, Silvestri: Saunders Comprehensive Review for the NCLEX-
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RN® Examination, 6th Edition
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Pharmacology c4
Test Bank c4
MULTIPLE CHOICE c4
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes th
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at the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medica
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tion is prescribed for:
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1. Pain relief c4
2. Increasing uterine contractions c4 c4
3. Decreasing uterine contractions c4 c4
4. Promoting fetal lung maturity c4 c4 c4
ANS: c4c4 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2
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to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed
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for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and ―promoting fet
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al lung maturity‖ are not actions of this medication.
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Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question.
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Remember that this medication is used for pain relief. Review the action of this medication if you had
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difficulty with this question and are unfamiliar with this medication.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunder
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s. OBJ: Client Needs: Physiological Integrity
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TOP: Content Area: Pharmacology c4 c4
MSC: Integrated Process: Nursing Process—Planning
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2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analge
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sic administration following cesarean birth. If the client develops respiratory depression and req
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uires naloxone (Narcan) as an antidote, the client may complain of which of the following?
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1. Increase in her pain level c4 c4 c4 c4
2. Decrease in her pain level c4 c4 c4 c4
3. Increase in the amount of itching from the opioid used in the epidural
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4. Decrease in the amount of itching from the opioid used in the epidural
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, ANS: c4c4 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
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which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain
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4level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid used
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in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖ are incorr
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
ect.
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medi
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cations used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antido
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te for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this questi
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on was difficult.
c4 c4
PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunder
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s. OBJ: Client Needs: Physiological Integrity
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TOP: Content Area: Pharmacology c4 c4
MSC: Integrated Process: Nursing Process—Assessment
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3. A client experiencing preterm labor at the twenty-
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ninth week of gestation has been admitted to the hospital. The client has a prescription to receive bet
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amethasone (Celestone). The nurse understands that the medication will do which of the following?
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1. Prevent spontaneous delivery. c4 c4
2. Stop the uterine contractions.
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3. Promote maturation of the fetal lungs. c4 c4 c4 c4 c4
4. Accelerate the growth rate of the fetus. c4 c4 c4 c4 c4 c4
ANS: c4c4 3
Rationale: Betamethasone (Celestone) is classified as an anti-
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inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which
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reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours
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4after administration of betamethasone to allow time for the lungs of the fetus to mature.
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Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind,
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eliminate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the strategic words
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4―twenty-
ninth week of gestation.‖ Specific knowledge about the medication and knowledge of the problems enc
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ountered by premature infants will assist in answering this question. Review the action of this medicat
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ion if this question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal- c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
, child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
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c4 c4 c4 c4 c4 c4
RN® Examination, 6th Edition
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Pharmacology c4
Test Bank c4
MULTIPLE CHOICE c4
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes th
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
at the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medica
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
tion is prescribed for:
c4 c4 c4
1. Pain relief c4
2. Increasing uterine contractions c4 c4
3. Decreasing uterine contractions c4 c4
4. Promoting fetal lung maturity c4 c4 c4
ANS: c4c4 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and ―promoting fet
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
al lung maturity‖ are not actions of this medication.
c4 c4 c4 c4 c4 c4 c4 c4
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question.
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Remember that this medication is used for pain relief. Review the action of this medication if you had
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
difficulty with this question and are unfamiliar with this medication.
c4 c4 c4 c4 c4 c4 c4 c4 c4
PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunder
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s. OBJ: Client Needs: Physiological Integrity
c4 c4 c4 c4
TOP: Content Area: Pharmacology c4 c4
MSC: Integrated Process: Nursing Process—Planning
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2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analge
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
sic administration following cesarean birth. If the client develops respiratory depression and req
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
uires naloxone (Narcan) as an antidote, the client may complain of which of the following?
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
1. Increase in her pain level c4 c4 c4 c4
2. Decrease in her pain level c4 c4 c4 c4
3. Increase in the amount of itching from the opioid used in the epidural
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
4. Decrease in the amount of itching from the opioid used in the epidural
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
, ANS: c4c4 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c
4level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid used
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖ are incorr
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
ect.
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medi
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
cations used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antido
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
te for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this questi
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
on was difficult.
c4 c4
PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunder
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
s. OBJ: Client Needs: Physiological Integrity
c4 c4 c4 c4
TOP: Content Area: Pharmacology c4 c4
MSC: Integrated Process: Nursing Process—Assessment
c 4 c4 c4 c4
3. A client experiencing preterm labor at the twenty-
c4 c4 c4 c4 c4 c4 c4
ninth week of gestation has been admitted to the hospital. The client has a prescription to receive bet
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
amethasone (Celestone). The nurse understands that the medication will do which of the following?
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
1. Prevent spontaneous delivery. c4 c4
2. Stop the uterine contractions.
c4 c4 c4
3. Promote maturation of the fetal lungs. c4 c4 c4 c4 c4
4. Accelerate the growth rate of the fetus. c4 c4 c4 c4 c4 c4
ANS: c4c4 3
Rationale: Betamethasone (Celestone) is classified as an anti-
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inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
reduces the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours
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4after administration of betamethasone to allow time for the lungs of the fetus to mature.
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind,
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
eliminate ―prevent spontaneous delivery‖ and ―stop the uterine contractions.‖ Note the strategic words
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c
4―twenty-
ninth week of gestation.‖ Specific knowledge about the medication and knowledge of the problems enc
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
ountered by premature infants will assist in answering this question. Review the action of this medicat
c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
ion if this question was difficult.
c4 c4 c4 c4 c4
PTS: 1
DIF: Level of Cognitive Ability: Understanding c4 c4 c4 c4
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal- c4 c4 c4 c4 c4 c4 c4 c4 c4 c4
, child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
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