Test Bank for Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th Edition by Linda Anne Silvestri and Angela Silvestri Complete Questions and Answers Pass Guaranteed

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for Saunders Comprehensive Review for the NCLEX-RN® Examination,
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jk 9th Edition by Linda Anne Silvestri and Angela Silvestri ||ISBN NO:
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jk 9780721677958|| All Chapters Covered||Complete Guide A+.
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EXAMSDOCS jkjk jkjk STUVIA

, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th Edition
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Pharmacology

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MULTIPLE CHOICE jk




1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
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that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
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medication is prescribed for:
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1. Pain relief jk




2. Increasing uterine contractions jk jk




3. Decreasing uterine contractions jk jk




4. Promoting fetal lung maturity jk jk jk




ANS: jk jk 1

Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to
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2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be
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prescribed for pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and
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“promoting fetal 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
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question. Remember that this medication is used for pain relief. Review the action of this medication
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if you had difficulty with this question and are unfamiliar with this medication.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding
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REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
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OBJ:
jk Client Needs: Physiological Integrity
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TOP: Content Area: Pharmacology jk jk


MSC: j kIntegrated Process: Nursing Process—Planning jk jk jk




2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid
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analgesic administration following cesarean birth. If the client develops respiratory depression
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and requires naloxone (Narcan) as an antidote, the client may complain of which of the
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following?
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1. Increase in her pain level jk jk jk jk



2. Decrease in her pain level jk jk jk jk



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: jk jk 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
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pain level. Therefore “decrease in her pain level,” “increase in the amount of itching from the
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opioid used in the epidural,” and “decrease in the amount of itching from the opioid used in the
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epidural” are incorrect.
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Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
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medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as
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an antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if
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this question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding
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REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
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OBJ:
jk Client Needs: Physiological Integrity jk jk jk


TOP: Content Area: Pharmacology jk jk


MSC: j k Integrated Process: Nursing Process—Assessment jk jk jk




3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to
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the hospital. The client has a prescription to receive betamethasone (Celestone). The nurse
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understands that the medication will do which of the following?
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1. Prevent spontaneous delivery. jk jk



2. Stop the uterine contractions. jk jk jk




3. Promote maturation of the fetal lungs. jk jk jk jk jk




4. Accelerate the growth rate of the fetus. jk jk jk jk jk jk




ANS: jk jk 3

Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
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increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
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respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
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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
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mind, eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the
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strategic words “twenty-ninth week of gestation.” Specific knowledge about the medication and
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knowledge of the problems encountered by premature infants will assist in answering this question.
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Review the action of this medication if this question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding
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REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St.
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Louis:
jk jk Saunders. OBJ: Client Needs: Physiological Integrity jk jk jk

, TOP: Content Area: Pharmacology jk jk


MSC: Integrated Process: Nursing Process—Planning
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4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely
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for which sign of magnesium toxicity?
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1. Proteinuria
2. Hyperactive deep tendon reflexes jk jk jk




3. Respiratory rate of 10 breaths/min jk jk jk jk



4. Serum magnesium level of 5 mEq/L jk jk jk jk jk




ANS: jk jk 3

Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of
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magnesium toxicity relate to central nervous system (CNS) depression and include respiratory
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depression, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart
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rate and blood pressure.
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Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
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develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
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Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is
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a CNS depressant. Begin to answer this question by eliminating “proteinuria” and “hyperactive deep
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tendon reflexes,” which are signs of preeclampsia. Select between the last two options using
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medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7
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mEq/L. Review this medication and the normal magnesium level if this question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Analyzing jk jk jk jk


REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby. jk jk jk jk jk jk jk jk jk jk jk jk jk jk


OBJ: Client Needs: Physiological Integrity jk jk jk


TOP: Content Area: Pharmacology
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MSC: Integrated Process: Nursing Process—Assessment
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5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the
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antenatal clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has
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reached how many weeks of gestation?
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1. 4
2. 14
3. 24
4. 34

ANS: jk jk 2

Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week
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of gestation. Before this time, the fetus is at risk because of the teratogenic effects of the
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medication. In
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