Saunders
Comprehensive
f
Review for the
f f f
NCLEX-RN®
f
ExaminationLatest 2025
f f
, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th
f f f f f f f f
Edition
f
Pharmacology
Test fBank
f
MULTIPLE fCHOICE
1. The fnurse fis fcaring ffor fa fclient fin flabor. fThe fnurse freviews fthe fphysician’s fprescriptions fand fnotes fthat
fthe fclient fhas fa fprescription ffor fbutorphanol ftartrate f(Stadol). fThe fnurse funderstands fthat fthis fmedication
fis fprescribed ffor:
1. Pain frelief
2. Increasing futerine fcontractions
3. Decreasing futerine fcontractions
4. Promoting ffetal flung fmaturity
ANS: f f 1
Rationale: fThe fclient fin flabor fmay fbe fgiven fparenteral fanalgesia fduring fthe ffirst fstage fof flabor, fup fto f2 fto
f3 fhours fbefore fthe fanticipated fdelivery. fButorphanol ftartrate fis fa fmedication fthat fmay fbe fprescribed ffor
fpain frelief. f―Increasing futerine fcontractions,‖ f―decreasing futerine fcontractions,‖ fand f―promoting ffetal
flung fmaturity‖ fare fnot factions fof fthis fmedication.
Test-Taking fStrategy: fKnowledge fof fthe faction fof fbutorphanol ftartrate fis frequired fto fanswer fthis
fquestion. fRemember fthat fthis fmedication fis fused ffor fpain frelief. fReview fthe faction fof fthis fmedication fif
fyou fhad fdifficulty fwith fthis fquestion fand fare funfamiliar fwith fthis fmedication.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: Lehne, fR. f(2010). fPharmacology ffor fnursing fcare f(7th fed.). fSt. fLouis: fSaunders.
fOBJ: Client fNeeds: fPhysiological fIntegrity
TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Planning
2. The fpostpartum fnurse fis fcaring ffor fa fclient fwith fan fepidural fcatheter fin fplace ffor fopioid fanalgesic
fadministration ffollowing fcesarean fbirth. fIf fthe fclient fdevelops frespiratory fdepression fand frequires
fnaloxone f(Narcan) fas fan fantidote, fthe fclient fmay fcomplain fof fwhich fof fthe ffollowing?
1. Increase fin fher fpain flevel
2. Decrease fin fher fpain flevel
3. Increase fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural
4. Decrease fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural
, ANS: f f 1
Rationale: fRemember fthat fopioids fare fused ffor fepidural fanalgesia. fNaloxone fis fan fopioid fantagonist,
fwhich freverses fthe feffects fof fopioids. fIf fit fis fgiven, fthe fclient fmay fcomplain fof fan fincrease fin fher fpain
flevel. fTherefore f―decrease fin fher fpain flevel,‖ f―increase fin fthe famount fof fitching ffrom fthe fopioid fused fin
fthe fepidural,‖ fand f―decrease fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural‖ fare fincorrect.
Test-Taking fStrategy: fTo fanswer fthis fquestion faccurately, fyou fmust fknow fthat fopioid fanalgesics fare fthe
fmedications fused fwith fepidural fanalgesia fto frelieve fpain. fTherefore fif fnaloxone fis fadministered fas fan
fantidote ffor fan fopioid fanalgesic, fthe fclient’s fpain fwill fincrease. fReview fthe feffects fof fnaloxone fif fthis
fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: Lehne, fR. f(2010). fPharmacology ffor fnursing fcare f(7th fed.). fSt. fLouis: fSaunders.
fOBJ: Client fNeeds: fPhysiological fIntegrity
TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Assessment
3. A fclient fexperiencing fpreterm flabor fat fthe ftwenty-ninth fweek fof fgestation fhas fbeen fadmitted fto fthe
fhospital. fThe fclient fhas fa fprescription fto freceive fbetamethasone f(Celestone). fThe fnurse funderstands fthat
fthe fmedication fwill fdo fwhich fof fthe ffollowing?
1. Prevent fspontaneous fdelivery.
2. Stop fthe futerine fcontractions.
3. Promote fmaturation fof fthe ffetal flungs.
4. Accelerate fthe fgrowth frate fof fthe ffetus.
ANS: f f 3
Rationale: fBetamethasone f(Celestone) fis fclassified fas fan fanti-inflammatory fand fcorticosteroid. fIt
fincreases fthe fsurfactant flevel fand flung fmaturity fin fthe ffetus, fwhich freduces fthe fincidence fof frespiratory
fdistress fsyndrome. fDelivery fmust fbe fdelayed ffor fat fleast f48 fhours fafter fadministration fof fbetamethasone
fto fallow ftime ffor fthe flungs fof fthe ffetus fto fmature.
Test-Taking fStrategy: fOptions fthat fare fcomparable for falike fare fnot flikely fto fbe fcorrect. fWith fthis fin
fmind, feliminate f―prevent fspontaneous fdelivery‖ fand f―stop fthe futerine fcontractions.‖ fNote fthe fstrategic
fwords f―twenty-ninth fweek fof fgestation.‖ fSpecific fknowledge fabout fthe fmedication fand fknowledge fof fthe
fproblems fencountered fby fpremature finfants fwill fassist fin fanswering fthis fquestion. fReview fthe faction fof
fthis fmedication fif fthis fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: McKinney, fE., fJames, fS., fMurray, fS., f& fAshwill, fJ. f(2009). fMaternal-child fnursing f(3rd fed.). fSt.
fLouis: fSaunders. OBJ: Client fNeeds: fPhysiological fIntegrity
, TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Planning
4. A fclient fwith fpreeclampsia fis freceiving fmagnesium fsulfate. fThe fnurse fassesses fthe fclient fclosely ffor
fwhich fsign fof fmagnesium ftoxicity?
1. Proteinuria
2. Hyperactive fdeep ftendon freflexes
3. Respiratory frate fof f10 fbreaths/min
4. Serum fmagnesium flevel fof f5 fmEq/L
ANS: f f 3
Rationale: fMagnesium ftoxicity fis fa frisk fassociated fwith fmagnesium fsulfate ftherapy. fSigns fof fmagnesium
ftoxicity frelate fto fcentral fnervous fsystem f(CNS) fdepression fand finclude frespiratory fdepression, floss fof
fdeep ftendon freflexes, fand fsudden fdrop fin ffetal fheart frate fand/or fmaternal fheart frate fand fblood fpressure.
Magnesium fis fexcreted fthrough fthe fkidneys. fIf frenal fimpairment fis fpresent, fmagnesium ftoxicity fcan
fdevelop fvery fquickly. fTherapeutic fserum flevels fof fmagnesium fare f4 fto f7 fmEq/L.
Test-Taking fStrategy: fTo fanswer fthis fquestion faccurately, fyou fmust frecall fthat fmagnesium fsulfate fis fa
fCNS fdepressant. fBegin fto fanswer fthis fquestion fby feliminating f―proteinuria‖ fand f―hyperactive fdeep
ftendon freflexes,‖ fwhich fare fsigns fof fpreeclampsia. fSelect fbetween fthe flast ftwo foptions fusing fmedication
fknowledge fand frecalling fthat fthe ftherapeutic fserum flevels fof fmagnesium fare f4 fto f7 fmEq/L. fReview fthis
fmedication fand fthe fnormal fmagnesium flevel fif fthis fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fAnalyzing
REF: Lowdermilk, fD., fPerry, fS., f& fCashion, fK. f(2010). fMaternity fnursing f(8th fed.). fSt. fLouis: fMosby.
OBJ: Client fNeeds: fPhysiological fIntegrity
fTOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Assessment
5. A fpregnant fclient fwho fhas fhuman fimmunodeficiency fvirus f(HIV) finfection fis fbeing fseen fin fthe fantenatal
fclinic. fThe fnurse frecalls fthat fzidovudine f(AZT) ftherapy fwill fbe finitiated fwhen fthe ffetus fhas freached fhow
fmany fweeks fof fgestation?
1. 4
2. 14
3. 24
4. 34
ANS: f f 2
Rationale: fThe fpregnant fwomen fwith fHIV finfection fwill fbe fprescribed foral fAZT fin fthe ffourteenth fweek
fof fgestation. fBefore fthis ftime, fthe ffetus fis fat frisk fbecause fof fthe fteratogenic feffects fof fthe fmedication. fIn
Comprehensive
f
Review for the
f f f
NCLEX-RN®
f
ExaminationLatest 2025
f f
, Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 5th
f f f f f f f f
Edition
f
Pharmacology
Test fBank
f
MULTIPLE fCHOICE
1. The fnurse fis fcaring ffor fa fclient fin flabor. fThe fnurse freviews fthe fphysician’s fprescriptions fand fnotes fthat
fthe fclient fhas fa fprescription ffor fbutorphanol ftartrate f(Stadol). fThe fnurse funderstands fthat fthis fmedication
fis fprescribed ffor:
1. Pain frelief
2. Increasing futerine fcontractions
3. Decreasing futerine fcontractions
4. Promoting ffetal flung fmaturity
ANS: f f 1
Rationale: fThe fclient fin flabor fmay fbe fgiven fparenteral fanalgesia fduring fthe ffirst fstage fof flabor, fup fto f2 fto
f3 fhours fbefore fthe fanticipated fdelivery. fButorphanol ftartrate fis fa fmedication fthat fmay fbe fprescribed ffor
fpain frelief. f―Increasing futerine fcontractions,‖ f―decreasing futerine fcontractions,‖ fand f―promoting ffetal
flung fmaturity‖ fare fnot factions fof fthis fmedication.
Test-Taking fStrategy: fKnowledge fof fthe faction fof fbutorphanol ftartrate fis frequired fto fanswer fthis
fquestion. fRemember fthat fthis fmedication fis fused ffor fpain frelief. fReview fthe faction fof fthis fmedication fif
fyou fhad fdifficulty fwith fthis fquestion fand fare funfamiliar fwith fthis fmedication.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: Lehne, fR. f(2010). fPharmacology ffor fnursing fcare f(7th fed.). fSt. fLouis: fSaunders.
fOBJ: Client fNeeds: fPhysiological fIntegrity
TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Planning
2. The fpostpartum fnurse fis fcaring ffor fa fclient fwith fan fepidural fcatheter fin fplace ffor fopioid fanalgesic
fadministration ffollowing fcesarean fbirth. fIf fthe fclient fdevelops frespiratory fdepression fand frequires
fnaloxone f(Narcan) fas fan fantidote, fthe fclient fmay fcomplain fof fwhich fof fthe ffollowing?
1. Increase fin fher fpain flevel
2. Decrease fin fher fpain flevel
3. Increase fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural
4. Decrease fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural
, ANS: f f 1
Rationale: fRemember fthat fopioids fare fused ffor fepidural fanalgesia. fNaloxone fis fan fopioid fantagonist,
fwhich freverses fthe feffects fof fopioids. fIf fit fis fgiven, fthe fclient fmay fcomplain fof fan fincrease fin fher fpain
flevel. fTherefore f―decrease fin fher fpain flevel,‖ f―increase fin fthe famount fof fitching ffrom fthe fopioid fused fin
fthe fepidural,‖ fand f―decrease fin fthe famount fof fitching ffrom fthe fopioid fused fin fthe fepidural‖ fare fincorrect.
Test-Taking fStrategy: fTo fanswer fthis fquestion faccurately, fyou fmust fknow fthat fopioid fanalgesics fare fthe
fmedications fused fwith fepidural fanalgesia fto frelieve fpain. fTherefore fif fnaloxone fis fadministered fas fan
fantidote ffor fan fopioid fanalgesic, fthe fclient’s fpain fwill fincrease. fReview fthe feffects fof fnaloxone fif fthis
fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: Lehne, fR. f(2010). fPharmacology ffor fnursing fcare f(7th fed.). fSt. fLouis: fSaunders.
fOBJ: Client fNeeds: fPhysiological fIntegrity
TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Assessment
3. A fclient fexperiencing fpreterm flabor fat fthe ftwenty-ninth fweek fof fgestation fhas fbeen fadmitted fto fthe
fhospital. fThe fclient fhas fa fprescription fto freceive fbetamethasone f(Celestone). fThe fnurse funderstands fthat
fthe fmedication fwill fdo fwhich fof fthe ffollowing?
1. Prevent fspontaneous fdelivery.
2. Stop fthe futerine fcontractions.
3. Promote fmaturation fof fthe ffetal flungs.
4. Accelerate fthe fgrowth frate fof fthe ffetus.
ANS: f f 3
Rationale: fBetamethasone f(Celestone) fis fclassified fas fan fanti-inflammatory fand fcorticosteroid. fIt
fincreases fthe fsurfactant flevel fand flung fmaturity fin fthe ffetus, fwhich freduces fthe fincidence fof frespiratory
fdistress fsyndrome. fDelivery fmust fbe fdelayed ffor fat fleast f48 fhours fafter fadministration fof fbetamethasone
fto fallow ftime ffor fthe flungs fof fthe ffetus fto fmature.
Test-Taking fStrategy: fOptions fthat fare fcomparable for falike fare fnot flikely fto fbe fcorrect. fWith fthis fin
fmind, feliminate f―prevent fspontaneous fdelivery‖ fand f―stop fthe futerine fcontractions.‖ fNote fthe fstrategic
fwords f―twenty-ninth fweek fof fgestation.‖ fSpecific fknowledge fabout fthe fmedication fand fknowledge fof fthe
fproblems fencountered fby fpremature finfants fwill fassist fin fanswering fthis fquestion. fReview fthe faction fof
fthis fmedication fif fthis fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fUnderstanding
REF: McKinney, fE., fJames, fS., fMurray, fS., f& fAshwill, fJ. f(2009). fMaternal-child fnursing f(3rd fed.). fSt.
fLouis: fSaunders. OBJ: Client fNeeds: fPhysiological fIntegrity
, TOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Planning
4. A fclient fwith fpreeclampsia fis freceiving fmagnesium fsulfate. fThe fnurse fassesses fthe fclient fclosely ffor
fwhich fsign fof fmagnesium ftoxicity?
1. Proteinuria
2. Hyperactive fdeep ftendon freflexes
3. Respiratory frate fof f10 fbreaths/min
4. Serum fmagnesium flevel fof f5 fmEq/L
ANS: f f 3
Rationale: fMagnesium ftoxicity fis fa frisk fassociated fwith fmagnesium fsulfate ftherapy. fSigns fof fmagnesium
ftoxicity frelate fto fcentral fnervous fsystem f(CNS) fdepression fand finclude frespiratory fdepression, floss fof
fdeep ftendon freflexes, fand fsudden fdrop fin ffetal fheart frate fand/or fmaternal fheart frate fand fblood fpressure.
Magnesium fis fexcreted fthrough fthe fkidneys. fIf frenal fimpairment fis fpresent, fmagnesium ftoxicity fcan
fdevelop fvery fquickly. fTherapeutic fserum flevels fof fmagnesium fare f4 fto f7 fmEq/L.
Test-Taking fStrategy: fTo fanswer fthis fquestion faccurately, fyou fmust frecall fthat fmagnesium fsulfate fis fa
fCNS fdepressant. fBegin fto fanswer fthis fquestion fby feliminating f―proteinuria‖ fand f―hyperactive fdeep
ftendon freflexes,‖ fwhich fare fsigns fof fpreeclampsia. fSelect fbetween fthe flast ftwo foptions fusing fmedication
fknowledge fand frecalling fthat fthe ftherapeutic fserum flevels fof fmagnesium fare f4 fto f7 fmEq/L. fReview fthis
fmedication fand fthe fnormal fmagnesium flevel fif fthis fquestion fwas fdifficult.
PTS: 1
DIF: Level fof fCognitive fAbility: fAnalyzing
REF: Lowdermilk, fD., fPerry, fS., f& fCashion, fK. f(2010). fMaternity fnursing f(8th fed.). fSt. fLouis: fMosby.
OBJ: Client fNeeds: fPhysiological fIntegrity
fTOP: Content fArea: fPharmacology
MSC: f Integrated fProcess: fNursing fProcess—Assessment
5. A fpregnant fclient fwho fhas fhuman fimmunodeficiency fvirus f(HIV) finfection fis fbeing fseen fin fthe fantenatal
fclinic. fThe fnurse frecalls fthat fzidovudine f(AZT) ftherapy fwill fbe finitiated fwhen fthe ffetus fhas freached fhow
fmany fweeks fof fgestation?
1. 4
2. 14
3. 24
4. 34
ANS: f f 2
Rationale: fThe fpregnant fwomen fwith fHIV finfection fwill fbe fprescribed foral fAZT fin fthe ffourteenth fweek
fof fgestation. fBefore fthis ftime, fthe ffetus fis fat frisk fbecause fof fthe fteratogenic feffects fof fthe fmedication. fIn
