THIS DOCUMENT BELONGS TO TESTBANKSPROF
Test Bank for Saunders Comprehensive Review for The
NCLEX-RN® Examination, 9th Edition
By Linda
Q&A Verified with Rationales| Grade A+ Assured
ISBN 9780323795302
~1~
,THIS DOCUMENT BELONGS TO TESTBANKSPROF
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
CORRECT 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
CORRECT ANSWER: 1
~2~
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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 Answerthis 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.
CORRECT 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
~3~
, THIS DOCUMENT BELONGS TO TESTBANKSPROF
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
CORRECT 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 Answerthis question accurately, you must recall that magnesium sulfate
is a CNS depressant. Begin to Answerthis 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?
~4~
Test Bank for Saunders Comprehensive Review for The
NCLEX-RN® Examination, 9th Edition
By Linda
Q&A Verified with Rationales| Grade A+ Assured
ISBN 9780323795302
~1~
,THIS DOCUMENT BELONGS TO TESTBANKSPROF
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
CORRECT 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
CORRECT ANSWER: 1
~2~
,THIS DOCUMENT BELONGS TO TESTBANKSPROF
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 Answerthis 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.
CORRECT 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
~3~
, THIS DOCUMENT BELONGS TO TESTBANKSPROF
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
CORRECT 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 Answerthis question accurately, you must recall that magnesium sulfate
is a CNS depressant. Begin to Answerthis 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?
~4~
