, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th
Edition
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
ANS: 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
, ANS: 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.
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.
ANS: 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
TEST B
4. A bclient bwith bpreeclampsia bis breceiving bmagnesium bsulfate. bThe bnurse bassesses bthe bclient bclosely
bfor bwhich bsign bof bmagnesium btoxicity?
1. Proteinuria
2. Hyperactive bdeep btendon breflexes
3. Respiratory brate bof b10 bbreaths/min
4. Serum bmagnesium blevel bof b5 bmEq/L
ANS: b b 3
Rationale: bMagnesium btoxicity bis ba brisk bassociated bwith bmagnesium bsulfate btherapy. bSigns bof
bmagnesium btoxicity brelate bto bcentral bnervous bsystem b(CNS) bdepression band binclude brespiratory
bdepression, bloss bof bdeep btendon breflexes, band bsudden bdrop bin bfetal bheart brate band/or bmaternal bheart brate
band bblood bpressure.
Magnesium bis bexcreted bthrough bthe bkidneys. bIf brenal bimpairment bis bpresent, bmagnesium btoxicity bcan
bdevelop bvery bquickly. bTherapeutic bserum blevels bof bmagnesium bare b4 bto b7 bmEq/L.
Test-Taking bStrategy: bTo banswer bthis bquestion baccurately, byou bmust brecall bthat bmagnesium bsulfate bis ba
bCNS bdepressant. bBegin bto banswer bthis bquestion bby beliminating b―proteinuria‖ band b―hyperactive bdeep
btendon breflexes,‖ bwhich bare bsigns bof bpreeclampsia. bSelect bbetween bthe blast btwo boptions busing
bmedication bknowledge band brecalling bthat bthe btherapeutic bserum blevels bof bmagnesium bare b4 bto b7
bmEq/L. bReview bthis bmedication band bthe bnormal bmagnesium blevel bif bthis bquestion bwas bdifficult.
PTS: 1
DIF: Level bof bCognitive bAbility: bAnalyzing
REF: Lowdermilk, bD., bPerry, bS., b& bCashion, bK. b(2010). bMaternity bnursing b(8th bed.). bSt. bLouis:
bMosby.
OBJ: Client bNeeds: bPhysiological bIntegrity
bTOP: Content bArea: bPharmacology
MSC: b Integrated bProcess: bNursing bProcess—Assessment
5. A bpregnant bclient bwho bhas bhuman bimmunodeficiency bvirus b(HIV) binfection bis bbeing bseen bin bthe
bantenatal bclinic. bThe bnurse brecalls bthat bzidovudine b(AZT) btherapy bwill bbe binitiated bwhen bthe bfetus bhas
breached bhow bmany bweeks bof bgestation?
1. 4
2. 14
3. 24
4. 34
ANS: b b 2
Rationale: bThe bpregnant bwomen bwith bHIV binfection bwill bbe bprescribed boral bAZT bin bthe bfourteenth
bweek bof bgestation. bBefore bthis btime, bthe bfetus bis bat brisk bbecause bof bthe bteratogenic beffects bof bthe
bmedication. bIn
Edition
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
ANS: 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
, ANS: 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.
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.
ANS: 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
TEST B
4. A bclient bwith bpreeclampsia bis breceiving bmagnesium bsulfate. bThe bnurse bassesses bthe bclient bclosely
bfor bwhich bsign bof bmagnesium btoxicity?
1. Proteinuria
2. Hyperactive bdeep btendon breflexes
3. Respiratory brate bof b10 bbreaths/min
4. Serum bmagnesium blevel bof b5 bmEq/L
ANS: b b 3
Rationale: bMagnesium btoxicity bis ba brisk bassociated bwith bmagnesium bsulfate btherapy. bSigns bof
bmagnesium btoxicity brelate bto bcentral bnervous bsystem b(CNS) bdepression band binclude brespiratory
bdepression, bloss bof bdeep btendon breflexes, band bsudden bdrop bin bfetal bheart brate band/or bmaternal bheart brate
band bblood bpressure.
Magnesium bis bexcreted bthrough bthe bkidneys. bIf brenal bimpairment bis bpresent, bmagnesium btoxicity bcan
bdevelop bvery bquickly. bTherapeutic bserum blevels bof bmagnesium bare b4 bto b7 bmEq/L.
Test-Taking bStrategy: bTo banswer bthis bquestion baccurately, byou bmust brecall bthat bmagnesium bsulfate bis ba
bCNS bdepressant. bBegin bto banswer bthis bquestion bby beliminating b―proteinuria‖ band b―hyperactive bdeep
btendon breflexes,‖ bwhich bare bsigns bof bpreeclampsia. bSelect bbetween bthe blast btwo boptions busing
bmedication bknowledge band brecalling bthat bthe btherapeutic bserum blevels bof bmagnesium bare b4 bto b7
bmEq/L. bReview bthis bmedication band bthe bnormal bmagnesium blevel bif bthis bquestion bwas bdifficult.
PTS: 1
DIF: Level bof bCognitive bAbility: bAnalyzing
REF: Lowdermilk, bD., bPerry, bS., b& bCashion, bK. b(2010). bMaternity bnursing b(8th bed.). bSt. bLouis:
bMosby.
OBJ: Client bNeeds: bPhysiological bIntegrity
bTOP: Content bArea: bPharmacology
MSC: b Integrated bProcess: bNursing bProcess—Assessment
5. A bpregnant bclient bwho bhas bhuman bimmunodeficiency bvirus b(HIV) binfection bis bbeing bseen bin bthe
bantenatal bclinic. bThe bnurse brecalls bthat bzidovudine b(AZT) btherapy bwill bbe binitiated bwhen bthe bfetus bhas
breached bhow bmany bweeks bof bgestation?
1. 4
2. 14
3. 24
4. 34
ANS: b b 2
Rationale: bThe bpregnant bwomen bwith bHIV binfection bwill bbe bprescribed boral bAZT bin bthe bfourteenth
bweek bof bgestation. bBefore bthis btime, bthe bfetus bis bat brisk bbecause bof bthe bteratogenic beffects bof bthe
bmedication. bIn
