Silvestri: Saunders Comprehensive Review For The
NCLEX-RN® Examination, 9th Edition
Pharmacology
MULTIPLE CHOICE
1. The Nurse Is Caring For A Client In Labor. The Nurse Reviews The Physician’s Prescriptions
And Notes That The Client Has A Prescription For Butorphanol Tartrate (Stadol). The Nurse Understands
That This Medication Is Prescribed For:
1. Pain Relief
2. Increasing Uterine Contractions
3. Decreasing Uterine Contractions
4. Promoting Fetal Lung Maturity
ANSWER: 1
Rationale: The Client In Labor May Be Given Parenteral Analgesia During The First Stage Of Labor, Up
To 2 To 3 Hours Before The Anticipated Delivery. Butorphanol Tartrate Is A Medication That May Be
Prescribed For Pain Relief. “Increasing Uterine Contractions,” “Decreasing Uterine Contractions,” And
“Promoting Fetal Lung Maturity” Are Not Actions Of This Medication.
Test-Taking Strategy: Knowledge Of The Action Of Butorphanol Tartrate Is Required To Answer This
Question. Remember That This Medication Is Used For Pain Relief. Review The Action Of This
Medication If You Had Difficulty With This Question And Are Unfamiliar With This Medication.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology For Nursing Care (7th Ed.). St. Louis: Saunders. OBJ: Client
Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
,2. The Postpartum Nurse Is Caring For A Client With An Epidural Catheter In Place For Opioid
Analgesic Administration Following Cesarean Birth. If The Client Develops Respiratory Depression And
Requires Naloxone (Narcan) As An Antidote, The Client May Complain Of Which Of The Following?
1. Increase In Her Pain Level
2. Decrease In Her Pain Level
3. Increase In The Amount Of Itching From The Opioid Used In The Epidural
4. Decrease In The Amount Of Itching From The Opioid Used In The Epidural
ANSWER: 1
Rationale: Remember That Opioids Are Used For Epidural Analgesia. Naloxone Is An Opioid
Antagonist, Which Reverses The Effects Of Opioids. If It Is Given, The Client May Complain Of An
Increase In Her Pain Level. Therefore “Decrease In Her Pain Level,” “Increase In The Amount Of Itching
From The Opioid Used In The Epidural,” And “Decrease In The Amount Of Itching From The Opioid
Used In The Epidural” Are Incorrect.
Test-Taking Strategy: To Answer This Question Accurately, You Must Know That Opioid Analgesics
Are The Medications Used With Epidural Analgesia To Relieve Pain. Therefore If Naloxone Is
Administered As An Antidote For An Opioid Analgesic, The Client’s Pain Will Increase. Review The
Effects Of Naloxone If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology For Nursing Care (7th Ed.). St. Louis: Saunders. OBJ: Client
Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A Client Experiencing Preterm Labor At The Twenty-Ninth Week Of Gestation Has Been
Admitted To The Hospital. The Client Has A Prescription To Receive Betamethasone (Celestone). The
Nurse Understands That The Medication Will Do Which Of The Following?
1. Prevent Spontaneous Delivery.
2. Stop The Uterine Contractions.
3. Promote Maturation Of The Fetal Lungs.
4. Accelerate The Growth Rate Of The Fetus.
,ANSWER: 3
Rationale: Betamethasone (Celestone) Is Classified As An Anti-Inflammatory And Corticosteroid. It
Increases The Surfactant Level And Lung Maturity In The Fetus, Which Reduces The Incidence Of
Respiratory Distress Syndrome. Delivery Must Be Delayed For At Least 48 Hours After Administration
Of Betamethasone To Allow Time For The Lungs Of The Fetus To Mature.
Test-Taking Strategy: Options That Are Comparable Or Alike Are Not Likely To Be Correct. With This
In Mind, Eliminate “Prevent Spontaneous Delivery” And “Stop The Uterine Contractions.” Note The
Strategic Words “Twenty-Ninth Week Of Gestation.” Specific Knowledge About The Medication And
Knowledge Of The Problems Encountered By Premature Infants Will Assist In Answering This Question.
Review The Action Of This Medication If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Mckinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-Child Nursing (3rd Ed.). St.
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A Client With Preeclampsia Is Receiving Magnesium Sulfate. The Nurse Assesses The Client
Closely For Which Sign Of Magnesium Toxicity?
1. Proteinuria
2. Hyperactive Deep Tendon Reflexes
3. Respiratory Rate Of 10 Breaths/Min
4. Serum Magnesium Level Of 5 Meq/L
ANSWER: 3
Rationale: Magnesium Toxicity Is A Risk Associated With Magnesium Sulfate Therapy. Signs Of
Magnesium Toxicity Relate To Central Nervous System (CNS) Depression And Include Respiratory
Depression, Loss Of Deep Tendon Reflexes, And Sudden Drop In Fetal Heart Rate And/Or Maternal
Heart Rate And Blood Pressure.
Magnesium Is Excreted Through The Kidneys. If Renal Impairment Is Present, Magnesium Toxicity Can
Develop Very Quickly. Therapeutic Serum Levels Of Magnesium Are 4 To 7 Meq/L.
, Test-Taking Strategy: To Answer This Question Accurately, You Must Recall That Magnesium Sulfate Is
A CNS Depressant. Begin To Answer This Question By Eliminating “Proteinuria” And “Hyperactive
Deep Tendon Reflexes,” Which Are Signs Of Preeclampsia. Select Between The Last Two Options Using
Medication Knowledge And Recalling That The Therapeutic Serum Levels Of Magnesium Are 4 To 7
Meq/L. Review This Medication And The Normal Magnesium Level If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity Nursing (8th Ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A Pregnant Client Who Has Human Immunodeficiency Virus (HIV) Infection Is Being Seen In
The Antenatal Clinic. The Nurse Recalls That Zidovudine (AZT) Therapy Will Be Initiated When The
Fetus Has Reached How Many Weeks Of Gestation?
1. 4
2. 14
3. 24
4. 34
ANSWER: 2
Rationale: The Pregnant Women With HIV Infection Will Be Prescribed Oral AZT In The Fourteenth
Week Of Gestation. Before This Time, The Fetus Is At Risk Because Of The Teratogenic Effects Of The
Medication. In
Addition, A Bolus Of AZT Is Given Intravenously During Labor, And The Neonate Is Treated For Six
Weeks After Birth.
Test-Taking Strategy: To Answer This Question Accurately, You Must Be Familiar With
Pharmacological Therapy For Clients Who Are HIV-Positive. Knowing That The Fetus Is Most
Vulnerable To The Effects Of Medications And Chemicals During The Period Of Organogenesis Will
Assist You In Selecting The Correct Answer. Review Treatment Measures For The Pregnant Client With
HIV Infection If You Had Difficulty With This Question.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
NCLEX-RN® Examination, 9th Edition
Pharmacology
MULTIPLE CHOICE
1. The Nurse Is Caring For A Client In Labor. The Nurse Reviews The Physician’s Prescriptions
And Notes That The Client Has A Prescription For Butorphanol Tartrate (Stadol). The Nurse Understands
That This Medication Is Prescribed For:
1. Pain Relief
2. Increasing Uterine Contractions
3. Decreasing Uterine Contractions
4. Promoting Fetal Lung Maturity
ANSWER: 1
Rationale: The Client In Labor May Be Given Parenteral Analgesia During The First Stage Of Labor, Up
To 2 To 3 Hours Before The Anticipated Delivery. Butorphanol Tartrate Is A Medication That May Be
Prescribed For Pain Relief. “Increasing Uterine Contractions,” “Decreasing Uterine Contractions,” And
“Promoting Fetal Lung Maturity” Are Not Actions Of This Medication.
Test-Taking Strategy: Knowledge Of The Action Of Butorphanol Tartrate Is Required To Answer This
Question. Remember That This Medication Is Used For Pain Relief. Review The Action Of This
Medication If You Had Difficulty With This Question And Are Unfamiliar With This Medication.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology For Nursing Care (7th Ed.). St. Louis: Saunders. OBJ: Client
Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
,2. The Postpartum Nurse Is Caring For A Client With An Epidural Catheter In Place For Opioid
Analgesic Administration Following Cesarean Birth. If The Client Develops Respiratory Depression And
Requires Naloxone (Narcan) As An Antidote, The Client May Complain Of Which Of The Following?
1. Increase In Her Pain Level
2. Decrease In Her Pain Level
3. Increase In The Amount Of Itching From The Opioid Used In The Epidural
4. Decrease In The Amount Of Itching From The Opioid Used In The Epidural
ANSWER: 1
Rationale: Remember That Opioids Are Used For Epidural Analgesia. Naloxone Is An Opioid
Antagonist, Which Reverses The Effects Of Opioids. If It Is Given, The Client May Complain Of An
Increase In Her Pain Level. Therefore “Decrease In Her Pain Level,” “Increase In The Amount Of Itching
From The Opioid Used In The Epidural,” And “Decrease In The Amount Of Itching From The Opioid
Used In The Epidural” Are Incorrect.
Test-Taking Strategy: To Answer This Question Accurately, You Must Know That Opioid Analgesics
Are The Medications Used With Epidural Analgesia To Relieve Pain. Therefore If Naloxone Is
Administered As An Antidote For An Opioid Analgesic, The Client’s Pain Will Increase. Review The
Effects Of Naloxone If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology For Nursing Care (7th Ed.). St. Louis: Saunders. OBJ: Client
Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A Client Experiencing Preterm Labor At The Twenty-Ninth Week Of Gestation Has Been
Admitted To The Hospital. The Client Has A Prescription To Receive Betamethasone (Celestone). The
Nurse Understands That The Medication Will Do Which Of The Following?
1. Prevent Spontaneous Delivery.
2. Stop The Uterine Contractions.
3. Promote Maturation Of The Fetal Lungs.
4. Accelerate The Growth Rate Of The Fetus.
,ANSWER: 3
Rationale: Betamethasone (Celestone) Is Classified As An Anti-Inflammatory And Corticosteroid. It
Increases The Surfactant Level And Lung Maturity In The Fetus, Which Reduces The Incidence Of
Respiratory Distress Syndrome. Delivery Must Be Delayed For At Least 48 Hours After Administration
Of Betamethasone To Allow Time For The Lungs Of The Fetus To Mature.
Test-Taking Strategy: Options That Are Comparable Or Alike Are Not Likely To Be Correct. With This
In Mind, Eliminate “Prevent Spontaneous Delivery” And “Stop The Uterine Contractions.” Note The
Strategic Words “Twenty-Ninth Week Of Gestation.” Specific Knowledge About The Medication And
Knowledge Of The Problems Encountered By Premature Infants Will Assist In Answering This Question.
Review The Action Of This Medication If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
REF: Mckinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-Child Nursing (3rd Ed.). St.
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A Client With Preeclampsia Is Receiving Magnesium Sulfate. The Nurse Assesses The Client
Closely For Which Sign Of Magnesium Toxicity?
1. Proteinuria
2. Hyperactive Deep Tendon Reflexes
3. Respiratory Rate Of 10 Breaths/Min
4. Serum Magnesium Level Of 5 Meq/L
ANSWER: 3
Rationale: Magnesium Toxicity Is A Risk Associated With Magnesium Sulfate Therapy. Signs Of
Magnesium Toxicity Relate To Central Nervous System (CNS) Depression And Include Respiratory
Depression, Loss Of Deep Tendon Reflexes, And Sudden Drop In Fetal Heart Rate And/Or Maternal
Heart Rate And Blood Pressure.
Magnesium Is Excreted Through The Kidneys. If Renal Impairment Is Present, Magnesium Toxicity Can
Develop Very Quickly. Therapeutic Serum Levels Of Magnesium Are 4 To 7 Meq/L.
, Test-Taking Strategy: To Answer This Question Accurately, You Must Recall That Magnesium Sulfate Is
A CNS Depressant. Begin To Answer This Question By Eliminating “Proteinuria” And “Hyperactive
Deep Tendon Reflexes,” Which Are Signs Of Preeclampsia. Select Between The Last Two Options Using
Medication Knowledge And Recalling That The Therapeutic Serum Levels Of Magnesium Are 4 To 7
Meq/L. Review This Medication And The Normal Magnesium Level If This Question Was Difficult.
PTS: 1
DIF: Level Of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity Nursing (8th Ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A Pregnant Client Who Has Human Immunodeficiency Virus (HIV) Infection Is Being Seen In
The Antenatal Clinic. The Nurse Recalls That Zidovudine (AZT) Therapy Will Be Initiated When The
Fetus Has Reached How Many Weeks Of Gestation?
1. 4
2. 14
3. 24
4. 34
ANSWER: 2
Rationale: The Pregnant Women With HIV Infection Will Be Prescribed Oral AZT In The Fourteenth
Week Of Gestation. Before This Time, The Fetus Is At Risk Because Of The Teratogenic Effects Of The
Medication. In
Addition, A Bolus Of AZT Is Given Intravenously During Labor, And The Neonate Is Treated For Six
Weeks After Birth.
Test-Taking Strategy: To Answer This Question Accurately, You Must Be Familiar With
Pharmacological Therapy For Clients Who Are HIV-Positive. Knowing That The Fetus Is Most
Vulnerable To The Effects Of Medications And Chemicals During The Period Of Organogenesis Will
Assist You In Selecting The Correct Answer. Review Treatment Measures For The Pregnant Client With
HIV Infection If You Had Difficulty With This Question.
PTS: 1
DIF: Level Of Cognitive Ability: Understanding
