Saunders
Comprehensiv
v
e
v forthe
v
NCLEX-RN®
Examination 2022
, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination,
v v v v v v v
5th Edition
v v
Pharmacology
v Test Bank v
MULTIPLE CHOICE v
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and
v v v v v v v v v v v v v v v
notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse
v v v v v v v v v v v v v
understands that this medication is prescribed for:
v v v v v v v
1. Pain relief v
2. Increasing uterine contractions v v
3. Decreasing uterine contractions v v
4. Promoting fetal lung maturity v v v
ANS: 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of
v v v v v v v v v v v v v v
vlabor, up to 2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a
v v v v v v v v v v v v v v
vmedication that may be prescribed for pain relief. ―Increasing uterine contractions,‖
v v v v v v v v v v
v―decreasing uterine v
contractions,‖ and ―promoting fetal lung maturity‖ are not actions of this medication.
v v v v v v v v v v v
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to
v v v v v v v v v v v
vanswer this question. Remember that this medication is used for pain relief. Review the
v v v v v v v v v v v v v
action of this medication if you had difficulty with this question and are unfamiliar
v v v v v v v v v v v v v v
vwith this medication.
v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. v v v v v v v v v
Louis: Saunders. OBJ:
v Client Needs: Physiological Integrity
v v v v v
TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Planning v v v
2. The postpartum nurse is caring for a client with an epidural catheter in place
v v v v v v v v v v v v v
vfor opioid analgesic administration following cesarean birth. If the client
v v v v v v v v v
vdevelops respiratory depression and requires naloxone (Narcan) as an antidote, the
v v v v v v v v v v
client may complain of which of the following?
v v v v v v v v
1. Increase in her pain level v v v v
2. Decrease in her pain level v v v v
3. Increase in the amount of itching from the opioid used in the
v v v v v v v v v v v
epidural
v
4. Decrease in the amount of itching from the opioid used in the
v v v v v v v v v v v
epidural
v
, ANS: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an
v v v v v v v v v v v
vopioid antagonist, which reverses the effects of opioids. If it is given, the client
v v v v v v v v v v v v v
vmay complain of an increase in her pain level. Therefore ―decrease in her pain level,‖
v v v v v v v v v v v v v v
―increase in the amount of itching from the opioid used in the epidural,‖ and ―decrease
v v v v v v v v v v v v v v v
in the amount of itching from the opioid used in the epidural‖ are incorrect.
v v v v v v v v v v v v v v
Test-Taking Strategy: To answer this question accurately, you must know that opioid
v v v v v v v v v v v
analgesics are the medications used with epidural analgesia to relieve pain. Therefore
v v v v v v v v v v v v
vif naloxone is administered as an antidote for an opioid analgesic, the client’s pain
v v v v v v v v v v v v v
will increase. Review the effects of naloxone if this question was difficult.
v v v v v v v v v v v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. v v v v v v v v v
Louis: Saunders. OBJ:
v Client Needs: Physiological Integrity
v v v v v
TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Assessment v v v
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been
v v v v v v v v v v v v
vadmitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The
v v v v v v v v v v v v v
nurse understands that the medication will do which of the following?
v v v v v v v v v v v
1. Prevent spontaneous delivery. v v
2. Stop the uterine contractions. v v v
3. Promote maturation of the fetal lungs. v v v v v
4. Accelerate the growth rate of the fetus. v v v v v v
ANS: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and
v v v v v v v v
corticosteroid. It increases the surfactant level and lung maturity in the fetus, which
v v v v v v v v v v v v v
reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at
v v v v v v v v v v v v v
least 48 hours after administration of betamethasone to allow time for the lungs of
v v v v v v v v v v v v v v
vthe fetus to mature.
v v v
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct.
v v v v v v v v v v v v v
vWith this in mind, eliminate ―prevent spontaneous delivery‖ and ―stop the uterine
v v v v v v v v v v v
contractions.‖ Note the strategic words ―twenty-ninth week of gestation.‖ Specific knowledge
v v v v v v v v v v v
about the medication and knowledge of the problems encountered by premature infants
v v v v v v v v v v v v
vwill assist in answering this question. Review the action of this medication if this
v v v v v v v v v v v v v
vquestion was difficult. v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing v v v v v v v v v v v
(3rd ed.). St. Louis: Saunders. OBJ:
v v Client Needs: Physiological Integrity
v v v v v v v
, TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Planning v v v
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the
v v v v v v v v v v v
client closely for which sign of magnesium toxicity?
v v v v v v v v
1. Proteinuria
2. Hyperactive deep tendon reflexes v v v
3. Respiratory rate of 10 breaths/min v v v v
4. Serum magnesium level of 5 mEq/L v v v v v
ANS: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
v v v v v v v v v v v v
magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
v v v v v v v v v v v v
vdepression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or
v v v v v v v v v v v v v
maternal heart rate and blood pressure.
v v v v v v
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium
v v v v v v v v v v v
toxicity can develop very quickly. Therapeutic serum levels of magnesium are 4 to
v v v v v v v v v v v v v
v7 mEq/L.
v
Test-Taking Strategy: To answer this question accurately, you must recall that
v v v v v v v v v v
vmagnesium sulfate is a CNS depressant. Begin to answer this question by eliminating
v v v v v v v v v v v v
―proteinuria‖ and
v v
―hyperactive deep tendon reflexes,‖ which are signs of preeclampsia. Select between the
v v v v v v v v v v v
last two options using medication knowledge and recalling that the therapeutic serum
v v v v v v v v v v v v
vlevels of magnesium are 4 to 7 mEq/L. Review this medication and the normal
v v v v v v v v v v v v v
vmagnesium level if this question was difficult. v v v v v v
PTS: 1
DIF: Level of Cognitive Ability: Analyzing v v v v
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. v v v v v v v v v v v v
vLouis: Mosby. v
OBJ: Client Needs: Physiological v v
Integrity TOP:
v Content Area: Pharmacology
v v v
MSC: Integrated Process: Nursing Process—Assessment v v v
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
v v v v v v v v v v v v v v v
vclinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the
v v v v v v v v v v v v
fetus has reached how many weeks of gestation?
v v v v v v v v
1. 4
2. 14
3. 24
4. 34
ANS: 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the
v v v v v v v v v v v v v
Comprehensiv
v
e
v forthe
v
NCLEX-RN®
Examination 2022
, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination,
v v v v v v v
5th Edition
v v
Pharmacology
v Test Bank v
MULTIPLE CHOICE v
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and
v v v v v v v v v v v v v v v
notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse
v v v v v v v v v v v v v
understands that this medication is prescribed for:
v v v v v v v
1. Pain relief v
2. Increasing uterine contractions v v
3. Decreasing uterine contractions v v
4. Promoting fetal lung maturity v v v
ANS: 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of
v v v v v v v v v v v v v v
vlabor, up to 2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a
v v v v v v v v v v v v v v
vmedication that may be prescribed for pain relief. ―Increasing uterine contractions,‖
v v v v v v v v v v
v―decreasing uterine v
contractions,‖ and ―promoting fetal lung maturity‖ are not actions of this medication.
v v v v v v v v v v v
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to
v v v v v v v v v v v
vanswer this question. Remember that this medication is used for pain relief. Review the
v v v v v v v v v v v v v
action of this medication if you had difficulty with this question and are unfamiliar
v v v v v v v v v v v v v v
vwith this medication.
v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. v v v v v v v v v
Louis: Saunders. OBJ:
v Client Needs: Physiological Integrity
v v v v v
TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Planning v v v
2. The postpartum nurse is caring for a client with an epidural catheter in place
v v v v v v v v v v v v v
vfor opioid analgesic administration following cesarean birth. If the client
v v v v v v v v v
vdevelops respiratory depression and requires naloxone (Narcan) as an antidote, the
v v v v v v v v v v
client may complain of which of the following?
v v v v v v v v
1. Increase in her pain level v v v v
2. Decrease in her pain level v v v v
3. Increase in the amount of itching from the opioid used in the
v v v v v v v v v v v
epidural
v
4. Decrease in the amount of itching from the opioid used in the
v v v v v v v v v v v
epidural
v
, ANS: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an
v v v v v v v v v v v
vopioid antagonist, which reverses the effects of opioids. If it is given, the client
v v v v v v v v v v v v v
vmay complain of an increase in her pain level. Therefore ―decrease in her pain level,‖
v v v v v v v v v v v v v v
―increase in the amount of itching from the opioid used in the epidural,‖ and ―decrease
v v v v v v v v v v v v v v v
in the amount of itching from the opioid used in the epidural‖ are incorrect.
v v v v v v v v v v v v v v
Test-Taking Strategy: To answer this question accurately, you must know that opioid
v v v v v v v v v v v
analgesics are the medications used with epidural analgesia to relieve pain. Therefore
v v v v v v v v v v v v
vif naloxone is administered as an antidote for an opioid analgesic, the client’s pain
v v v v v v v v v v v v v
will increase. Review the effects of naloxone if this question was difficult.
v v v v v v v v v v v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. v v v v v v v v v
Louis: Saunders. OBJ:
v Client Needs: Physiological Integrity
v v v v v
TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Assessment v v v
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been
v v v v v v v v v v v v
vadmitted to the hospital. The client has a prescription to receive betamethasone (Celestone). The
v v v v v v v v v v v v v
nurse understands that the medication will do which of the following?
v v v v v v v v v v v
1. Prevent spontaneous delivery. v v
2. Stop the uterine contractions. v v v
3. Promote maturation of the fetal lungs. v v v v v
4. Accelerate the growth rate of the fetus. v v v v v v
ANS: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and
v v v v v v v v
corticosteroid. It increases the surfactant level and lung maturity in the fetus, which
v v v v v v v v v v v v v
reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at
v v v v v v v v v v v v v
least 48 hours after administration of betamethasone to allow time for the lungs of
v v v v v v v v v v v v v v
vthe fetus to mature.
v v v
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct.
v v v v v v v v v v v v v
vWith this in mind, eliminate ―prevent spontaneous delivery‖ and ―stop the uterine
v v v v v v v v v v v
contractions.‖ Note the strategic words ―twenty-ninth week of gestation.‖ Specific knowledge
v v v v v v v v v v v
about the medication and knowledge of the problems encountered by premature infants
v v v v v v v v v v v v
vwill assist in answering this question. Review the action of this medication if this
v v v v v v v v v v v v v
vquestion was difficult. v v
PTS: 1
DIF: Level of Cognitive Ability: Understanding v v v v
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing v v v v v v v v v v v
(3rd ed.). St. Louis: Saunders. OBJ:
v v Client Needs: Physiological Integrity
v v v v v v v
, TOP: Content Area: Pharmacology v v
MSC: Integrated Process: Nursing Process—Planning v v v
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the
v v v v v v v v v v v
client closely for which sign of magnesium toxicity?
v v v v v v v v
1. Proteinuria
2. Hyperactive deep tendon reflexes v v v
3. Respiratory rate of 10 breaths/min v v v v
4. Serum magnesium level of 5 mEq/L v v v v v
ANS: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
v v v v v v v v v v v v
magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
v v v v v v v v v v v v
vdepression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or
v v v v v v v v v v v v v
maternal heart rate and blood pressure.
v v v v v v
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium
v v v v v v v v v v v
toxicity can develop very quickly. Therapeutic serum levels of magnesium are 4 to
v v v v v v v v v v v v v
v7 mEq/L.
v
Test-Taking Strategy: To answer this question accurately, you must recall that
v v v v v v v v v v
vmagnesium sulfate is a CNS depressant. Begin to answer this question by eliminating
v v v v v v v v v v v v
―proteinuria‖ and
v v
―hyperactive deep tendon reflexes,‖ which are signs of preeclampsia. Select between the
v v v v v v v v v v v
last two options using medication knowledge and recalling that the therapeutic serum
v v v v v v v v v v v v
vlevels of magnesium are 4 to 7 mEq/L. Review this medication and the normal
v v v v v v v v v v v v v
vmagnesium level if this question was difficult. v v v v v v
PTS: 1
DIF: Level of Cognitive Ability: Analyzing v v v v
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. v v v v v v v v v v v v
vLouis: Mosby. v
OBJ: Client Needs: Physiological v v
Integrity TOP:
v Content Area: Pharmacology
v v v
MSC: Integrated Process: Nursing Process—Assessment v v v
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
v v v v v v v v v v v v v v v
vclinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the
v v v v v v v v v v v v
fetus has reached how many weeks of gestation?
v v v v v v v v
1. 4
2. 14
3. 24
4. 34
ANS: 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the
v v v v v v v v v v v v v
