t rub the medication into the skin.”
F F F F F F F
2. “The medication is applied everywhere except the face.”
F F F F F F F
3. “I need to wash the sites gently before I apply the medication.”
F F F F F F F F F F F
4. “I need to apply the medication generously and allow it to absorb.”
F F F F F F F F F F F
ANS: 3 F
Rationale: Topical corticosteroids should be applied sparingly and rubbed into the area thoroughly. The
F F F F F F F F F F F F F F
affected area should be cleansed gently prior to application. It should not be applied everywhere or over
F F F F F F F F F F F F F F F F F
extensive areas. Systemic absorption is more likely to occur with extensive application. It is applied to the
F F F F F F F F F F F F F F F F F
affected sites. F
Test-Taking Strategy: Note the strategic words “indicates an understanding.” Look for the option that
F F F F F F F F F F F F F F
indicates that the mother understands how to apply the cream. Eliminate “The medication is applied
F F F F F F F F F F F F F F F
everywhere except the face.” because cream should be applied only to areas that are affected. Eliminate“I
F F F F F F F F F F F F F F F F F
need to apply the medication generously and allow it to absorb.” because of the strategic word “generously.”
F F F F F F F F F F F F F F F F F
Eliminate “I shouldn’t rub the medication into the skin.” because of the strategic words “shouldn’t rub.”
F F F F F F F F F F F F F F F F
Review the procedure for application of this cream if you had difficulty with this question.
F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ: FClient Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
13. The nurse working in the ambulatory care center is providing medication instructions about
F F F F F F F F F F F F F
methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). F F F F F F F F F F F F
The nurse recommends that the mother give the medication to the child:
F F F F F F F F F F F
, Pharmacology Test Bank 9
1. At bedtime F
2. With the evening meal F F F
3. Just before the noontime meal F F F F
4. In the morning, 2 hours before breakfast
F F F F F F
ANS: 3 F
Rationale: Methylphenidate is best taken shortly before a meal. It should not be taken after 12 noon or 1PM
F F F F F F F F F F F F F F F F F F F F
for children or after 6 PM for adults, because the stimulating effect may keep the client awake. The other
F F F F F F F F F F F F F F F F F F F
options are incorrect. F F
Test-Taking Strategy: Knowledge about the correct administration procedure for this medication is required
F F F F F F F F F F F F F
to answer this question. Remember that it is best to administer it shortly before the noontimemeal. If you had
F F F F F F F F F F F F F F F F F F F F
difficulty with this question, review the client teaching points for methylphenidate.
F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Teaching and Learning F F F F
14. A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication
F F F F F F F F F F F F F
information to the mother would plan to emphasize which of the following most important instructions
F F F F F F F F F F F F F F F
about giving this medication to the child?
F F F F F F
1. Give the medication with milk. F F F F
2. Give the medication with ice cream. F F F F F
3. Mix the medication in a Styrofoam cup.
F F F F F F
4. Use a straw when giving the medication.
F F F F F F
ANS: 4 F
Rationale: Because tetracycline can cause staining of the teeth, straws should be used and the mouthrinsed
F F F F F F F F F F F F F F F F F
after administration. The medication should be administered 1 hour before or 2 hours after the
F F F F F F F F F F F F F F F
administration of milk, which would eliminate “give the medication with milk” and “give the medication
F F F F F F F F F F F F F F F
with ice cream.” “Mix the medication in a Styrofoam cup” is unnecessary.
F F F F F F F F F F F
Test-Taking Strategy: Eliminate “give the medication with milk” and “give the medication with ice cream”
F F F F F F F F F F F F F F F
first because they are comparable or alike—they are both milk products. Recalling that tetracycline can
F F F F F F F F F F F F F F F
cause staining of the teeth will direct you to the correct option from those remaining. Ifyou had difficulty with
F F F F F F F F F F F F F F F F F F F F
this question, review the client teaching points related to the administration of tetracycline hydrochloride.
F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Kee, J., Hayes, E., & McCuistion, L. (2009). Pharmacology: a nursing process approach (6th
F F F F F F F F F F F F F F
ed.). St. Louis: Saunders.
F OBJ: F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Teaching and Learning
F F F F F
, Pharmacology Test Bank 10
15. The nurse is providing instructions to the parent of a child with iron deficiency anemia about the
F F F F F F F F F F F F F F F F F
administration of a liquid oral iron supplement. Which of the following statements, if made by the F F F F F F F F F F F F F F F F
parent, indicates an understanding of the administration of this medication?
F F F F F F F F F
1. “I should give the iron with food.”
F F F F F F
2. “I can mix the iron with cereal to give it.”
F F F F F F F F F
3. “I should add the iron to the formula in the baby’s bottle.”
F F F F F F F F F F F
4. “I should use a medicine dropper and place the iron near the back of the throat.”
F F F F F F F F F F F F F F F
ANS: 4 F
Rationale: Oral iron supplement should be administered through a straw or medicine dropper placed atthe
F F F F F F F F F F F F F F F F
back of the mouth because it will stain the teeth. The parents should be instructed to brush or wipe the teeth
F F F F F F F F F F F F F F F F F F F F F
after administration. Iron is administered between meals because absorption is decreased if there is food in
F F F F F F F F F F F F F F F F
the stomach. Iron requires an acidic environment to facilitate its absorption in the duodenum.
F F F F F F F F F F F F F
Test-Taking Strategy: Eliminate “I should give the iron with food.” “I can mix the iron with cereal togive it.”
F F F F F F F F F F F F F F F F F F F F
and “I should add the iron to the formula in the baby’s bottle.” first because they are comparable or alike and
F F F F F F F F F F F F F F F F F F F F F
because medication should not be added to formula and food. Also, note thestrategic word “liquid” in the
F F F F F F F F F F F F F F F F F F
question. This should assist in recalling that liquid iron stains teeth.
F F F F F F F F F F
Review the teaching points related to this medication if you had difficulty with this question.
F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
16. The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high
F F F F F F F F F F F F F F
doses of this medication can cause which side effect?
F F F F F F F F
1. Alopecia
2. Hyperkalemia
3. Hypercalcemia
4. Thinning of the skin F F F
ANS: 3 F
Rationale: Calcipotriene (Dovonex), an analogue of vitamin D3, is indicated for mild to moderate psoriasis.
F F F F F F F F F F F F F F F
Responses are equal to those achieved with medium-potency topical glucocorticoids. The mostcommon
F F F F F F F F F F F F F
adverse effect is local irritation. Unlike glucocorticoids, calcipotriene does not cause thinning of the skin. At
F F F F F F F F F F F F F F F F
high doses, calcipotriene has caused hypercalcemia. Hyperkalemia is not a side effect.
F F F F F F F F F F F
Test-Taking Strategy: Note the strategic words “high doses.” Remember that hypercalcemia is a concern.
F F F F F F F F F F F F F F
Note that the relationship between the name of the medication and “hypercalcemia.” The medication name
F F F F F F F F F F F F F F F
begins with calci-, which is similar to calcium. Review this medication if you haddifficulty with this question.
F F F F F F F F F F F F F F F F F
PTS: 1
, Pharmacology Test Bank 2
Silvestri: Saunders Comprehensive Review for the
NCLEX-RN® Examination, 5th Edition
Pharmacology
Test Bank
MULTIPLE CHOICE
1. TheI!nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the
F F F F F F F F F F F F F F F F F F
client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medicationis
F F F F F F F F F F F F F F F
prescribed for: F
1. Pain relief F
2. Increasing uterine contractions F F
3. Decreasing uterine contractions F F
4. Promoting fetal lung maturity F F F
ANS: 1 F
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to3
F F F F F F F F F F F F F F F F F F F F F
hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain
F F F F F F F F F F F F F F F F
relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lung
F F F F F F F F F F F
maturity” are not actions of this medication.
F F F F F F
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question.
F F F F F F F F F F F F F F F
Remember that this medication is used for pain relief. Review the action of this medication ifyou had
F F F F F F F F F F F F F F F F F F
difficulty with this question and are unfamiliar with this medication.
F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding
F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Planning F F F
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
F F F F F F F F F F F F F F F F F
administration following cesarean birth. If the client develops respiratory depression and requires
F F F F F F F F F F F F
naloxone (Narcan) as an antidote, the client may complain of which of the following?
F F F F F F F F F F F F F
1. Increase in her pain level F F F F
2. Decrease in her pain level F F F F
3. Increase in the amount of itching from the opioid used in the epidural
F F F F F F F F F F F F
4. Decrease in the amount of itching from the opioid used in the epidural
F F F F F F F F F F F F
ANS: 1 F
, Pharmacology Test Bank 3
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which
F F F F F F F F F F F F F F F
reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
F F F F F F F F F F F F F F F F F F F F
Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in the
F F F F F F F F F F F F F F F F F F
epidural,” and “decrease in the amount of itching from the opioid used in the epidural” are incorrect.
F F F F F F F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
F F F F F F F F F F F F F F F
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote
F F F F F F F F F F F F F F F F
for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question was
F F F F F F F F F F F F F F F F F F
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Assessment F F F
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital.
F F F F F F F F F F F F F F F F F
The client has a prescription to receive betamethasone (Celestone). The nurse understands thatthe
F F F F F F F F F F F F F F
medication will do which of the following? F F F F F F
1. Prevent spontaneous delivery. F F
2. Stop the uterine contractions. F F F
3. Promote maturation of the fetal lungs. F F F F F
4. Accelerate the growth rate of the fetus. F F F F F F
ANS: 3 F
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It increases
F F F F F F F F F F F F
the surfactant level and lung maturity in the fetus, which reduces the incidence of respiratory distress
F F F F F F F F F F F F F F F F
syndrome. Delivery must be delayed for at least 48 hours after administration of betamethasoneto allow time
F F F F F F F F F F F F F F F F F
for the lungs of the fetus to mature.
F F F F F F F
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind,
F F F F F F F F F F F F F F F F F F
eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words
F F F F F F F F F F F F F
“twenty-ninth week of gestation.” Specific knowledge about the medication and knowledge of theproblems
F F F F F F F F F F F F F F
encountered by premature infants will assist in answering this question. Review the action of this medication
F F F F F F F F F F F F F F F F
if this question was difficult.
F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Planning
F F F F
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
F F F F F F F F F F F F F F F
which sign of magnesium toxicity?
F F F F
, Pharmacology Test Bank 4
1. Proteinuria
2. Hyperactive deep tendon reflexes F F F
3. Respiratory rate of 10 breaths/min F F F F
4. Serum magnesium level of 5 mEq/L F F F F F
ANS: 3 F
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
F F F F F F F F F F F F F F
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of deep
F F F F F F F F F F F F F F F
tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood pressure.
F F F F F F F F F F F F F F F
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity candevelop
F F F F F F F F F F F F F F F
very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
F F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS
F F F F F F F F F F F F F F F F
depressant. Begin to answer this question by eliminating “proteinuria” and “hyperactive deep tendon
F F F F F F F F F F F F F
reflexes,” which are signs of preeclampsia. Select between the last two options using medicationknowledge
F F F F F F F F F F F F F F F
and recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L. Review this medication and
F F F F F F F F F F F F F F F F F F
the normal magnesium level if this question was difficult.
F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Analyzing F F F F
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby. F F F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Assessment
F F F F
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
F F F F F F F F F F F F F F F F
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
F F F F F F F F F F F F F F F F F
many weeks of gestation?
F F F
1. 4
2. 14
3. 24
4. 34
ANS: 2 F
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth weekof
F F F F F F F F F F F F F F F F F
gestation. Before this time, the fetus is at risk because of the teratogenic effects of the medication. In
F F F F F F F F F F F F F F F F F
addition, a bolus of AZT is given intravenously during labor, and the neonate is treated for six weeksafter
F F F F F F F F F F F F F F F F F F F
birth.
Test-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological
F F F F F F F F F F F F F
therapy for clients who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of
F F F F F F F F F F F F F F F F F
medications and chemicals during the period of organogenesis will assist you in selecting the correct answer.
F F F F F F F F F F F F F F F F
Review treatment measures for the pregnant client with HIV infection if you had difficulty withthis question.
F F F F F F F F F F F F F F F F
PTS: 1
, Pharmacology Test Bank 5
DIF: Level of Cognitive Ability: Understanding F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Planning F F F
6. The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a
F F F F F F F F F F F F F F F F
newborn. The nurse plans to explain to the parents that the purpose of the medication is to:
F F F F F F F F F F F F F F F F
1. Help the newborn to see more clearly.
F F F F F F
2. Guard against infection acquired during intrauterine life.
F F F F F F
3. Ensure the sterility of the conjunctiva in the newborn.
F F F F F F F F
4. Protect the newborn from contracting an eye infection during birth.
F F F F F F F F F
ANS: 4 F
Rationale: The use of eye prophylaxis with an agent such as erythromycin protects the newborn from
F F F F F F F F F F F F F F F F
contracting a conjunctival infection during birth. This infection, called ophthalmia neonatorum, resultsfrom
F F F F F F F F F F F F F
maternal vaginal infection with chlamydia or gonorrhea. This prophylaxis is mandatory in the United States.
F F F F F F F F F F F F F F F
“Help the newborn to see more clearly,” “guard against infection acquired during intrauterine life,” and
F F F F F F F F F F F F F F F
“ensure the sterility of the conjunctiva in the newborn” do not describe the purposes of this medication.
F F F F F F F F F F F F F F F F
Test-Taking Strategy: Familiarity with the purpose of this medication is needed to answer this question.
F F F F F F F F F F F F F F F
Remember erythromycin protects the newborn from contracting a conjunctival infection during birth.
F F F F F F F F F F F
Review the purpose of this medication if you had difficulty with this question.
F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Health Promotion and Maintenance F F F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Teaching and Learning F F F F
7. The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the
F F F F F F F F F F F F F F F F
newborn. Before giving the medication, the nurse explains to the client that this medication will:
F F F F F F F F F F F F F F
1. Prevent clotting abnormalities in the newborn.
F F F F F
2. Stimulate the liver to produce vitamin K. F F F F F F
3. Prevent vitamin deficiency of fat-soluble vitamins.
F F F F F
4. Supplement the infant, because breast milk and formula are low in vitamin K.
F F F F F F F F F F F F
ANS: 1 F
Rationale: Vitamin K is given to the newborn to prevent clotting abnormalities. Vitamin K is usually
F F F F F F F F F F F F F F F F
produced by bacteria in the gastrointestinal tract, which is sterile in the newborn. The other options are
F F F F F F F F F F F F F F F F F
incorrect reasons for administering this medication to a newborn.
F F F F F F F F
Test-Taking Strategy: Use the process of elimination. Thinking about the action and purpose of vitaminK will
F F F F F F F F F F F F F F F F F
assist in answering correctly. Review the rationale for this newborn prophylaxis if this question was difficult.
F F F F F F F F F F F F F F F
, Pharmacology Test Bank 6
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ: F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Implementation
F F F F
8. The client who has developed atrial fibrillation is not responding to medication therapy and has been placed
F F F F F F F F F F F F F F F F F
on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client. The nursewould tell
F F F F F F F F F F F F F F F F F
the client to avoid which of the following foods while taking this medication?
F F F F F F F F F F F F
1. Cherries
2. Potatoes
3. Broccoli
4. Spaghetti
ANS: 3 F
Rationale: Anticoagulant medications work by antagonizing the action of vitamin K, which is needed for
F F F F F F F F F F F F F F F
clotting. When a client is taking an anticoagulant, foods high in vitamin K are often omitted from thediet.
F F F F F F F F F F F F F F F F F F F
Vitamin K is found in large amounts in green leafy vegetables, such as broccoli, cabbage, turnip greens, and
F F F F F F F F F F F F F F F F F F
lettuce. The other options listed are foods that are lower in vitamin K.
F F F F F F F F F F F F
Test-Taking Strategy: Knowledge about the relationship between warfarin and vitamin K is needed toanswer
F F F F F F F F F F F F F F F
this question. Note the strategic word “avoid” in the question. This tells you that the correct option is a food
F F F F F F F F F F F F F F F F F F F F
that is high in vitamin K. If you had difficulty with this question, review foods high invitamin K.
F F F F F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Nursing Process—Implementation F F F
9. A client in preterm labor is being started on intravenous magnesium sulfate to stop the contractions. The
F F F F F F F F F F F F F F F F F
nurse checks the medication to ensure that which medication is available as an antidote if needed?
F F F F F F F F F F F F F F F
1. Magnesium oxide F
2. Vitamin K F
3. Aluminum hydroxide F
4. Calcium gluconate F
ANS: 4 F
Rationale: The antidote for magnesium sulfate is calcium gluconate. This medication should be available if
F F F F F F F F F F F F F F F
the client experiences magnesium toxicity. The other options are incorrect. “Magnesiumoxide” and
F F F F F F F F F F F F F
“aluminum hydroxide” are antacids. Vitamin K is the antidote for warfarin (Coumadin).
F F F F F F F F F F F
, Pharmacology Test Bank 7
Test-Taking Strategy: Eliminate “magnesium oxide” and “aluminum hydroxide” first because they are
F F F F F F F F F F F F
comparable or alike and are antacids. For the remaining options, recall that vitamin K is the antidote for
F F F F F F F F F F F F F F F F F F
warfarin (Coumadin). Remember that the antidote for magnesium sulfate is calcium gluconate. If this
F F F F F F F F F F F F F F
question was difficult, review this medication and the relationship between magnesium and calcium.
F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ:F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Implementation
F F F F
10. The nurse had just given an intramuscular dose of methylergonovine (Methergine) to a client following
F F F F F F F F F F F F F F F
delivery of an infant. The nurse determines that this medication had the intended effect after evaluatingfor
F F F F F F F F F F F F F F F F F
which of the following findings?
F F F F
1. Decreased pulse rate F F
2. Increased urine output F F
3. Improved uterine tone F F
4. Increased blood pressure F F
ANS: 3 F
Rationale: Methylergonovine is an ergot alkaloid that is given following delivery to treat postpartum
F F F F F F F F F F F F F F
hemorrhage. It acts by vasoconstricting arterioles and directly stimulating uterine muscle contractions.
F F F F F F F F F F F
Blood pressure may increase, but this is not the intended therapeutic effect. “Decreased pulse rate” and
F F F F F F F F F F F F F F F F
“increased urine output” are unrelated to the effects of this medication.
F F F F F F F F F F
Test-Taking Strategy: To answer this question accurately, recall the action of the medication and its usein the
F F F F F F F F F F F F F F F F F F
immediate postpartum period. Remember that this medication improves uterine tone. Review theaction of
F F F F F F F F F F F F F F
methylergonovine if you had difficulty with this question. F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ:F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
11. The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receivingthe
F F F F F F F F F F F F F F F F F F F F
medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates
F F F F F F F F F F F F F F F F F
that the physician will prescribe:
F F F F
1. Discontinuation of the medication F F F
2. A decrease of the dosage of the medication
F F F F F F F
3. An increase of the dosage of the medication
F F F F F F F
4. Continuation of the presently prescribed dosage F F F F F
ANS: 4 F
, Pharmacology Test Bank 8
Rationale: When carbamazepine is administered, blood levels need to be monitored periodically to check
F F F F F F F F F F F F F F
for the child’s absorption of the medication. The amount of the medication prescribed is based onthe blood
F F F F F F F F F F F F F F F F F F
level achieved. The therapeutic serum range of carbamazepine is 4 to 12 mcg/mL. The nurse would
F F F F F F F F F F F F F F F F
anticipate that the physician will continue the presently prescribed dosage.
F F F F F F F F F
Test-Taking Strategy: Knowing the therapeutic serum drug level of carbamazepine will direct you to the
F F F F F F F F F F F F F F F
correct option. Remember that the therapeutic serum range is 4 to 12 mcg/mL. If you had difficulty withthis
F F F F F F F F F F F F F F F F F F F
question, learn the therapeutic serum drug level of carbamazepine.
F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Understanding F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Planning
F F F F
12. The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the
F F F F F F F F F F F F F F F F F
application of topical cortisone cream to the affected skin sites. Which of the following statements, if made
F F F F F F F F F F F F F F F F F
by the mother, indicates an understanding of the use of this medication?
F F F F F F F F F F F
1. “I shouldn’t rub the medication into the skin.”
F F F F F F F
2. “The medication is applied everywhere except the face.”
F F F F F F F
3. “I need to wash the sites gently before I apply the medication.”
F F F F F F F F F F F
4. “I need to apply the medication generously and allow it to absorb.”
F F F F F F F F F F F
ANS: 3 F
Rationale: Topical corticosteroids should be applied sparingly and rubbed into the area thoroughly. The
F F F F F F F F F F F F F F
affected area should be cleansed gently prior to application. It should not be applied everywhere or over
F F F F F F F F F F F F F F F F F
extensive areas. Systemic absorption is more likely to occur with extensive application. It is applied to the
F F F F F F F F F F F F F F F F F
affected sites. F
Test-Taking Strategy: Note the strategic words “indicates an understanding.” Look for the option that
F F F F F F F F F F F F F F
indicates that the mother understands how to apply the cream. Eliminate “The medication is applied
F F F F F F F F F F F F F F F
everywhere except the face.” because cream should be applied only to areas that are affected. Eliminate“I
F F F F F F F F F F F F F F F F F
need to apply the medication generously and allow it to absorb.” because of the strategic word “generously.”
F F F F F F F F F F F F F F F F F
Eliminate “I shouldn’t rub the medication into the skin.” because of the strategic words “shouldn’t rub.”
F F F F F F F F F F F F F F F F
Review the procedure for application of this cream if you had difficulty with this question.
F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care(4th
F F F F F F F F F F F F F F F
ed.). St. Louis: Mosby.
F OBJ: FClient Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
13. The nurse working in the ambulatory care center is providing medication instructions about
F F F F F F F F F F F F F
methylphenidate (Ritalin) to the mother of a child with attention-deficit/hyperactivity disorder (ADHD). F F F F F F F F F F F F
The nurse recommends that the mother give the medication to the child:
F F F F F F F F F F F
, Pharmacology Test Bank 9
1. At bedtime F
2. With the evening meal F F F
3. Just before the noontime meal F F F F
4. In the morning, 2 hours before breakfast
F F F F F F
ANS: 3 F
Rationale: Methylphenidate is best taken shortly before a meal. It should not be taken after 12 noon or 1PM
F F F F F F F F F F F F F F F F F F F F
for children or after 6 PM for adults, because the stimulating effect may keep the client awake. The other
F F F F F F F F F F F F F F F F F F F
options are incorrect. F F
Test-Taking Strategy: Knowledge about the correct administration procedure for this medication is required
F F F F F F F F F F F F F
to answer this question. Remember that it is best to administer it shortly before the noontimemeal. If you had
F F F F F F F F F F F F F F F F F F F F
difficulty with this question, review the client teaching points for methylphenidate.
F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
F F F F F F F F F F F F
OBJ: Client Needs: Physiological Integrity F F F
TOP: Content Area: Pharmacology F F
MSC: F Integrated Process: Teaching and Learning F F F F
14. A child has been prescribed to take tetracycline hydrochloride. The nurse providing medication
F F F F F F F F F F F F F
information to the mother would plan to emphasize which of the following most important instructions
F F F F F F F F F F F F F F F
about giving this medication to the child?
F F F F F F
1. Give the medication with milk. F F F F
2. Give the medication with ice cream. F F F F F
3. Mix the medication in a Styrofoam cup.
F F F F F F
4. Use a straw when giving the medication.
F F F F F F
ANS: 4 F
Rationale: Because tetracycline can cause staining of the teeth, straws should be used and the mouthrinsed
F F F F F F F F F F F F F F F F F
after administration. The medication should be administered 1 hour before or 2 hours after the
F F F F F F F F F F F F F F F
administration of milk, which would eliminate “give the medication with milk” and “give the medication
F F F F F F F F F F F F F F F
with ice cream.” “Mix the medication in a Styrofoam cup” is unnecessary.
F F F F F F F F F F F
Test-Taking Strategy: Eliminate “give the medication with milk” and “give the medication with ice cream”
F F F F F F F F F F F F F F F
first because they are comparable or alike—they are both milk products. Recalling that tetracycline can
F F F F F F F F F F F F F F F
cause staining of the teeth will direct you to the correct option from those remaining. Ifyou had difficulty with
F F F F F F F F F F F F F F F F F F F F
this question, review the client teaching points related to the administration of tetracycline hydrochloride.
F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Applying F F F F
REF: Kee, J., Hayes, E., & McCuistion, L. (2009). Pharmacology: a nursing process approach (6th
F F F F F F F F F F F F F F
ed.). St. Louis: Saunders.
F OBJ: F Client Needs: Physiological Integrity F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Teaching and Learning
F F F F F
, Pharmacology Test Bank 10
15. The nurse is providing instructions to the parent of a child with iron deficiency anemia about the
F F F F F F F F F F F F F F F F F
administration of a liquid oral iron supplement. Which of the following statements, if made by the F F F F F F F F F F F F F F F F
parent, indicates an understanding of the administration of this medication?
F F F F F F F F F
1. “I should give the iron with food.”
F F F F F F
2. “I can mix the iron with cereal to give it.”
F F F F F F F F F
3. “I should add the iron to the formula in the baby’s bottle.”
F F F F F F F F F F F
4. “I should use a medicine dropper and place the iron near the back of the throat.”
F F F F F F F F F F F F F F F
ANS: 4 F
Rationale: Oral iron supplement should be administered through a straw or medicine dropper placed atthe
F F F F F F F F F F F F F F F F
back of the mouth because it will stain the teeth. The parents should be instructed to brush or wipe the teeth
F F F F F F F F F F F F F F F F F F F F F
after administration. Iron is administered between meals because absorption is decreased if there is food in
F F F F F F F F F F F F F F F F
the stomach. Iron requires an acidic environment to facilitate its absorption in the duodenum.
F F F F F F F F F F F F F
Test-Taking Strategy: Eliminate “I should give the iron with food.” “I can mix the iron with cereal togive it.”
F F F F F F F F F F F F F F F F F F F F
and “I should add the iron to the formula in the baby’s bottle.” first because they are comparable or alike and
F F F F F F F F F F F F F F F F F F F F F
because medication should not be added to formula and food. Also, note thestrategic word “liquid” in the
F F F F F F F F F F F F F F F F F F
question. This should assist in recalling that liquid iron stains teeth.
F F F F F F F F F F
Review the teaching points related to this medication if you had difficulty with this question.
F F F F F F F F F F F F F F
PTS: 1
DIF: Level of Cognitive Ability: Evaluating F F F F
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. F F F F F F F F F F F F F F F
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
F F F F
TOP: Content Area: Pharmacology F F
MSC: Integrated Process: Nursing Process—Evaluation
F F F F
16. The client with psoriasis is being treated with calcipotriene (Dovonex) cream. Administration of high
F F F F F F F F F F F F F F
doses of this medication can cause which side effect?
F F F F F F F F
1. Alopecia
2. Hyperkalemia
3. Hypercalcemia
4. Thinning of the skin F F F
ANS: 3 F
Rationale: Calcipotriene (Dovonex), an analogue of vitamin D3, is indicated for mild to moderate psoriasis.
F F F F F F F F F F F F F F F
Responses are equal to those achieved with medium-potency topical glucocorticoids. The mostcommon
F F F F F F F F F F F F F
adverse effect is local irritation. Unlike glucocorticoids, calcipotriene does not cause thinning of the skin. At
F F F F F F F F F F F F F F F F
high doses, calcipotriene has caused hypercalcemia. Hyperkalemia is not a side effect.
F F F F F F F F F F F
Test-Taking Strategy: Note the strategic words “high doses.” Remember that hypercalcemia is a concern.
F F F F F F F F F F F F F F
Note that the relationship between the name of the medication and “hypercalcemia.” The medication name
F F F F F F F F F F F F F F F
begins with calci-, which is similar to calcium. Review this medication if you haddifficulty with this question.
F F F F F F F F F F F F F F F F F
PTS: 1
