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