Test Bank for Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th Edition by Linda Anne Silvestri and Angela Silvestri Complete Questions and Answers Pass Guaranteed

SILVESTRI TEST BANK: SAUNDERS COMPREHENSIVE REVIEW FOR
THE
Silvestri: Suanders Comprehensive Review for the NCLEX-RN Eximination,9th
NCLEX Edition-RN EXAMINATION 9TH EDITION
Pharmacologyr

TestrBank

MULTIPLErCHOICE

1. Thernurserisrcaringrforrarclientrinrlabor.rThernurserreviewsrtherphysician’srprescriptionsrandrnotesrthatrthercli
entrhasrarprescriptionrforrbutorphanolrtartrater(Stadol).rThernurserunderstandsrthatrthisrmedicationrisrprescri
bedrfor:
1. Painrrelief
2. Increasingruterinercontractions
3. Decreasingruterinercontractions
4. Promotingrfetalrlungrmaturity

ANS:r r 1

Rationale:rTherclientrinrlaborrmayrbergivenrparenteralranalgesiarduringrtherfirstrstagerofrlabor,ruprtor2rtor3rhou
rsrbeforertheranticipatedrdelivery.rButorphanolrtartraterisrarmedicationrthatrmayrberprescribedrforrpainrrelief.r
“Increasingruterinercontractions,”r“decreasingruterinercontractions,”randr“promotingrfetalrlungrmaturity”rar
ernotractionsrofrthisrmedication.

Test-
TakingrStrategy:rKnowledgerofrtheractionrofrbutorphanolrtartraterisrrequiredrtoranswerrthisrquestion.rReme
mberrthatrthisrmedicationrisrusedrforrpainrrelief.rReviewrtheractionrofrthisrmedicationrifryourhadrdifficultyrwit
hrthisrquestionrandrarerunfamiliarrwithrthisrmedication.

PTS: 1
DIF: LevelrofrCognitiverAbility:rUnderstanding
REF:
Lehne,rR.r(2010).rPharmacologyrforrnursingrcarer(7thred.).rSt.rLouis:rSaunders.rO
BJ: ClientrNeeds:rPhysiologicalrIntegrity
TOP: ContentrArea:rPharmacology
MSC:r IntegratedrProcess:rNursingrProcess—Planning

2. Therpostpartumrnurserisrcaringrforrarclientrwithranrepiduralrcatheterrinrplacerforropioidranalgesicradm
inistrationrfollowingrcesareanrbirth.rIfrtherclientrdevelopsrrespiratoryrdepressionrandrrequiresrnaloxo
ner(Narcan)rasranrantidote,rtherclientrmayrcomplainrofrwhichrofrtherfollowing?
1. Increaserinrherrpainrlevel
2. Decreaserinrherrpainrlevel
3. Increaserinrtheramountrofritchingrfromrtheropioidrusedrinrtherepidural

,4. Decreaserinrtheramountrofritchingrfromrtheropioidrusedrinrtherepidural

, ANS:r r 1

Rationale:rRememberrthatropioidsrarerusedrforrepiduralranalgesia.rNaloxonerisranropioidrantagonist,rwhichrr
eversesrthereffectsrofropioids.rIfritrisrgiven,rtherclientrmayrcomplainrofranrincreaserinrherrpainrlevel.rThereforer
“decreaserinrherrpainrlevel,”r“increaserinrtheramountrofritchingrfromrtheropioidrusedrinrtherepidural,”randr“de
creaserinrtheramountrofritchingrfromrtheropioidrusedrinrtherepidural”rarerincorrect.

Test-
TakingrStrategy:rToranswerrthisrquestionraccurately,ryourmustrknowrthatropioidranalgesicsrarerthermedicatio
nsrusedrwithrepiduralranalgesiartorrelieverpain.rThereforerifrnaloxonerisradministeredrasranrantidoterforranropi
oidranalgesic,rtherclient’srpainrwillrincrease.rReviewrthereffectsrofrnaloxonerifrthisrquestionrwasrdifficult.

PTS: 1
DIF: LevelrofrCognitiverAbility:rUnderstanding
REF:
Lehne,rR.r(2010).rPharmacologyrforrnursingrcarer(7thred.).rSt.rLouis:rSaunders.rO
BJ: ClientrNeeds:rPhysiologicalrIntegrity
TOP: ContentrArea:rPharmacology
MSC:r IntegratedrProcess:rNursingrProcess—Assessment

3. Arclientrexperiencingrpretermrlaborratrthertwenty-
ninthrweekrofrgestationrhasrbeenradmittedrtortherhospital.rTherclientrhasrarprescriptionrtorreceiverbetametha
soner(Celestone).rThernurserunderstandsrthatrthermedicationrwillrdorwhichrofrtherfollowing?
1. Preventrspontaneousrdelivery.
2. Stoprtheruterinercontractions.
3. Promotermaturationrofrtherfetalrlungs.
4. Acceleraterthergrowthrraterofrtherfetus.

ANS:r r 3

Rationale:rBetamethasoner(Celestone)risrclassifiedrasranranti-
inflammatoryrandrcorticosteroid.rItrincreasesrthersurfactantrlevelrandrlungrmaturityrinrtherfetus,rwhichrreduc
esrtherincidencerofrrespiratoryrdistressrsyndrome.rDeliveryrmustrberdelayedrforratrleastr48rhoursrafterradmini
strationrofrbetamethasonertorallowrtimerforrtherlungsrofrtherfetusrtormature.

Test-
TakingrStrategy:rOptionsrthatrarercomparablerorralikerarernotrlikelyrtorbercorrect.rWithrthisrinrmind,reliminat
er“preventrspontaneousrdelivery”randr“stoprtheruterinercontractions.”rNotertherstrategicrwordsr“twenty-
ninthrweekrofrgestation.”rSpecificrknowledgeraboutrthermedicationrandrknowledgerofrtherproblemsrencounte
redrbyrprematurerinfantsrwillrassistrinransweringrthisrquestion.rReviewrtheractionrofrthisrmedicationrifrthisrqu
estionrwasrdifficult.

PTS: 1
DIF: LevelrofrCognitiverAbility:rUnderstanding
REF: McKinney,rE.,rJames,rS.,rMurray,rS.,r&rAshwill,rJ.r(2009).rMaternal-
childrnursingr(3rdred.).rSt.rLouis:rSaunders. OBJ: ClientrNeeds:rPhysiologicalrIntegrity

, TOP: ContentrArea:rPharmacology
MSC:r IntegratedrProcess:rNursingrProcess—Planning

4. Arclientrwithrpreeclampsiarisrreceivingrmagnesiumrsulfate.rThernurserassessesrtherclientrcloselyrforrwhi
chrsignrofrmagnesiumrtoxicity?
1. Proteinuria
2. Hyperactiverdeeprtendonrreflexes
3. Respiratoryrraterofr10rbreaths/min
4. Serumrmagnesiumrlevelrofr5rmEq/L

ANS:r r 3

Rationale:rMagnesiumrtoxicityrisrarriskrassociatedrwithrmagnesiumrsulfatertherapy.rSignsrofrmagnesiumrtox
icityrrelatertorcentralrnervousrsystemr(CNS)rdepressionrandrincluderrespiratoryrdepression,rlossrofrdeeprtend
onrreflexes,randrsuddenrdroprinrfetalrheartrraterand/orrmaternalrheartrraterandrbloodrpressure.
Magnesiumrisrexcretedrthroughrtherkidneys.rIfrrenalrimpairmentrisrpresent,rmagnesiumrtoxicityrcanrdevelopr
veryrquickly.rTherapeuticrserumrlevelsrofrmagnesiumrarer4rtor7rmEq/L.

Test-
TakingrStrategy:rToranswerrthisrquestionraccurately,ryourmustrrecallrthatrmagnesiumrsulfaterisrarCNSrdepre
ssant.rBeginrtoranswerrthisrquestionrbyreliminatingr“proteinuria”randr“hyperactiverdeeprtendonrreflexes,”rw
hichrarersignsrofrpreeclampsia.rSelectrbetweenrtherlastrtworoptionsrusingrmedicationrknowledgerandrrecallin
grthatrthertherapeuticrserumrlevelsrofrmagnesiumrarer4rtor7rmEq/L.rReviewrthisrmedicationrandrthernormalrm
agnesiumrlevelrifrthisrquestionrwasrdifficult.

PTS: 1
DIF: LevelrofrCognitiverAbility:rAnalyzing
REF: Lowdermilk,rD.,rPerry,rS.,r&rCashion,rK.r(2010).rMaternityrnursingr(8thred.).rSt.rLouis:rMosby.
OBJ:
ClientrNeeds:rPhysiologicalrIntegrityrTOP:
ContentrArea:rPharmacology
MSC:r IntegratedrProcess:rNursingrProcess—Assessment

5. Arpregnantrclientrwhorhasrhumanrimmunodeficiencyrvirusr(HIV)rinfectionrisrbeingrseenrinrtherantenatalrclin
ic.rThernurserrecallsrthatrzidovudiner(AZT)rtherapyrwillrberinitiatedrwhenrtherfetusrhasrreachedrhowrmanyrw
eeksrofrgestation?
1. 4
2. 14
3. 24
4. 34

ANS:r r 2

Rationale:rTherpregnantrwomenrwithrHIVrinfectionrwillrberprescribedroralrAZTrinrtherfourteenthrweekrofrge
station.rBeforerthisrtime,rtherfetusrisratrriskrbecauserofrtherteratogenicreffectsrofrthermedication.rIn