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