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TEST BANK FOR SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-RN® EXAMINATION, 9TH EDITION BY LINDA ANNE SILVESTRI AND ANGELA SILVESTRI COMPLETE QUESTIONS AND ANSWERS

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TEST BANK FOR SAUNDERS COMPREHENSIVE REVIEW FOR THE NCLEX-RN® EXAMINATION, 9TH EDITION BY LINDA ANNE SILVESTRI AND ANGELA SILVESTRI COMPLETE QUESTIONS AND ANSWERS

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NCLEX-RN.
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Uploaded on
May 16, 2025
Number of pages
287
Written in
2024/2025
Type
Exam (elaborations)
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  • 9th editi

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, Pharmacology

Test Bank
fy fy




MULTIPLE CHOICE fy




1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


medication is prescribed for:
fy fy fy fy



1. Pain relief fy



2. Increasing uterine contractions fy fy




3. Decreasing uterine contractions fy fy




4. Promoting fetal lung maturity fy fy fy




ANS: fy fy 1

Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


prescribed for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and
fy fy fy fy fy fy fy fy fy fy fy


―promoting fetal lung maturity‖ are not actions of this medication.
fy fy fy fy fy fy fy fy fy fy




Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this
fy fy fy fy fy fy fy fy fy fy fy fy fy


question. Remember that this medication is used for pain relief. Review the action of this medication
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


if you had difficulty with this question and are unfamiliar with this medication.
fy fy fy fy fy fy fy fy fy fy fy fy fy




PTS: 1
DIF: Level of Cognitive Ability: Understanding fy fy fy fy


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis:
fy fy fy fy fy fy fy fy fy fy


Saunders. OBJ:
fy Client Needs: Physiological Integrity
fy fy fy fy


TOP: Content Area: Pharmacology fy fy


MSC: Integrated Process: Nursing Process—Planning
f y fy fy fy




2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


analgesic administration following cesarean birth. If the client develops respiratory depression
fy fy fy fy fy fy fy fy fy fy fy


and requires naloxone (Narcan) as an antidote, the client may complain of which of the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


following?
fy



1. Increase in her pain level fy fy fy fy



2. Decrease in her pain level fy fy fy fy



3. Increase in the amount of itching from the opioid used in the epidural
fy fy fy fy fy fy fy fy fy fy fy fy




4. Decrease in the amount of itching from the opioid used in the epidural
fy fy fy fy fy fy fy fy fy fy fy fy

, ANS: fy fy 1

Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
fy fy fy fy fy fy fy fy fy fy fy fy fy


which reverses the effects of opioids. If it is given, the client may complain of an increase in her
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


pain level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


opioid used in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


epidural‖ are incorrect.
fy fy fy




Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


an antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


this question was difficult.
fy fy fy fy




PTS: 1
DIF: Level of Cognitive Ability: Understanding fy fy fy fy


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: fy fy fy fy fy fy fy fy fy fy


Saunders. OBJ:
fy Client Needs: Physiological Integrity
fy fy fy fy


TOP: Content Area: Pharmacology fy fy


MSC: Integrated Process: Nursing Process—Assessment
f y fy fy fy




3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
fy fy fy fy fy fy fy fy fy fy fy fy fy


that the medication will do which of the following?
fy fy fy fy fy fy fy fy fy



1. Prevent spontaneous delivery. fy fy



2. Stop the uterine contractions.
fy fy fy




3. Promote maturation of the fetal lungs. fy fy fy fy fy




4. Accelerate the growth rate of the fetus. fy fy fy fy fy fy




ANS: fy fy 3

Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
fy fy fy fy fy fy fy fy fy fy


increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


betamethasone to allow time for the lungs of the fetus to mature.
fy fy fy fy fy fy fy fy fy fy fy fy




Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


mind, eliminate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the
fy fy fy fy fy fy fy fy fy fy fy fy


strategic words ―twenty-ninth week of gestation.‖ Specific knowledge about the medication and
fy fy fy fy fy fy fy fy fy fy fy fy


knowledge of the problems encountered by premature infants will assist in answering this question.
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


Review the action of this medication if this question was difficult.
fy fy fy fy fy fy fy fy fy fy fy




PTS: 1
DIF: Level of Cognitive Ability: Understanding fy fy fy fy


REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). fy fy fy fy fy fy fy fy fy fy fy fy fy


St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
fy fy fy fy fy fy

, TOP: Content Area: Pharmacology fy fy


MSC: Integrated Process: Nursing Process—Planning
f y fy fy fy




4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely
fy fy fy fy fy fy fy fy fy fy fy fy fy


for which sign of magnesium toxicity?
fy fy fy fy fy fy



1. Proteinuria
2. Hyperactive deep tendon reflexes fy fy fy



3. Respiratory rate of 10 breaths/min fy fy fy fy




4. Serum magnesium level of 5 mEq/L fy fy fy fy fy




ANS: fy fy 3

Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
fy fy fy fy fy fy fy fy fy fy fy fy


magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
fy fy fy fy fy fy fy fy fy fy fy fy


depression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


rate and blood pressure.
fy fy fy fy


Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
fy fy fy fy fy fy fy fy fy fy fy fy fy


develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
fy fy fy fy fy fy fy fy fy fy fy fy fy




Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is
fy fy fy fy fy fy fy fy fy fy fy fy fy


a CNS depressant. Begin to answer this question by eliminating ―proteinuria‖ and ―hyperactive deep
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


tendon reflexes,‖ which are signs of preeclampsia. Select between the last two options using
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


mEq/L. Review this medication and the normal magnesium level if this question was difficult.
fy fy fy fy fy fy fy fy fy fy fy fy fy fy




PTS: 1
DIF: Level of Cognitive Ability: Analyzing fy fy fy fy


REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: fy fy fy fy fy fy fy fy fy fy fy fy fy


Mosby.
fy


OBJ: Client Needs: Physiological Integrity fy fy fy


TOP: Content Area: Pharmacology
fy fy fy


MSC: Integrated Process: Nursing Process—Assessment
f y fy fy fy




5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


reached how many weeks of gestation?
fy fy fy fy fy fy



1. 4
2. 14
3. 24
4. 34

ANS: fy fy 2

Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth
fy fy fy fy fy fy fy fy fy fy fy fy fy fy


week of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the
fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy fy


medication. In
fy fy

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