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