, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th
jk jk jk jk jk jk jk jk
Edition
jk
Pharmacology
jk Test Bank jk
MULTIPLE CHOICE jk
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication is prescribed for:
jk jk jk jk
1. Pain relief jk
2. Increasing uterine contractions jk jk
3. Decreasing uterine contractions jk jk
4. Promoting fetal lung maturity jk jk jk
ANS: jk jk 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
prescribed for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and
jk jk jk jk jk jk jk jk jk jk jk
―promoting fetal lung maturity‖ are not actions of this medication.
jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this
jk jk jk jk jk jk jk jk jk jk jk jk jk
question. Remember that this medication is used for pain relief. Review the action of this medication
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
if you had difficulty with this question and are unfamiliar with this medication.
jk jk jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis:
jk jk jk jk jk jk jk jk jk jk
Saunders. OBJ:
jk Client Needs: Physiological Integrity
jk jk jk jk
TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Planning
j k jk jk jk
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
analgesic administration following cesarean birth. If the client develops respiratory depression
jk jk jk jk jk jk jk jk jk jk jk
and requires naloxone (Narcan) as an antidote, the client may complain of which of the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
following?
jk
1. Increase in her pain level jk jk jk jk
2. Decrease in her pain level jk jk jk jk
3. Increase in the amount of itching from the opioid used in the epidural
jk jk jk jk jk jk jk jk jk jk jk jk
4. Decrease in the amount of itching from the opioid used in the epidural
jk jk jk jk jk jk jk jk jk jk jk jk
, ANS: jk jk 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
jk jk jk jk jk jk jk jk jk jk jk jk jk
which reverses the effects of opioids. If it is given, the client may complain of an increase in her
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
pain level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
used in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
are incorrect.
jk jk
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
this question was difficult.
jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: jk jk jk jk jk jk jk jk jk jk
Saunders. OBJ:
jk Client Needs: Physiological Integrity
jk jk jk jk
TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Assessment
j k jk jk jk
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
jk jk jk jk jk jk jk jk jk jk jk jk jk
that the medication will do which of the following?
jk jk jk jk jk jk jk jk jk
1. Prevent spontaneous delivery. jk jk
2. Stop the uterine contractions.jk jk jk
3. Promote maturation of the fetal lungs. jk jk jk jk jk
4. Accelerate the growth rate of the fetus. jk jk jk jk jk jk
ANS: jk jk 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
jk jk jk jk jk jk jk jk jk jk
increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
betamethasone to allow time for the lungs of the fetus to mature.
jk jk jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
mind, eliminate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the
jk jk jk jk jk jk jk jk jk jk jk jk
strategic words ―twenty-ninth week of gestation.‖ Specific knowledge about the medication and
jk jk jk jk jk jk jk jk jk jk jk jk
knowledge of the problems encountered by premature infants will assist in answering this question.
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
Review the action of this medication if this question was difficult.
jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). jk jk jk jk jk jk jk jk jk jk jk jk jk
St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
jk jk jk jk jk jk
, TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Planning
j k jk jk jk
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely
jk jk jk jk jk jk jk jk jk jk jk jk jk
for which sign of magnesium toxicity?
jk jk jk jk jk jk
1. Proteinuria
2. Hyperactive deep tendon reflexes jk jk jk
3. Respiratory rate of 10 breaths/min jk jk jk jk
4. Serum magnesium level of 5 mEq/L jk jk jk jk jk
ANS: jk jk 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
jk jk jk jk jk jk jk jk jk jk jk jk
magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
jk jk jk jk jk jk jk jk jk jk jk jk
depression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
rate and blood pressure.
jk jk jk jk
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
jk jk jk jk jk jk jk jk jk jk jk jk jk
develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
jk jk jk jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is
jk jk jk jk jk jk jk jk jk jk jk jk jk
a CNS depressant. Begin to answer this question by eliminating ―proteinuria‖ and ―hyperactive deep
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
tendon reflexes,‖ which are signs of preeclampsia. Select between the last two options using
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
mEq/L. Review this medication and the normal magnesium level if this question was difficult.
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Analyzing jk jk jk jk
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: jk jk jk jk jk jk jk jk jk jk jk jk jk
Mosby.
jk
OBJ: Client Needs: Physiological Integrity jk jk jk
TOP: Content Area: Pharmacology
jk jk jk
MSC: Integrated Process: Nursing Process—Assessment
j k jk jk jk
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
reached how many weeks of gestation?
jk jk jk jk jk jk
1. 4
2. 14
3. 24
4. 34
ANS: jk jk 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
week of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication. In
jk jk
jk jk jk jk jk jk jk jk
Edition
jk
Pharmacology
jk Test Bank jk
MULTIPLE CHOICE jk
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication is prescribed for:
jk jk jk jk
1. Pain relief jk
2. Increasing uterine contractions jk jk
3. Decreasing uterine contractions jk jk
4. Promoting fetal lung maturity jk jk jk
ANS: jk jk 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
prescribed for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and
jk jk jk jk jk jk jk jk jk jk jk
―promoting fetal lung maturity‖ are not actions of this medication.
jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this
jk jk jk jk jk jk jk jk jk jk jk jk jk
question. Remember that this medication is used for pain relief. Review the action of this medication
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
if you had difficulty with this question and are unfamiliar with this medication.
jk jk jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis:
jk jk jk jk jk jk jk jk jk jk
Saunders. OBJ:
jk Client Needs: Physiological Integrity
jk jk jk jk
TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Planning
j k jk jk jk
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
analgesic administration following cesarean birth. If the client develops respiratory depression
jk jk jk jk jk jk jk jk jk jk jk
and requires naloxone (Narcan) as an antidote, the client may complain of which of the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
following?
jk
1. Increase in her pain level jk jk jk jk
2. Decrease in her pain level jk jk jk jk
3. Increase in the amount of itching from the opioid used in the epidural
jk jk jk jk jk jk jk jk jk jk jk jk
4. Decrease in the amount of itching from the opioid used in the epidural
jk jk jk jk jk jk jk jk jk jk jk jk
, ANS: jk jk 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
jk jk jk jk jk jk jk jk jk jk jk jk jk
which reverses the effects of opioids. If it is given, the client may complain of an increase in her
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
pain level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
used in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
are incorrect.
jk jk
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
this question was difficult.
jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: jk jk jk jk jk jk jk jk jk jk
Saunders. OBJ:
jk Client Needs: Physiological Integrity
jk jk jk jk
TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Assessment
j k jk jk jk
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
jk jk jk jk jk jk jk jk jk jk jk jk jk
that the medication will do which of the following?
jk jk jk jk jk jk jk jk jk
1. Prevent spontaneous delivery. jk jk
2. Stop the uterine contractions.jk jk jk
3. Promote maturation of the fetal lungs. jk jk jk jk jk
4. Accelerate the growth rate of the fetus. jk jk jk jk jk jk
ANS: jk jk 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
jk jk jk jk jk jk jk jk jk jk
increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
betamethasone to allow time for the lungs of the fetus to mature.
jk jk jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
mind, eliminate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the
jk jk jk jk jk jk jk jk jk jk jk jk
strategic words ―twenty-ninth week of gestation.‖ Specific knowledge about the medication and
jk jk jk jk jk jk jk jk jk jk jk jk
knowledge of the problems encountered by premature infants will assist in answering this question.
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
Review the action of this medication if this question was difficult.
jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Understanding jk jk jk jk
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). jk jk jk jk jk jk jk jk jk jk jk jk jk
St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
jk jk jk jk jk jk
, TOP: Content Area: Pharmacology jk jk
MSC: Integrated Process: Nursing Process—Planning
j k jk jk jk
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely
jk jk jk jk jk jk jk jk jk jk jk jk jk
for which sign of magnesium toxicity?
jk jk jk jk jk jk
1. Proteinuria
2. Hyperactive deep tendon reflexes jk jk jk
3. Respiratory rate of 10 breaths/min jk jk jk jk
4. Serum magnesium level of 5 mEq/L jk jk jk jk jk
ANS: jk jk 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
jk jk jk jk jk jk jk jk jk jk jk jk
magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
jk jk jk jk jk jk jk jk jk jk jk jk
depression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
rate and blood pressure.
jk jk jk jk
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
jk jk jk jk jk jk jk jk jk jk jk jk jk
develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
jk jk jk jk jk jk jk jk jk jk jk jk jk
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is
jk jk jk jk jk jk jk jk jk jk jk jk jk
a CNS depressant. Begin to answer this question by eliminating ―proteinuria‖ and ―hyperactive deep
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
tendon reflexes,‖ which are signs of preeclampsia. Select between the last two options using
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
mEq/L. Review this medication and the normal magnesium level if this question was difficult.
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
PTS: 1
DIF: Level of Cognitive Ability: Analyzing jk jk jk jk
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: jk jk jk jk jk jk jk jk jk jk jk jk jk
Mosby.
jk
OBJ: Client Needs: Physiological Integrity jk jk jk
TOP: Content Area: Pharmacology
jk jk jk
MSC: Integrated Process: Nursing Process—Assessment
j k jk jk jk
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
reached how many weeks of gestation?
jk jk jk jk jk jk
1. 4
2. 14
3. 24
4. 34
ANS: jk jk 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth
jk jk jk jk jk jk jk jk jk jk jk jk jk jk
week of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the
jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk jk
medication. In
jk jk
