Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th
Edition
Pharmacologyh
TesthBank
MULTIPLEhCHOICE
1. Thehnursehishcaringhforhahclienthinhlabor.hThehnursehreviewshthehphysician’shprescriptionshandhnoteshth
aththehclienthhashahprescriptionhforhbutorphanolhtartrateh(Stadol).hThehnursehunderstandshthaththishmedi
cationhishprescribedhfor:
1. Painhrelief
2. Increasinghuterinehcontractions
3. Decreasinghuterinehcontractions
4. Promotinghfetalhlunghmaturity
ANS:h h 1
Rationale:hThehclienthinhlaborhmayhbehgivenhparenteralhanalgesiahduringhthehfirsthstagehofhlabor,huphtoh
2htoh3hhourshbeforehthehanticipatedhdelivery.hButorphanolhtartratehishahmedicationhthathmayhbehprescrib
edhforhpainhrelief.h“Increasinghuterinehcontractions,”h“decreasinghuterinehcontractions,”handh“promoting
hfetalhlunghmaturity”harehnothactionshofhthishmedication.
Test-
TakinghStrategy:hKnowledgehofhthehactionhofhbutorphanolhtartratehishrequiredhtohanswerhthishquestion.
hRememberhthaththishmedicationhishusedhforhpainhrelief.hReviewhthehactionhofhthishmedicationhifhyouhha
dhdifficultyhwithhthishquestionhandharehunfamiliarhwithhthishmedication.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
2. Thehpostpartumhnursehishcaringhforhahclienthwithhanhepiduralhcatheterhinhplacehforhopioidhanalge
sichadministrationhfollowinghcesareanhbirth.hIfhthehclienthdevelopshrespiratoryhdepressionhandhre
quireshnaloxoneh(Narcan)hashanhantidote,hthehclienthmayhcomplainhofhwhichhofhthehfollowing?
1. Increasehinhherhpainhlevel
2. Decreasehinhherhpainhlevel
3. Increasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural
4. Decreasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural
, ANS:h h 1
Rationale:hRememberhthathopioidsharehusedhforhepiduralhanalgesia.hNaloxonehishanhopioidhantagonist,h
whichhreverseshtheheffectshofhopioids.hIfhithishgiven,hthehclienthmayhcomplainhofhanhincreasehinhherhpai
nhlevel.hThereforeh“decreasehinhherhpainhlevel,”h“increasehinhthehamounthofhitchinghfromhthehopioidhuse
dhinhthehepidural,”handh“decreasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural”harehin
correct.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthknowhthathopioidhanalgesicsharehthehme
dicationshusedhwithhepiduralhanalgesiahtohrelievehpain.hThereforehifhnaloxonehishadministeredhashanhant
idotehforhanhopioidhanalgesic,hthehclient’shpainhwillhincrease.hReviewhtheheffectshofhnaloxonehifhthishqu
estionhwashdifficult.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Assessment
3. Ahclienthexperiencinghpretermhlaborhaththehtwenty-
ninthhweekhofhgestationhhashbeenhadmittedhtohthehhospital.hThehclienthhashahprescriptionhtohreceivehbe
tamethasoneh(Celestone).hThehnursehunderstandshthaththehmedicationhwillhdohwhichhofhthehfollowing?
1. Preventhspontaneoushdelivery.
2. Stophthehuterinehcontractions.
3. Promotehmaturationhofhthehfetalhlungs.
4. Acceleratehthehgrowthhratehofhthehfetus.
ANS:h h 3
Rationale:hBetamethasoneh(Celestone)hishclassifiedhashanhanti-
inflammatoryhandhcorticosteroid.hIthincreaseshthehsurfactanthlevelhandhlunghmaturityhinhthehfetus,hwhic
hhreduceshthehincidencehofhrespiratoryhdistresshsyndrome.hDeliveryhmusthbehdelayedhforhathleasth48hho
urshafterhadministrationhofhbetamethasonehtohallowhtimehforhthehlungshofhthehfetushtohmature.
Test-
TakinghStrategy:hOptionshthatharehcomparablehorhalikeharehnothlikelyhtohbehcorrect.hWithhthishinhmind,
heliminateh“preventhspontaneoushdelivery”handh“stophthehuterinehcontractions.”hNotehthehstrategichword
sh“twenty-
ninthhweekhofhgestation.”hSpecifichknowledgehabouththehmedicationhandhknowledgehofhthehproblemshen
counteredhbyhprematurehinfantshwillhassisthinhansweringhthishquestion.hReviewhthehactionhofhthishmedic
ationhifhthishquestionhwashdifficult.
, PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF: McKinney,hE.,hJames,hS.,hMurray,hS.,h&hAshwill,hJ.h(2009).hMaternal-
childhnursingh(3rdhed.).hSt.hLouis:hSaunders. OBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
4. Ahclienthwithhpreeclampsiahishreceivinghmagnesiumhsulfate.hThehnursehassesseshthehclienthcloselyh
forhwhichhsignhofhmagnesiumhtoxicity?
1. Proteinuria
2. Hyperactivehdeephtendonhreflexes
3. Respiratoryhratehofh10hbreaths/min
4. Serumhmagnesiumhlevelhofh5hmEq/L
ANS:h h 3
Rationale:hMagnesiumhtoxicityhishahriskhassociatedhwithhmagnesiumhsulfatehtherapy.hSignshofhmagnesi
umhtoxicityhrelatehtohcentralhnervoushsystemh(CNS)hdepressionhandhincludehrespiratoryhdepression,hlos
shofhdeephtendonhreflexes,handhsuddenhdrophinhfetalhhearthratehand/orhmaternalhhearthratehandhbloodhpre
ssure.
Magnesiumhishexcretedhthroughhthehkidneys.hIfhrenalhimpairmenthishpresent,hmagnesiumhtoxicityhcanhd
evelophveryhquickly.hTherapeutichserumhlevelshofhmagnesiumhareh4htoh7hmEq/L.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthrecallhthathmagnesiumhsulfatehishahCN
Shdepressant.hBeginhtohanswerhthishquestionhbyheliminatingh“proteinuria”handh“hyperactivehdeephtendo
nhreflexes,”hwhichharehsignshofhpreeclampsia.hSelecthbetweenhthehlasthtwohoptionshusinghmedicationhkn
owledgehandhrecallinghthaththehtherapeutichserumhlevelshofhmagnesiumhareh4htoh7hmEq/L.hReviewhthish
medicationhandhthehnormalhmagnesiumhlevelhifhthishquestionhwashdifficult.
PTS: 1
DIF: LevelhofhCognitivehAbility:hAnalyzing
REF:
Lowdermilk,hD.,hPerry,hS.,h&hCashion,hK.h(2010).hMaternityhnursingh(8thhed.).hSt.hLouis:hMosb
y.
OBJ:
ClienthNeeds:hPhysiologicalhIntegrityhTOP:
ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Assessment
5. Ahpregnanthclienthwhohhashhumanhimmunodeficiencyhvirush(HIV)hinfectionhishbeinghseenhinhthehanten
atalhclinic.hThehnursehrecallshthathzidovudineh(AZT)htherapyhwillhbehinitiatedhwhenhthehfetushhashreach
edhhowhmanyhweekshofhgestation?
1. 4
, 2. 14
3. 24
4. 34
ANS:h h 2
Rationale:hThehpregnanthwomenhwithhHIVhinfectionhwillhbehprescribedhoralhAZThinhthehfourteenthhwe
ekhofhgestation.hBeforehthishtime,hthehfetushishathriskhbecausehofhthehteratogenicheffectshofhthehmedicati
on.hIn
addition,hahbolushofhAZThishgivenhintravenouslyhduringhlabor,handhthehneonatehishtreatedhforhsixhweeks
hafterhbirth.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthbehfamiliarhwithhpharmacologicalhther
apyhforhclientshwhoharehHIV-
positive.hKnowinghthaththehfetushishmosthvulnerablehtohtheheffectshofhmedicationshandhchemicalshdurin
ghthehperiodhofhorganogenesishwillhassisthyouhinhselectinghthehcorrecthanswer.hReviewhtreatmenthmeasu
reshforhthehpregnanthclienthwithhHIVhinfectionhifhyouhhadhdifficultyhwithhthishquestion.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
6. Thehnursehhashahroutinehprescriptionhtohinstillherythromycinhointmenth(Ilotycin)hintohtheheyesho
fhahnewborn.hThehnursehplanshtohexplainhtohthehparentshthaththehpurposehofhthehmedicationhisht
o:
1. Helphthehnewbornhtohseehmorehclearly.
2. Guardhagainsthinfectionhacquiredhduringhintrauterinehlife.
3. Ensurehthehsterilityhofhthehconjunctivahinhthehnewborn.
4. Protecththehnewbornhfromhcontractinghanheyehinfectionhduringhbirth.
ANS:h h 4
Rationale:hThehusehofheyehprophylaxishwithhanhagenthsuchhasherythromycinhprotectshthehnewbornhfrom
hcontractinghahconjunctivalhinfectionhduringhbirth.hThishinfection,hcalledhophthalmiahneonatorum,hresult
shfromhmaternalhvaginalhinfectionhwithhchlamydiahorhgonorrhea.hThishprophylaxishishmandatoryhinhtheh
UnitedhStates.h“Helphthehnewbornhtohseehmorehclearly,”h“guardhagainsthinfectionhacquiredhduringhintra
uterinehlife,”handh“ensurehthehsterilityhofhthehconjunctivahinhthehnewborn”hdohnothdescribehthehpurposes
hofhthishmedication.
Edition
Pharmacologyh
TesthBank
MULTIPLEhCHOICE
1. Thehnursehishcaringhforhahclienthinhlabor.hThehnursehreviewshthehphysician’shprescriptionshandhnoteshth
aththehclienthhashahprescriptionhforhbutorphanolhtartrateh(Stadol).hThehnursehunderstandshthaththishmedi
cationhishprescribedhfor:
1. Painhrelief
2. Increasinghuterinehcontractions
3. Decreasinghuterinehcontractions
4. Promotinghfetalhlunghmaturity
ANS:h h 1
Rationale:hThehclienthinhlaborhmayhbehgivenhparenteralhanalgesiahduringhthehfirsthstagehofhlabor,huphtoh
2htoh3hhourshbeforehthehanticipatedhdelivery.hButorphanolhtartratehishahmedicationhthathmayhbehprescrib
edhforhpainhrelief.h“Increasinghuterinehcontractions,”h“decreasinghuterinehcontractions,”handh“promoting
hfetalhlunghmaturity”harehnothactionshofhthishmedication.
Test-
TakinghStrategy:hKnowledgehofhthehactionhofhbutorphanolhtartratehishrequiredhtohanswerhthishquestion.
hRememberhthaththishmedicationhishusedhforhpainhrelief.hReviewhthehactionhofhthishmedicationhifhyouhha
dhdifficultyhwithhthishquestionhandharehunfamiliarhwithhthishmedication.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
2. Thehpostpartumhnursehishcaringhforhahclienthwithhanhepiduralhcatheterhinhplacehforhopioidhanalge
sichadministrationhfollowinghcesareanhbirth.hIfhthehclienthdevelopshrespiratoryhdepressionhandhre
quireshnaloxoneh(Narcan)hashanhantidote,hthehclienthmayhcomplainhofhwhichhofhthehfollowing?
1. Increasehinhherhpainhlevel
2. Decreasehinhherhpainhlevel
3. Increasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural
4. Decreasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural
, ANS:h h 1
Rationale:hRememberhthathopioidsharehusedhforhepiduralhanalgesia.hNaloxonehishanhopioidhantagonist,h
whichhreverseshtheheffectshofhopioids.hIfhithishgiven,hthehclienthmayhcomplainhofhanhincreasehinhherhpai
nhlevel.hThereforeh“decreasehinhherhpainhlevel,”h“increasehinhthehamounthofhitchinghfromhthehopioidhuse
dhinhthehepidural,”handh“decreasehinhthehamounthofhitchinghfromhthehopioidhusedhinhthehepidural”harehin
correct.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthknowhthathopioidhanalgesicsharehthehme
dicationshusedhwithhepiduralhanalgesiahtohrelievehpain.hThereforehifhnaloxonehishadministeredhashanhant
idotehforhanhopioidhanalgesic,hthehclient’shpainhwillhincrease.hReviewhtheheffectshofhnaloxonehifhthishqu
estionhwashdifficult.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Assessment
3. Ahclienthexperiencinghpretermhlaborhaththehtwenty-
ninthhweekhofhgestationhhashbeenhadmittedhtohthehhospital.hThehclienthhashahprescriptionhtohreceivehbe
tamethasoneh(Celestone).hThehnursehunderstandshthaththehmedicationhwillhdohwhichhofhthehfollowing?
1. Preventhspontaneoushdelivery.
2. Stophthehuterinehcontractions.
3. Promotehmaturationhofhthehfetalhlungs.
4. Acceleratehthehgrowthhratehofhthehfetus.
ANS:h h 3
Rationale:hBetamethasoneh(Celestone)hishclassifiedhashanhanti-
inflammatoryhandhcorticosteroid.hIthincreaseshthehsurfactanthlevelhandhlunghmaturityhinhthehfetus,hwhic
hhreduceshthehincidencehofhrespiratoryhdistresshsyndrome.hDeliveryhmusthbehdelayedhforhathleasth48hho
urshafterhadministrationhofhbetamethasonehtohallowhtimehforhthehlungshofhthehfetushtohmature.
Test-
TakinghStrategy:hOptionshthatharehcomparablehorhalikeharehnothlikelyhtohbehcorrect.hWithhthishinhmind,
heliminateh“preventhspontaneoushdelivery”handh“stophthehuterinehcontractions.”hNotehthehstrategichword
sh“twenty-
ninthhweekhofhgestation.”hSpecifichknowledgehabouththehmedicationhandhknowledgehofhthehproblemshen
counteredhbyhprematurehinfantshwillhassisthinhansweringhthishquestion.hReviewhthehactionhofhthishmedic
ationhifhthishquestionhwashdifficult.
, PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF: McKinney,hE.,hJames,hS.,hMurray,hS.,h&hAshwill,hJ.h(2009).hMaternal-
childhnursingh(3rdhed.).hSt.hLouis:hSaunders. OBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
4. Ahclienthwithhpreeclampsiahishreceivinghmagnesiumhsulfate.hThehnursehassesseshthehclienthcloselyh
forhwhichhsignhofhmagnesiumhtoxicity?
1. Proteinuria
2. Hyperactivehdeephtendonhreflexes
3. Respiratoryhratehofh10hbreaths/min
4. Serumhmagnesiumhlevelhofh5hmEq/L
ANS:h h 3
Rationale:hMagnesiumhtoxicityhishahriskhassociatedhwithhmagnesiumhsulfatehtherapy.hSignshofhmagnesi
umhtoxicityhrelatehtohcentralhnervoushsystemh(CNS)hdepressionhandhincludehrespiratoryhdepression,hlos
shofhdeephtendonhreflexes,handhsuddenhdrophinhfetalhhearthratehand/orhmaternalhhearthratehandhbloodhpre
ssure.
Magnesiumhishexcretedhthroughhthehkidneys.hIfhrenalhimpairmenthishpresent,hmagnesiumhtoxicityhcanhd
evelophveryhquickly.hTherapeutichserumhlevelshofhmagnesiumhareh4htoh7hmEq/L.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthrecallhthathmagnesiumhsulfatehishahCN
Shdepressant.hBeginhtohanswerhthishquestionhbyheliminatingh“proteinuria”handh“hyperactivehdeephtendo
nhreflexes,”hwhichharehsignshofhpreeclampsia.hSelecthbetweenhthehlasthtwohoptionshusinghmedicationhkn
owledgehandhrecallinghthaththehtherapeutichserumhlevelshofhmagnesiumhareh4htoh7hmEq/L.hReviewhthish
medicationhandhthehnormalhmagnesiumhlevelhifhthishquestionhwashdifficult.
PTS: 1
DIF: LevelhofhCognitivehAbility:hAnalyzing
REF:
Lowdermilk,hD.,hPerry,hS.,h&hCashion,hK.h(2010).hMaternityhnursingh(8thhed.).hSt.hLouis:hMosb
y.
OBJ:
ClienthNeeds:hPhysiologicalhIntegrityhTOP:
ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Assessment
5. Ahpregnanthclienthwhohhashhumanhimmunodeficiencyhvirush(HIV)hinfectionhishbeinghseenhinhthehanten
atalhclinic.hThehnursehrecallshthathzidovudineh(AZT)htherapyhwillhbehinitiatedhwhenhthehfetushhashreach
edhhowhmanyhweekshofhgestation?
1. 4
, 2. 14
3. 24
4. 34
ANS:h h 2
Rationale:hThehpregnanthwomenhwithhHIVhinfectionhwillhbehprescribedhoralhAZThinhthehfourteenthhwe
ekhofhgestation.hBeforehthishtime,hthehfetushishathriskhbecausehofhthehteratogenicheffectshofhthehmedicati
on.hIn
addition,hahbolushofhAZThishgivenhintravenouslyhduringhlabor,handhthehneonatehishtreatedhforhsixhweeks
hafterhbirth.
Test-
TakinghStrategy:hTohanswerhthishquestionhaccurately,hyouhmusthbehfamiliarhwithhpharmacologicalhther
apyhforhclientshwhoharehHIV-
positive.hKnowinghthaththehfetushishmosthvulnerablehtohtheheffectshofhmedicationshandhchemicalshdurin
ghthehperiodhofhorganogenesishwillhassisthyouhinhselectinghthehcorrecthanswer.hReviewhtreatmenthmeasu
reshforhthehpregnanthclienthwithhHIVhinfectionhifhyouhhadhdifficultyhwithhthishquestion.
PTS: 1
DIF: LevelhofhCognitivehAbility:hUnderstanding
REF:
Lehne,hR.h(2010).hPharmacologyhforhnursinghcareh(7thhed.).hSt.hLouis:hSaunde
rs.hOBJ: ClienthNeeds:hPhysiologicalhIntegrity
TOP: ContenthArea:hPharmacology
MSC:h IntegratedhProcess:hNursinghProcess—Planning
6. Thehnursehhashahroutinehprescriptionhtohinstillherythromycinhointmenth(Ilotycin)hintohtheheyesho
fhahnewborn.hThehnursehplanshtohexplainhtohthehparentshthaththehpurposehofhthehmedicationhisht
o:
1. Helphthehnewbornhtohseehmorehclearly.
2. Guardhagainsthinfectionhacquiredhduringhintrauterinehlife.
3. Ensurehthehsterilityhofhthehconjunctivahinhthehnewborn.
4. Protecththehnewbornhfromhcontractinghanheyehinfectionhduringhbirth.
ANS:h h 4
Rationale:hThehusehofheyehprophylaxishwithhanhagenthsuchhasherythromycinhprotectshthehnewbornhfrom
hcontractinghahconjunctivalhinfectionhduringhbirth.hThishinfection,hcalledhophthalmiahneonatorum,hresult
shfromhmaternalhvaginalhinfectionhwithhchlamydiahorhgonorrhea.hThishprophylaxishishmandatoryhinhtheh
UnitedhStates.h“Helphthehnewbornhtohseehmorehclearly,”h“guardhagainsthinfectionhacquiredhduringhintra
uterinehlife,”handh“ensurehthehsterilityhofhthehconjunctivahinhthehnewborn”hdohnothdescribehthehpurposes
hofhthishmedication.
