Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th
Edition
Pharmacology
Test Bank
MULTIPLE CHOICE
1. Thenurseiscaringforaclientinlabor.Thenursereviewsthephysician’sprescriptionsandnotesthattheclienthas
aprescriptionforbutorphanoltartrate(Stadol).Thenurseunderstandsthatthismedicationisprescribedfor:
1. Painrelief
2. Increasinguterinecontractions
3. Decreasinguterinecontractions
4. Promotingfetallungmaturity
ANS:1
Rationale:Theclientinlabormaybegivenparenteralanalgesiaduringthefirststageoflabor,upto2to3hoursbefo
retheanticipateddelivery.Butorphanoltartrateisamedicationthatmaybeprescribedforpainrelief.“Increasingu
terinecontractions,”“decreasinguterinecontractions,”and“promotingfetallungmaturity”arenotactionsofthis
medication.
Test-
TakingStrategy:Knowledgeoftheactionofbutorphanoltartrateisrequiredtoanswerthisquestion.Remembert
hatthismedicationisusedforpainrelief.Reviewtheactionofthismedicationifyouhaddifficultywiththisquestio
nandareunfamiliarwiththismedication.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
2. Thepostpartumnurseiscaringforaclientwithanepiduralcatheterinplaceforopioidanalgesicadministr
ationfollowingcesareanbirth.Iftheclientdevelopsrespiratorydepressionandrequiresnaloxone(Narca
n)asanantidote,theclientmaycomplainofwhichofthefollowing?
1. Increaseinherpainlevel
2. Decreaseinherpainlevel
3. Increaseintheamountofitchingfromtheopioidusedintheepidural
4. Decreaseintheamountofitchingfromtheopioidusedintheepidural
, ANS:1
Rationale:Rememberthatopioidsareusedforepiduralanalgesia.Naloxoneisanopioidantagonist,whichrevers
estheeffectsofopioids.Ifitisgiven,theclientmaycomplainofanincreaseinherpainlevel.Therefore“decreasein
herpainlevel,”“increaseintheamountofitchingfromtheopioidusedintheepidural,”and“decreaseintheamount
ofitchingfromtheopioidusedintheepidural”areincorrect.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustknowthatopioidanalgesicsarethemedicationsus
edwithepiduralanalgesiatorelievepain.Thereforeifnaloxoneisadministeredasanantidoteforanopioidanalges
ic,theclient’spainwillincrease.Reviewtheeffectsofnaloxoneifthisquestionwasdifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Assessment
3. Aclientexperiencingpretermlaboratthetwenty-
ninthweekofgestationhasbeenadmittedtothehospital.Theclienthasaprescriptiontoreceivebetamethasone(
Celestone).Thenurseunderstandsthatthemedicationwilldowhichofthefollowing?
1. Preventspontaneousdelivery.
2. Stoptheuterinecontractions.
3. Promotematurationofthefetallungs.
4. Acceleratethegrowthrateofthefetus.
ANS:3
Rationale:Betamethasone(Celestone)isclassifiedasananti-
inflammatoryandcorticosteroid.Itincreasesthesurfactantlevelandlungmaturityinthefetus,whichreducesthe
incidenceofrespiratorydistresssyndrome.Deliverymustbedelayedforatleast48hoursafteradministrationofb
etamethasonetoallowtimeforthelungsofthefetustomature.
Test-
TakingStrategy:Optionsthatarecomparableoralikearenotlikelytobecorrect.Withthisinmind,eliminate“prev
entspontaneousdelivery”and“stoptheuterinecontractions.”Notethestrategicwords“twenty-
ninthweekofgestation.”Specificknowledgeaboutthemedicationandknowledgeoftheproblemsencounteredb
yprematureinfantswillassistinansweringthisquestion.Reviewtheactionofthismedicationifthisquestionwasd
ifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: McKinney,E.,James,S.,Murray,S.,&Ashwill,J.(2009).Maternal-
childnursing(3rded.).St.Louis:Saunders. OBJ: ClientNeeds:PhysiologicalIntegrity
, TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
4. Aclientwithpreeclampsiaisreceivingmagnesiumsulfate.Thenurseassessestheclientcloselyforwhichsi
gnofmagnesiumtoxicity?
1. Proteinuria
2. Hyperactivedeeptendonreflexes
3. Respiratoryrateof10breaths/min
4. Serummagnesiumlevelof5mEq/L
ANS:3
Rationale:Magnesiumtoxicityisariskassociatedwithmagnesiumsulfatetherapy.Signsofmagnesiumtoxicity
relatetocentralnervoussystem(CNS)depressionandincluderespiratorydepression,lossofdeeptendonreflexes
,andsuddendropinfetalheartrateand/ormaternalheartrateandbloodpressure.
Magnesiumisexcretedthroughthekidneys.Ifrenalimpairmentispresent,magnesiumtoxicitycandevelopvery
quickly.Therapeuticserumlevelsofmagnesiumare4to7mEq/L.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustrecallthatmagnesiumsulfateisaCNSdepressant.
Begintoanswerthisquestionbyeliminating“proteinuria”and“hyperactivedeeptendonreflexes,”whicharesig
nsofpreeclampsia.Selectbetweenthelasttwooptionsusingmedicationknowledgeandrecallingthatthetherape
uticserumlevelsofmagnesiumare4to7mEq/L.Reviewthismedicationandthenormalmagnesiumlevelifthisqu
estionwasdifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Analyzing
REF: Lowdermilk,D.,Perry,S.,&Cashion,K.(2010).Maternitynursing(8thed.).St.Louis:Mosby.
OBJ:
ClientNeeds:PhysiologicalIntegrityTOP:
ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Assessment
5. Apregnantclientwhohashumanimmunodeficiencyvirus(HIV)infectionisbeingseenintheantenatalclinic.Th
enurserecallsthatzidovudine(AZT)therapywillbeinitiatedwhenthefetushasreachedhowmanyweeksofgesta
tion?
1. 4
2. 14
3. 24
4. 34
ANS:2
Rationale:ThepregnantwomenwithHIVinfectionwillbeprescribedoralAZTinthefourteenthweekofgestati
on.Beforethistime,thefetusisatriskbecauseoftheteratogeniceffectsofthemedication.In
, addition,abolusofAZTisgivenintravenouslyduringlabor,andtheneonateistreatedforsixweeksafterbirth.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustbefamiliarwithpharmacologicaltherapyforclien
tswhoareHIV-
positive.Knowingthatthefetusismostvulnerabletotheeffectsofmedicationsandchemicalsduringtheperiodof
organogenesiswillassistyouinselectingthecorrectanswer.Reviewtreatmentmeasuresforthepregnantclientw
ithHIVinfectionifyouhaddifficultywiththisquestion.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
6. Thenursehasaroutineprescriptiontoinstillerythromycinointment(Ilotycin)intotheeyesofanewborn
.Thenurseplanstoexplaintotheparentsthatthepurposeofthemedicationisto:
1. Helpthenewborntoseemoreclearly.
2. Guardagainstinfectionacquiredduringintrauterinelife.
3. Ensurethesterilityoftheconjunctivainthenewborn.
4. Protectthenewbornfromcontractinganeyeinfectionduringbirth.
ANS:4
Rationale:Theuseofeyeprophylaxiswithanagentsuchaserythromycinprotectsthenewbornfromcontractinga
conjunctivalinfectionduringbirth.Thisinfection,calledophthalmianeonatorum,resultsfrommaternalvaginal
infectionwithchlamydiaorgonorrhea.ThisprophylaxisismandatoryintheUnitedStates.“Helpthenewborntos
eemoreclearly,”“guardagainstinfectionacquiredduringintrauterinelife,”and“ensurethesterilityoftheconjun
ctivainthenewborn”donotdescribethepurposesofthismedication.
Test-
TakingStrategy:Familiaritywiththepurposeofthismedicationisneededtoanswerthisquestion.Rememberery
thromycinprotectsthenewbornfromcontractingaconjunctivalinfectionduringbirth.
Reviewthepurposeofthismedicationifyouhaddifficultywiththisquestion.
PTS: 1
DIF: LevelofCognitiveAbility:Applying
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:HealthPromotionandMaintenance
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:TeachingandLearning
7. Thenursehasaroutineprescriptiontoadministeraninjectionofphytonadione(vitaminK)tothenewborn
.Beforegivingthemedication,thenurseexplainstotheclientthatthismedicationwill:
Edition
Pharmacology
Test Bank
MULTIPLE CHOICE
1. Thenurseiscaringforaclientinlabor.Thenursereviewsthephysician’sprescriptionsandnotesthattheclienthas
aprescriptionforbutorphanoltartrate(Stadol).Thenurseunderstandsthatthismedicationisprescribedfor:
1. Painrelief
2. Increasinguterinecontractions
3. Decreasinguterinecontractions
4. Promotingfetallungmaturity
ANS:1
Rationale:Theclientinlabormaybegivenparenteralanalgesiaduringthefirststageoflabor,upto2to3hoursbefo
retheanticipateddelivery.Butorphanoltartrateisamedicationthatmaybeprescribedforpainrelief.“Increasingu
terinecontractions,”“decreasinguterinecontractions,”and“promotingfetallungmaturity”arenotactionsofthis
medication.
Test-
TakingStrategy:Knowledgeoftheactionofbutorphanoltartrateisrequiredtoanswerthisquestion.Remembert
hatthismedicationisusedforpainrelief.Reviewtheactionofthismedicationifyouhaddifficultywiththisquestio
nandareunfamiliarwiththismedication.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
2. Thepostpartumnurseiscaringforaclientwithanepiduralcatheterinplaceforopioidanalgesicadministr
ationfollowingcesareanbirth.Iftheclientdevelopsrespiratorydepressionandrequiresnaloxone(Narca
n)asanantidote,theclientmaycomplainofwhichofthefollowing?
1. Increaseinherpainlevel
2. Decreaseinherpainlevel
3. Increaseintheamountofitchingfromtheopioidusedintheepidural
4. Decreaseintheamountofitchingfromtheopioidusedintheepidural
, ANS:1
Rationale:Rememberthatopioidsareusedforepiduralanalgesia.Naloxoneisanopioidantagonist,whichrevers
estheeffectsofopioids.Ifitisgiven,theclientmaycomplainofanincreaseinherpainlevel.Therefore“decreasein
herpainlevel,”“increaseintheamountofitchingfromtheopioidusedintheepidural,”and“decreaseintheamount
ofitchingfromtheopioidusedintheepidural”areincorrect.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustknowthatopioidanalgesicsarethemedicationsus
edwithepiduralanalgesiatorelievepain.Thereforeifnaloxoneisadministeredasanantidoteforanopioidanalges
ic,theclient’spainwillincrease.Reviewtheeffectsofnaloxoneifthisquestionwasdifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Assessment
3. Aclientexperiencingpretermlaboratthetwenty-
ninthweekofgestationhasbeenadmittedtothehospital.Theclienthasaprescriptiontoreceivebetamethasone(
Celestone).Thenurseunderstandsthatthemedicationwilldowhichofthefollowing?
1. Preventspontaneousdelivery.
2. Stoptheuterinecontractions.
3. Promotematurationofthefetallungs.
4. Acceleratethegrowthrateofthefetus.
ANS:3
Rationale:Betamethasone(Celestone)isclassifiedasananti-
inflammatoryandcorticosteroid.Itincreasesthesurfactantlevelandlungmaturityinthefetus,whichreducesthe
incidenceofrespiratorydistresssyndrome.Deliverymustbedelayedforatleast48hoursafteradministrationofb
etamethasonetoallowtimeforthelungsofthefetustomature.
Test-
TakingStrategy:Optionsthatarecomparableoralikearenotlikelytobecorrect.Withthisinmind,eliminate“prev
entspontaneousdelivery”and“stoptheuterinecontractions.”Notethestrategicwords“twenty-
ninthweekofgestation.”Specificknowledgeaboutthemedicationandknowledgeoftheproblemsencounteredb
yprematureinfantswillassistinansweringthisquestion.Reviewtheactionofthismedicationifthisquestionwasd
ifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: McKinney,E.,James,S.,Murray,S.,&Ashwill,J.(2009).Maternal-
childnursing(3rded.).St.Louis:Saunders. OBJ: ClientNeeds:PhysiologicalIntegrity
, TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
4. Aclientwithpreeclampsiaisreceivingmagnesiumsulfate.Thenurseassessestheclientcloselyforwhichsi
gnofmagnesiumtoxicity?
1. Proteinuria
2. Hyperactivedeeptendonreflexes
3. Respiratoryrateof10breaths/min
4. Serummagnesiumlevelof5mEq/L
ANS:3
Rationale:Magnesiumtoxicityisariskassociatedwithmagnesiumsulfatetherapy.Signsofmagnesiumtoxicity
relatetocentralnervoussystem(CNS)depressionandincluderespiratorydepression,lossofdeeptendonreflexes
,andsuddendropinfetalheartrateand/ormaternalheartrateandbloodpressure.
Magnesiumisexcretedthroughthekidneys.Ifrenalimpairmentispresent,magnesiumtoxicitycandevelopvery
quickly.Therapeuticserumlevelsofmagnesiumare4to7mEq/L.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustrecallthatmagnesiumsulfateisaCNSdepressant.
Begintoanswerthisquestionbyeliminating“proteinuria”and“hyperactivedeeptendonreflexes,”whicharesig
nsofpreeclampsia.Selectbetweenthelasttwooptionsusingmedicationknowledgeandrecallingthatthetherape
uticserumlevelsofmagnesiumare4to7mEq/L.Reviewthismedicationandthenormalmagnesiumlevelifthisqu
estionwasdifficult.
PTS: 1
DIF: LevelofCognitiveAbility:Analyzing
REF: Lowdermilk,D.,Perry,S.,&Cashion,K.(2010).Maternitynursing(8thed.).St.Louis:Mosby.
OBJ:
ClientNeeds:PhysiologicalIntegrityTOP:
ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Assessment
5. Apregnantclientwhohashumanimmunodeficiencyvirus(HIV)infectionisbeingseenintheantenatalclinic.Th
enurserecallsthatzidovudine(AZT)therapywillbeinitiatedwhenthefetushasreachedhowmanyweeksofgesta
tion?
1. 4
2. 14
3. 24
4. 34
ANS:2
Rationale:ThepregnantwomenwithHIVinfectionwillbeprescribedoralAZTinthefourteenthweekofgestati
on.Beforethistime,thefetusisatriskbecauseoftheteratogeniceffectsofthemedication.In
, addition,abolusofAZTisgivenintravenouslyduringlabor,andtheneonateistreatedforsixweeksafterbirth.
Test-
TakingStrategy:Toanswerthisquestionaccurately,youmustbefamiliarwithpharmacologicaltherapyforclien
tswhoareHIV-
positive.Knowingthatthefetusismostvulnerabletotheeffectsofmedicationsandchemicalsduringtheperiodof
organogenesiswillassistyouinselectingthecorrectanswer.Reviewtreatmentmeasuresforthepregnantclientw
ithHIVinfectionifyouhaddifficultywiththisquestion.
PTS: 1
DIF: LevelofCognitiveAbility:Understanding
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:PhysiologicalIntegrity
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:NursingProcess—Planning
6. Thenursehasaroutineprescriptiontoinstillerythromycinointment(Ilotycin)intotheeyesofanewborn
.Thenurseplanstoexplaintotheparentsthatthepurposeofthemedicationisto:
1. Helpthenewborntoseemoreclearly.
2. Guardagainstinfectionacquiredduringintrauterinelife.
3. Ensurethesterilityoftheconjunctivainthenewborn.
4. Protectthenewbornfromcontractinganeyeinfectionduringbirth.
ANS:4
Rationale:Theuseofeyeprophylaxiswithanagentsuchaserythromycinprotectsthenewbornfromcontractinga
conjunctivalinfectionduringbirth.Thisinfection,calledophthalmianeonatorum,resultsfrommaternalvaginal
infectionwithchlamydiaorgonorrhea.ThisprophylaxisismandatoryintheUnitedStates.“Helpthenewborntos
eemoreclearly,”“guardagainstinfectionacquiredduringintrauterinelife,”and“ensurethesterilityoftheconjun
ctivainthenewborn”donotdescribethepurposesofthismedication.
Test-
TakingStrategy:Familiaritywiththepurposeofthismedicationisneededtoanswerthisquestion.Rememberery
thromycinprotectsthenewbornfromcontractingaconjunctivalinfectionduringbirth.
Reviewthepurposeofthismedicationifyouhaddifficultywiththisquestion.
PTS: 1
DIF: LevelofCognitiveAbility:Applying
REF: Lehne,R.(2010).Pharmacologyfornursingcare(7thed.).St.Louis:Saunders.OBJ:
ClientNeeds:HealthPromotionandMaintenance
TOP: ContentArea:Pharmacology
MSC:IntegratedProcess:TeachingandLearning
7. Thenursehasaroutineprescriptiontoadministeraninjectionofphytonadione(vitaminK)tothenewborn
.Beforegivingthemedication,thenurseexplainstotheclientthatthismedicationwill:
