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Test Bank for Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th Edition
by Linda Anne Silvestri and Angela Silvestri
All Chapters | Expert Verified Answers | Grade A+
1|Page
, TESTBANKS BY TESTBANKSNERD
Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination,
Pharmacology Test Bank
MULTIPLE CHOICE
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the client
has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for:
1. Pain relief
2. Increasing uterine contractions
3. Decreasing uterine contractions
4. Promoting fetal lung maturity
ANSWER: 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to 3 hours before
the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain relief. “Increasing uterine
contractions,” “decreasing uterine contractions,” and “promoting fetal lung maturity” are not actions of this medication.
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Remember that
this medication is used for pain relief. Review the action of this medication if you had difficulty with this question and are
unfamiliar with this medication.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration
following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the
client may complain of which of the following?
1. Increase in her pain level
2. Decrease in her pain level
3. Increase in the amount of itching from the opioid used in the epidural
4. Decrease in the amount of itching from the opioid used in the epidural
ANSWER: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which reverses the
effects of opioids. If it is given, the client may complain of an increase in her pain level. Therefore “decrease in her pain
level,” “increase in the amount of itching from the opioid used in the epidural,” and “decrease in the amount of itching
from the opioid used in the epidural” are incorrect.
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Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medications used
with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote for an opioid analgesic, the
client’s pain will increase. Review the effects of naloxone if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The
client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which
of the following?
1. Prevent spontaneous delivery.
2. Stop the uterine contractions.
3. Promote maturation of the fetal lungs.
4. Accelerate the growth rate of the fetus.
ANSWER: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It increases the surfactant
level and lung maturity in the fetus, which reduces the incidence of respiratory distress syndrome. Delivery must be
delayed for at least 48 hours after administration of betamethasone to allow time for the lungs of the fetus to mature.
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eliminate
“prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words “twenty-ninth week of
gestation.” Specific knowledge about the medication and knowledge of the problems encountered by premature infants
will assist in answering this question. Review the action of this medication if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of
magnesium toxicity?
1. Proteinuria
2. Hyperactive deep tendon reflexes
3. Respiratory rate of 10 breaths/min
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4. Serum magnesium level of 5 mEq/L
ANSWER: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium toxicity relate to
central nervous system (CNS) depression and include respiratory depression, loss of deep tendon reflexes, and sudden
drop in fetal heart rate and/or maternal heart rate and blood pressure.
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can develop very quickly.
Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS depressant.
Begin to answer this question by eliminating “proteinuria” and “hyperactive deep tendon reflexes,” which are signs of
preeclampsia. Select between the last two options using medication knowledge and recalling that the therapeutic serum
levels of magnesium are 4 to 7 mEq/L. Review this medication and the normal magnesium level if this question was
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic.
The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of
gestation?
1. 4
2. 14
3. 24
4. 34
ANSWER: 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week of gestation. Before
this time, the fetus is at risk because of the teratogenic effects of the medication. In addition, a bolus of AZT is given
intravenously during labor, and the neonate is treated for six weeks after birth.
Test-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological therapy for clients
who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of medications and chemicals during the
period of organogenesis will assist you in selecting the correct answer. Review treatment measures for the pregnant
client with HIV infection if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
4|Page
Test Bank for Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th Edition
by Linda Anne Silvestri and Angela Silvestri
All Chapters | Expert Verified Answers | Grade A+
1|Page
, TESTBANKS BY TESTBANKSNERD
Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination,
Pharmacology Test Bank
MULTIPLE CHOICE
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the client
has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for:
1. Pain relief
2. Increasing uterine contractions
3. Decreasing uterine contractions
4. Promoting fetal lung maturity
ANSWER: 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to 3 hours before
the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain relief. “Increasing uterine
contractions,” “decreasing uterine contractions,” and “promoting fetal lung maturity” are not actions of this medication.
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Remember that
this medication is used for pain relief. Review the action of this medication if you had difficulty with this question and are
unfamiliar with this medication.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration
following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the
client may complain of which of the following?
1. Increase in her pain level
2. Decrease in her pain level
3. Increase in the amount of itching from the opioid used in the epidural
4. Decrease in the amount of itching from the opioid used in the epidural
ANSWER: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which reverses the
effects of opioids. If it is given, the client may complain of an increase in her pain level. Therefore “decrease in her pain
level,” “increase in the amount of itching from the opioid used in the epidural,” and “decrease in the amount of itching
from the opioid used in the epidural” are incorrect.
2|Page
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Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medications used
with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote for an opioid analgesic, the
client’s pain will increase. Review the effects of naloxone if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The
client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which
of the following?
1. Prevent spontaneous delivery.
2. Stop the uterine contractions.
3. Promote maturation of the fetal lungs.
4. Accelerate the growth rate of the fetus.
ANSWER: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It increases the surfactant
level and lung maturity in the fetus, which reduces the incidence of respiratory distress syndrome. Delivery must be
delayed for at least 48 hours after administration of betamethasone to allow time for the lungs of the fetus to mature.
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eliminate
“prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words “twenty-ninth week of
gestation.” Specific knowledge about the medication and knowledge of the problems encountered by premature infants
will assist in answering this question. Review the action of this medication if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of
magnesium toxicity?
1. Proteinuria
2. Hyperactive deep tendon reflexes
3. Respiratory rate of 10 breaths/min
3|Page
, TESTBANKS BY TESTBANKSNERD
4. Serum magnesium level of 5 mEq/L
ANSWER: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium toxicity relate to
central nervous system (CNS) depression and include respiratory depression, loss of deep tendon reflexes, and sudden
drop in fetal heart rate and/or maternal heart rate and blood pressure.
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can develop very quickly.
Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a CNS depressant.
Begin to answer this question by eliminating “proteinuria” and “hyperactive deep tendon reflexes,” which are signs of
preeclampsia. Select between the last two options using medication knowledge and recalling that the therapeutic serum
levels of magnesium are 4 to 7 mEq/L. Review this medication and the normal magnesium level if this question was
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic.
The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how many weeks of
gestation?
1. 4
2. 14
3. 24
4. 34
ANSWER: 2
Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week of gestation. Before
this time, the fetus is at risk because of the teratogenic effects of the medication. In addition, a bolus of AZT is given
intravenously during labor, and the neonate is treated for six weeks after birth.
Test-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological therapy for clients
who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of medications and chemicals during the
period of organogenesis will assist you in selecting the correct answer. Review treatment measures for the pregnant
client with HIV infection if you had difficulty with this question.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological
Integrity
4|Page
