SILVESTRI TEST BANK: SAUNDERS COMPREHENSIVE REVIEW-
FOR-THE
Silvestri:-Saunders-Comprehensive-Review-for-the-NCLEX-RN®-Examination,-5th-
th
NCLEX-RN
Edition EXAMINATION 5 EDITION
Pharmacology-
Test-Bank
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
ANS:- - 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
, ANS:- - 1
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-answer-this-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.
ANS:- - 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
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
ANS:- - 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-answer-this-question-accurately,-you-must-recall-that-magnesium-sulfate-is-a-
CNS-depressant.-Begin-to-answer-this-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?
1. 4
2. 14
3. 24
4. 34
ANS:- - 2
Rationale:-The-pregnant-women-with-HIV-infection-will-be-prescribed-oral-AZT-in-the-fourteenth-week-
of-gestation.-Before-this-time,-the-fetus-is-at-risk-because-of-the-teratogenic-effects-of-the-medication.-In
, addition,-a-bolus-of-AZT-is-given-intravenously-during-labor,-and-the-neonate-is-treated-for-six-weeks-
after-birth.
Test-Taking-Strategy:-To-answer-this-question-accurately,-you-must-be-familiar-with-pharmacological-
therapy-for-clients-who-are-HIV-positive.-Knowing-that-the-fetus-is-most-vulnerable-to-the-effects-of-
medications-and-chemicals-during-the-period-of-organogenesis-will-assist-you-in-selecting-the-correct-
answer.-Review-treatment-measures-for-the-pregnant-client-with-HIV-infection-if-you-had-difficulty-with-
this-question.
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
6. The-nurse-has-a-routine-prescription-to-instill-erythromycin-ointment-(Ilotycin)-into-the-eyes-of-a-
newborn.-The-nurse-plans-to-explain-to-the-parents-that-the-purpose-of-the-medication-is-to:
1. Help-the-newborn-to-see-more-clearly.
2. Guard-against-infection-acquired-during-intrauterine-life.
3. Ensure-the-sterility-of-the-conjunctiva-in-the-newborn.
4. Protect-the-newborn-from-contracting-an-eye-infection-during-birth.
ANS:- - 4
Rationale:-The-use-of-eye-prophylaxis-with-an-agent-such-as-erythromycin-protects-the-newborn-from-
contracting-a-conjunctival-infection-during-birth.-This-infection,-called-ophthalmia-neonatorum,-results-
from-maternal-vaginal-infection-with-chlamydia-or-gonorrhea.-This-prophylaxis-is-mandatory-in-the-
United-States.-―Help-the-newborn-to-see-more-clearly,‖-―guard-against-infection-acquired-during-
intrauterine-life,‖-and-―ensure-the-sterility-of-the-conjunctiva-in-the-newborn‖-do-not-describe-the-
purposes-of-this-medication.
Test-Taking-Strategy:-Familiarity-with-the-purpose-of-this-medication-is-needed-to-answer-this-question.-
Remember-erythromycin-protects-the-newborn-from-contracting-a-conjunctival-infection-during-birth.
Review-the-purpose-of-this-medication-if-you-had-difficulty-with-this-question.
PTS: 1
DIF: Level-of-Cognitive-Ability:-Applying
REF: Lehne,-R.-(2010).-Pharmacology-for-nursing-care-(7th-ed.).-St.-Louis:-Saunders.-
OBJ: Client-Needs:-Health-Promotion-and-Maintenance
TOP: Content-Area:-Pharmacology
MSC:- Integrated-Process:-Teaching-and-Learning
7. The-nurse-has-a-routine-prescription-to-administer-an-injection-of-phytonadione-(vitamin-K)-to-the-
newborn.-Before-giving-the-medication,-the-nurse-explains-to-the-client-that-this-medication-will:
FOR-THE
Silvestri:-Saunders-Comprehensive-Review-for-the-NCLEX-RN®-Examination,-5th-
th
NCLEX-RN
Edition EXAMINATION 5 EDITION
Pharmacology-
Test-Bank
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
ANS:- - 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
, ANS:- - 1
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-answer-this-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.
ANS:- - 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
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
ANS:- - 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-answer-this-question-accurately,-you-must-recall-that-magnesium-sulfate-is-a-
CNS-depressant.-Begin-to-answer-this-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?
1. 4
2. 14
3. 24
4. 34
ANS:- - 2
Rationale:-The-pregnant-women-with-HIV-infection-will-be-prescribed-oral-AZT-in-the-fourteenth-week-
of-gestation.-Before-this-time,-the-fetus-is-at-risk-because-of-the-teratogenic-effects-of-the-medication.-In
, addition,-a-bolus-of-AZT-is-given-intravenously-during-labor,-and-the-neonate-is-treated-for-six-weeks-
after-birth.
Test-Taking-Strategy:-To-answer-this-question-accurately,-you-must-be-familiar-with-pharmacological-
therapy-for-clients-who-are-HIV-positive.-Knowing-that-the-fetus-is-most-vulnerable-to-the-effects-of-
medications-and-chemicals-during-the-period-of-organogenesis-will-assist-you-in-selecting-the-correct-
answer.-Review-treatment-measures-for-the-pregnant-client-with-HIV-infection-if-you-had-difficulty-with-
this-question.
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
6. The-nurse-has-a-routine-prescription-to-instill-erythromycin-ointment-(Ilotycin)-into-the-eyes-of-a-
newborn.-The-nurse-plans-to-explain-to-the-parents-that-the-purpose-of-the-medication-is-to:
1. Help-the-newborn-to-see-more-clearly.
2. Guard-against-infection-acquired-during-intrauterine-life.
3. Ensure-the-sterility-of-the-conjunctiva-in-the-newborn.
4. Protect-the-newborn-from-contracting-an-eye-infection-during-birth.
ANS:- - 4
Rationale:-The-use-of-eye-prophylaxis-with-an-agent-such-as-erythromycin-protects-the-newborn-from-
contracting-a-conjunctival-infection-during-birth.-This-infection,-called-ophthalmia-neonatorum,-results-
from-maternal-vaginal-infection-with-chlamydia-or-gonorrhea.-This-prophylaxis-is-mandatory-in-the-
United-States.-―Help-the-newborn-to-see-more-clearly,‖-―guard-against-infection-acquired-during-
intrauterine-life,‖-and-―ensure-the-sterility-of-the-conjunctiva-in-the-newborn‖-do-not-describe-the-
purposes-of-this-medication.
Test-Taking-Strategy:-Familiarity-with-the-purpose-of-this-medication-is-needed-to-answer-this-question.-
Remember-erythromycin-protects-the-newborn-from-contracting-a-conjunctival-infection-during-birth.
Review-the-purpose-of-this-medication-if-you-had-difficulty-with-this-question.
PTS: 1
DIF: Level-of-Cognitive-Ability:-Applying
REF: Lehne,-R.-(2010).-Pharmacology-for-nursing-care-(7th-ed.).-St.-Louis:-Saunders.-
OBJ: Client-Needs:-Health-Promotion-and-Maintenance
TOP: Content-Area:-Pharmacology
MSC:- Integrated-Process:-Teaching-and-Learning
7. The-nurse-has-a-routine-prescription-to-administer-an-injection-of-phytonadione-(vitamin-K)-to-the-
newborn.-Before-giving-the-medication,-the-nurse-explains-to-the-client-that-this-medication-will:
