Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
Silvestri: Saunders Comprehensive Review for the NCLEX-RN®
g g g g g g g
Examination, 5thEdition
g g
Pharmacology
Test gBank
g
MULTIPLE gCHOICE
1. The gnurse gis gcaring gfor ga gclient gin glabor. gThe gnurse greviews gthe gphysician’s gprescriptions gand gnotes
gthat gthe gclient ghas ga gprescription gfor gbutorphanol gtartrate g(Stadol). gThe gnurse gunderstands gthat gthis
gmedication gis gprescribed gfor:
1. Pain grelief
2. Increasing guterine gcontractions
3. Decreasing guterine gcontractions
4. Promoting gfetal glung gmaturity
ANS: g 1
Rationale: gThe gclient gin glabor gmay gbe ggiven gparenteral ganalgesia gduring gthe gfirst gstage gof glabor, gup gto
g2 gto g3 ghours gbefore gthe ganticipated gdelivery. gButorphanol gtartrate gis ga gmedication gthat gmay gbe
gprescribed gfor
pain grelief. g“Increasing guterine gcontractions,” g“decreasing guterine gcontractions,” gand g“promoting gfetal
glung gmaturity” gare gnot gactions gof gthis gmedication.
Test-Taking gStrategy: gKnowledge gof gthe gaction gof gbutorphanol gtartrate gis grequired gto ganswer gthis
gquestion. gRemember gthat gthis gmedication gis gused gfor gpain grelief. gReview gthe gaction gof gthis gmedication
gif gyou ghad gdifficulty gwith gthis gquestion gand gare gunfamiliar gwith gthis gmedication.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: Lehne, gR. g(2010). gPharmacology gfor gnursing gcare g(7th ged.). gSt. gLouis:
gSaunders. gOBJ: Client gNeeds: gPhysiological gIntegrity
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Planning
2. The gpostpartum gnurse gis gcaring gfor ga gclient gwith gan gepidural gcatheter gin gplace gfor gopioid
ganalgesic gadministration gfollowing gcesarean gbirth. gIf gthe gclient gdevelops grespiratory
gdepression gand grequires gnaloxone g(Narcan) gas gan gantidote, gthe gclient gmay gcomplain gof gwhich
gof gthe gfollowing?
1. Increase gin gher gpain glevel
2. Decrease gin gher gpain glevel
3. Increase gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe gepidural
,Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
4. Decrease gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe gepidural
, Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
ANS: g 1
Rationale: gRemember gthat gopioids gare gused gfor gepidural ganalgesia. gNaloxone gis gan gopioid gantagonist,
gwhich greverses gthe geffects gof gopioids. gIf git gis ggiven, gthe gclient gmay gcomplain gof gan gincrease gin gher
gpain glevel. gTherefore g“decrease gin gher gpain glevel,” g“increase gin gthe gamount gof gitching gfrom gthe
gopioid gused gin gthe gepidural,” gand g“decrease gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe
gepidural” gare gincorrect.
Test-Taking gStrategy: gTo ganswer gthis gquestion gaccurately, gyou gmust gknow gthat gopioid ganalgesics gare
gthe gmedications gused gwith gepidural ganalgesia gto grelieve gpain. gTherefore gif gnaloxone gis gadministered
gas gan gantidote gfor gan gopioid ganalgesic, gthe gclient’s gpain gwill gincrease. gReview gthe geffects gof
gnaloxone gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: Lehne, gR. g(2010). gPharmacology gfor gnursing gcare g(7th ged.). gSt. gLouis:
gSaunders. gOBJ: Client gNeeds: gPhysiological gIntegrity
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Assessment
3. A gclient gexperiencing gpreterm glabor gat gthe gtwenty-ninth gweek gof ggestation ghas gbeen gadmitted gto gthe
ghospital. gThe gclient ghas ga gprescription gto greceive gbetamethasone g(Celestone). gThe gnurse gunderstands
gthat gthe gmedication gwill gdo gwhich gof gthe gfollowing?
1. Prevent gspontaneous gdelivery.
2. Stop gthe guterine gcontractions.
3. Promote gmaturation gof gthe gfetal glungs.
4. Accelerate gthe ggrowth grate gof gthe gfetus.
ANS: g 3
Rationale: gBetamethasone g(Celestone) gis gclassified gas gan ganti-inflammatory gand gcorticosteroid. gIt
gincreases gthe gsurfactant glevel gand glung gmaturity gin gthe gfetus, gwhich greduces gthe gincidence gof
grespiratory gdistress gsyndrome. gDelivery gmust gbe gdelayed gfor gat gleast g48 ghours gafter gadministration gof
gbetamethasone gto gallow gtime gfor gthe glungs gof gthe gfetus gto gmature.
Test-Taking gStrategy: gOptions gthat gare gcomparable gor galike gare gnot glikely gto gbe gcorrect. gWith gthis gin
gmind, geliminate g“prevent gspontaneous gdelivery” gand g“stop gthe guterine gcontractions.” gNote gthe
gstrategic gwords g“twenty-ninth gweek gof ggestation.” gSpecific gknowledge gabout gthe gmedication gand
gknowledge gof gthe gproblems gencountered gby gpremature ginfants gwill gassist gin ganswering gthis gquestion.
gReview gthe gaction gof gthis gmedication gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: McKinney, gE., gJames, gS., gMurray, gS., g& gAshwill, gJ. g(2009). gMaternal-child gnursing g(3rd ged.).
gSt. gLouis: gSaunders. OBJ: Client gNeeds: gPhysiological gIntegrity
, Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Planning
4. A gclient gwith gpreeclampsia gis greceiving gmagnesium gsulfate. gThe gnurse gassesses gthe gclient gclosely
gfor gwhich gsign gof gmagnesium gtoxicity?
1. Proteinuria
2. Hyperactive gdeep gtendon greflexes
3. Respiratory grate gof g10 gbreaths/min
4. Serum gmagnesium glevel gof g5 gmEq/L
ANS: g 3
Rationale: gMagnesium gtoxicity gis ga grisk gassociated gwith gmagnesium gsulfate gtherapy. gSigns gof
gmagnesium gtoxicity grelate gto gcentral gnervous gsystem g(CNS) gdepression gand ginclude grespiratory
gdepression, gloss gof gdeep gtendon greflexes, gand gsudden gdrop gin gfetal gheart grate gand/or gmaternal gheart
grate gand gblood gpressure.
Magnesium gis gexcreted gthrough gthe gkidneys. gIf grenal gimpairment gis gpresent, gmagnesium gtoxicity gcan
gdevelop gvery gquickly. gTherapeutic gserum glevels gof gmagnesium gare g4 gto g7 gmEq/L.
Test-Taking gStrategy: gTo ganswer gthis gquestion gaccurately, gyou gmust grecall gthat gmagnesium gsulfate gis
ga gCNS gdepressant. gBegin gto ganswer gthis gquestion gby geliminating g“proteinuria” gand g“hyperactive gdeep
gtendon greflexes,” gwhich gare gsigns gof gpreeclampsia. gSelect gbetween gthe glast gtwo goptions gusing
gmedication gknowledge gand grecalling gthat gthe gtherapeutic gserum glevels gof gmagnesium gare g4 gto g7
gmEq/L. gReview gthis gmedication gand gthe gnormal gmagnesium glevel gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gAnalyzing
REF: Lowdermilk, gD., gPerry, gS., g& gCashion, gK. g(2010). gMaternity gnursing g(8th ged.). gSt. gLouis:
gMosby.
OBJ: Client gNeeds: gPhysiological
gIntegrity gTOP: g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Assessment
5. A gpregnant gclient gwho ghas ghuman gimmunodeficiency gvirus g(HIV) ginfection gis gbeing gseen gin gthe
gantenatal gclinic. gThe gnurse grecalls gthat gzidovudine g(AZT) gtherapy gwill gbe ginitiated gwhen gthe gfetus
ghas greached ghow gmany gweeks gof ggestation?
1. 4
2. 14
3. 24
4. 34
ANS: g 2
Rationale: gThe gpregnant gwomen gwith gHIV ginfection gwill gbe gprescribed goral gAZT gin gthe gfourteenth
gweek
g Edition
Silvestri: Saunders Comprehensive Review for the NCLEX-RN®
g g g g g g g
Examination, 5thEdition
g g
Pharmacology
Test gBank
g
MULTIPLE gCHOICE
1. The gnurse gis gcaring gfor ga gclient gin glabor. gThe gnurse greviews gthe gphysician’s gprescriptions gand gnotes
gthat gthe gclient ghas ga gprescription gfor gbutorphanol gtartrate g(Stadol). gThe gnurse gunderstands gthat gthis
gmedication gis gprescribed gfor:
1. Pain grelief
2. Increasing guterine gcontractions
3. Decreasing guterine gcontractions
4. Promoting gfetal glung gmaturity
ANS: g 1
Rationale: gThe gclient gin glabor gmay gbe ggiven gparenteral ganalgesia gduring gthe gfirst gstage gof glabor, gup gto
g2 gto g3 ghours gbefore gthe ganticipated gdelivery. gButorphanol gtartrate gis ga gmedication gthat gmay gbe
gprescribed gfor
pain grelief. g“Increasing guterine gcontractions,” g“decreasing guterine gcontractions,” gand g“promoting gfetal
glung gmaturity” gare gnot gactions gof gthis gmedication.
Test-Taking gStrategy: gKnowledge gof gthe gaction gof gbutorphanol gtartrate gis grequired gto ganswer gthis
gquestion. gRemember gthat gthis gmedication gis gused gfor gpain grelief. gReview gthe gaction gof gthis gmedication
gif gyou ghad gdifficulty gwith gthis gquestion gand gare gunfamiliar gwith gthis gmedication.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: Lehne, gR. g(2010). gPharmacology gfor gnursing gcare g(7th ged.). gSt. gLouis:
gSaunders. gOBJ: Client gNeeds: gPhysiological gIntegrity
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Planning
2. The gpostpartum gnurse gis gcaring gfor ga gclient gwith gan gepidural gcatheter gin gplace gfor gopioid
ganalgesic gadministration gfollowing gcesarean gbirth. gIf gthe gclient gdevelops grespiratory
gdepression gand grequires gnaloxone g(Narcan) gas gan gantidote, gthe gclient gmay gcomplain gof gwhich
gof gthe gfollowing?
1. Increase gin gher gpain glevel
2. Decrease gin gher gpain glevel
3. Increase gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe gepidural
,Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
4. Decrease gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe gepidural
, Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
ANS: g 1
Rationale: gRemember gthat gopioids gare gused gfor gepidural ganalgesia. gNaloxone gis gan gopioid gantagonist,
gwhich greverses gthe geffects gof gopioids. gIf git gis ggiven, gthe gclient gmay gcomplain gof gan gincrease gin gher
gpain glevel. gTherefore g“decrease gin gher gpain glevel,” g“increase gin gthe gamount gof gitching gfrom gthe
gopioid gused gin gthe gepidural,” gand g“decrease gin gthe gamount gof gitching gfrom gthe gopioid gused gin gthe
gepidural” gare gincorrect.
Test-Taking gStrategy: gTo ganswer gthis gquestion gaccurately, gyou gmust gknow gthat gopioid ganalgesics gare
gthe gmedications gused gwith gepidural ganalgesia gto grelieve gpain. gTherefore gif gnaloxone gis gadministered
gas gan gantidote gfor gan gopioid ganalgesic, gthe gclient’s gpain gwill gincrease. gReview gthe geffects gof
gnaloxone gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: Lehne, gR. g(2010). gPharmacology gfor gnursing gcare g(7th ged.). gSt. gLouis:
gSaunders. gOBJ: Client gNeeds: gPhysiological gIntegrity
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Assessment
3. A gclient gexperiencing gpreterm glabor gat gthe gtwenty-ninth gweek gof ggestation ghas gbeen gadmitted gto gthe
ghospital. gThe gclient ghas ga gprescription gto greceive gbetamethasone g(Celestone). gThe gnurse gunderstands
gthat gthe gmedication gwill gdo gwhich gof gthe gfollowing?
1. Prevent gspontaneous gdelivery.
2. Stop gthe guterine gcontractions.
3. Promote gmaturation gof gthe gfetal glungs.
4. Accelerate gthe ggrowth grate gof gthe gfetus.
ANS: g 3
Rationale: gBetamethasone g(Celestone) gis gclassified gas gan ganti-inflammatory gand gcorticosteroid. gIt
gincreases gthe gsurfactant glevel gand glung gmaturity gin gthe gfetus, gwhich greduces gthe gincidence gof
grespiratory gdistress gsyndrome. gDelivery gmust gbe gdelayed gfor gat gleast g48 ghours gafter gadministration gof
gbetamethasone gto gallow gtime gfor gthe glungs gof gthe gfetus gto gmature.
Test-Taking gStrategy: gOptions gthat gare gcomparable gor galike gare gnot glikely gto gbe gcorrect. gWith gthis gin
gmind, geliminate g“prevent gspontaneous gdelivery” gand g“stop gthe guterine gcontractions.” gNote gthe
gstrategic gwords g“twenty-ninth gweek gof ggestation.” gSpecific gknowledge gabout gthe gmedication gand
gknowledge gof gthe gproblems gencountered gby gpremature ginfants gwill gassist gin ganswering gthis gquestion.
gReview gthe gaction gof gthis gmedication gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gUnderstanding
REF: McKinney, gE., gJames, gS., gMurray, gS., g& gAshwill, gJ. g(2009). gMaternal-child gnursing g(3rd ged.).
gSt. gLouis: gSaunders. OBJ: Client gNeeds: gPhysiological gIntegrity
, Silvestri: gSaunders gComprehensive gReview gfor gthe gNCLEX-RN® gExamination, g5th
g Edition
TOP: g g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Planning
4. A gclient gwith gpreeclampsia gis greceiving gmagnesium gsulfate. gThe gnurse gassesses gthe gclient gclosely
gfor gwhich gsign gof gmagnesium gtoxicity?
1. Proteinuria
2. Hyperactive gdeep gtendon greflexes
3. Respiratory grate gof g10 gbreaths/min
4. Serum gmagnesium glevel gof g5 gmEq/L
ANS: g 3
Rationale: gMagnesium gtoxicity gis ga grisk gassociated gwith gmagnesium gsulfate gtherapy. gSigns gof
gmagnesium gtoxicity grelate gto gcentral gnervous gsystem g(CNS) gdepression gand ginclude grespiratory
gdepression, gloss gof gdeep gtendon greflexes, gand gsudden gdrop gin gfetal gheart grate gand/or gmaternal gheart
grate gand gblood gpressure.
Magnesium gis gexcreted gthrough gthe gkidneys. gIf grenal gimpairment gis gpresent, gmagnesium gtoxicity gcan
gdevelop gvery gquickly. gTherapeutic gserum glevels gof gmagnesium gare g4 gto g7 gmEq/L.
Test-Taking gStrategy: gTo ganswer gthis gquestion gaccurately, gyou gmust grecall gthat gmagnesium gsulfate gis
ga gCNS gdepressant. gBegin gto ganswer gthis gquestion gby geliminating g“proteinuria” gand g“hyperactive gdeep
gtendon greflexes,” gwhich gare gsigns gof gpreeclampsia. gSelect gbetween gthe glast gtwo goptions gusing
gmedication gknowledge gand grecalling gthat gthe gtherapeutic gserum glevels gof gmagnesium gare g4 gto g7
gmEq/L. gReview gthis gmedication gand gthe gnormal gmagnesium glevel gif gthis gquestion gwas gdifficult.
PTS: 1
DIF: Level gof gCognitive gAbility: gAnalyzing
REF: Lowdermilk, gD., gPerry, gS., g& gCashion, gK. g(2010). gMaternity gnursing g(8th ged.). gSt. gLouis:
gMosby.
OBJ: Client gNeeds: gPhysiological
gIntegrity gTOP: g Content gArea: gPharmacology
MSC: g Integrated gProcess: gNursing gProcess—Assessment
5. A gpregnant gclient gwho ghas ghuman gimmunodeficiency gvirus g(HIV) ginfection gis gbeing gseen gin gthe
gantenatal gclinic. gThe gnurse grecalls gthat gzidovudine g(AZT) gtherapy gwill gbe ginitiated gwhen gthe gfetus
ghas greached ghow gmany gweeks gof ggestation?
1. 4
2. 14
3. 24
4. 34
ANS: g 2
Rationale: gThe gpregnant gwomen gwith gHIV ginfection gwill gbe gprescribed goral gAZT gin gthe gfourteenth
gweek
