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