Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination,
ik ik ik ik ik ik ik
5th Edition
ik ik
Pharmacology
ik Test ikBank
MULTIPLE ikCHOICE
1. The iknurse ikis ikcaring ikfor ika ikclient ikin iklabor. ikThe iknurse ikreviews ikthe ikphysician’s ikprescriptions ikand
iknotes ikthat ikthe ikclient ikhas ika ikprescription ikfor ikbutorphanol iktartrate ik(Stadol). ikThe iknurse ikunderstands ikthat
ikthis ikmedication ikis ikprescribed ikfor:
1. Pain ikrelief
2. Increasing ikuterine ikcontractions
3. Decreasing ikuterine ikcontractions
4. Promoting ikfetal iklung ikmaturity
ANS: i k i k 1
Rationale: ikThe ikclient ikin iklabor ikmay ikbe ikgiven ikparenteral ikanalgesia ikduring ikthe ikfirst ikstage ikof iklabor, ikup
ikto ik2 ikto ik3 ikhours ikbefore ikthe ikanticipated ikdelivery. ikButorphanol iktartrate ikis ika ikmedication ikthat ikmay ikbe
ikprescribed ikfor ikpain ikrelief. ik―Increasing ikuterine ikcontractions,‖ ik―decreasing ikuterine ikcontractions,‖ ikand
ik―promoting ikfetal iklung ikmaturity‖ ikare iknot ikactions ikof ikthis ikmedication.
Test-Taking ikStrategy: ikKnowledge ikof ikthe ikaction ikof ikbutorphanol iktartrate ikis ikrequired ikto ikanswer ikthis
ikquestion. ikRemember ikthat ikthis ikmedication ikis ikused ikfor ikpain ikrelief. ikReview ikthe ikaction ikof ikthis
ikmedication ikif ikyou ikhad ikdifficulty ikwith ikthis ikquestion ikand ikare ikunfamiliar ikwith ikthis ikmedication.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikUnderstanding
REF: Lehne, ikR. ik(2010). ikPharmacology ikfor iknursing ikcare ik(7th iked.). ikSt. ikLouis:
ikSaunders. ikOBJ: Client ikNeeds: ikPhysiological ikIntegrity
TOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikNursing ikProcess—Planning
2. The ikpostpartum iknurse ikis ikcaring ikfor ika ikclient ikwith ikan ikepidural ikcatheter ikin ikplace ikfor ikopioid
ikanalgesic ikadministration ikfollowing ikcesarean ikbirth. ikIf ikthe ikclient ikdevelops ikrespiratory
ikdepression ikand ikrequires iknaloxone ik(Narcan) ikas ikan ikantidote, ikthe ikclient ikmay ikcomplain ikof
ikwhich ikof ikthe ikfollowing?
1. Increase ikin ikher ikpain iklevel
2. Decrease ikin ikher ikpain iklevel
3. Increase ikin ikthe ikamount ikof ikitching ikfrom ikthe ikopioid ikused ikin ikthe ikepidural
4. Decrease ikin ikthe ikamount ikof ikitching ikfrom ikthe ikopioid ikused ikin ikthe ikepidural
, ANS: i k i k 1
Rationale: ikRemember ikthat ikopioids ikare ikused ikfor ikepidural ikanalgesia. ikNaloxone ikis ikan ikopioid
ikantagonist, ikwhich ikreverses ikthe ikeffects ikof ikopioids. ikIf ikit ikis ikgiven, ikthe ikclient ikmay ikcomplain ikof ikan
ikincrease ikin ikher ikpain iklevel. ikTherefore ik―decrease ikin ikher ikpain iklevel,‖ ik―increase ikin ikthe ikamount ikof
ikitching ikfrom ikthe ikopioid ikused ikin ikthe ikepidural,‖ ikand ik―decrease ikin ikthe ikamount ikof ikitching ikfrom ikthe
ikopioid ikused ikin ikthe ikepidural‖ ikare ikincorrect.
Test-Taking ikStrategy: ikTo ikanswer ikthis ikquestion ikaccurately, ikyou ikmust ikknow ikthat ikopioid ikanalgesics ikare
ikthe ikmedications ikused ikwith ikepidural ikanalgesia ikto ikrelieve ikpain. ikTherefore ikif iknaloxone ikis
ikadministered ikas ikan ikantidote ikfor ikan ikopioid ikanalgesic, ikthe ikclient’s ikpain ikwill ikincrease. ikReview ikthe
ikeffects ikof iknaloxone ikif ikthis ikquestion ikwas ikdifficult.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikUnderstanding
REF: Lehne, ikR. ik(2010). ikPharmacology ikfor iknursing ikcare ik(7th iked.). ikSt. ikLouis:
ikSaunders. ikOBJ: Client ikNeeds: ikPhysiological ikIntegrity
TOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikNursing ikProcess—Assessment
3. A ikclient ikexperiencing ikpreterm iklabor ikat ikthe iktwenty-ninth ikweek ikof ikgestation ikhas ikbeen ikadmitted ikto
ikthe ikhospital. ikThe ikclient ikhas ika ikprescription ikto ikreceive ikbetamethasone ik(Celestone). ikThe iknurse
ikunderstands ikthat ikthe ikmedication ikwill ikdo ikwhich ikof ikthe ikfollowing?
1. Prevent ikspontaneous ikdelivery.
2. Stop ikthe ikuterine ikcontractions.
3. Promote ikmaturation ikof ikthe ikfetal iklungs.
4. Accelerate ikthe ikgrowth ikrate ikof ikthe ikfetus.
ANS: i k i k 3
Rationale: ikBetamethasone ik(Celestone) ikis ikclassified ikas ikan ikanti-inflammatory ikand ikcorticosteroid. ikIt
ikincreases ikthe iksurfactant iklevel ikand iklung ikmaturity ikin ikthe ikfetus, ikwhich ikreduces ikthe ikincidence ikof
ikrespiratory ikdistress iksyndrome. ikDelivery ikmust ikbe ikdelayed ikfor ikat ikleast ik48 ikhours ikafter ikadministration
ikof ikbetamethasone ikto ikallow iktime ikfor ikthe iklungs ikof ikthe ikfetus ikto ikmature.
Test-Taking ikStrategy: ikOptions ikthat ikare ikcomparable ikor ikalike ikare iknot iklikely ikto ikbe ikcorrect. ikWith ikthis
ikin ikmind, ikeliminate ik―prevent ikspontaneous ikdelivery‖ ikand ik―stop ikthe ikuterine ikcontractions.‖ ikNote ikthe
ikstrategic ikwords ik―twenty-ninth ikweek ikof ikgestation.‖ ikSpecific ikknowledge ikabout ikthe ikmedication ikand
ikknowledge ikof ikthe ikproblems ikencountered ikby ikpremature ikinfants ikwill ikassist ikin ikanswering ikthis
ikquestion. ikReview ikthe ikaction ikof ikthis ikmedication ikif ikthis ikquestion ikwas ikdifficult.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikUnderstanding
REF: McKinney, ikE., ikJames, ikS., ikMurray, ikS., ik& ikAshwill, ikJ. ik(2009). ikMaternal-child iknursing ik(3rd
iked.). ikSt. ikLouis: ikSaunders. OBJ: Client ikNeeds: ikPhysiological ikIntegrity
, TOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikNursing ikProcess—Planning
4. A ikclient ikwith ikpreeclampsia ikis ikreceiving ikmagnesium iksulfate. ikThe iknurse ikassesses ikthe ikclient
ikclosely ikfor ikwhich iksign ikof ikmagnesium iktoxicity?
1. Proteinuria
2. Hyperactive ikdeep iktendon ikreflexes
3. Respiratory ikrate ikof ik10 ikbreaths/min
4. Serum ikmagnesium iklevel ikof ik5 ikmEq/L
ANS: i k i k 3
Rationale: ikMagnesium iktoxicity ikis ika ikrisk ikassociated ikwith ikmagnesium iksulfate iktherapy. ikSigns ikof
ikmagnesium iktoxicity ikrelate ikto ikcentral iknervous iksystem ik(CNS) ikdepression ikand ikinclude ikrespiratory
ikdepression, ikloss ikof ikdeep iktendon ikreflexes, ikand iksudden ikdrop ikin ikfetal ikheart ikrate ikand/or ikmaternal ikheart
ikrate ikand ikblood ikpressure.
Magnesium ikis ikexcreted ikthrough ikthe ikkidneys. ikIf ikrenal ikimpairment ikis ikpresent, ikmagnesium iktoxicity ikcan
ikdevelop ikvery ikquickly. ikTherapeutic ikserum iklevels ikof ikmagnesium ikare ik4 ikto ik7 ikmEq/L.
Test-Taking ikStrategy: ikTo ikanswer ikthis ikquestion ikaccurately, ikyou ikmust ikrecall ikthat ikmagnesium iksulfate
ikis ika ikCNS ikdepressant. ikBegin ikto ikanswer ikthis ikquestion ikby ikeliminating ik―proteinuria‖ ikand ik―hyperactive
ikdeep iktendon ikreflexes,‖ ikwhich ikare iksigns ikof ikpreeclampsia. ikSelect ikbetween ikthe iklast iktwo ikoptions ikusing
ikmedication ikknowledge ikand ikrecalling ikthat ikthe iktherapeutic ikserum iklevels ikof ikmagnesium ikare ik4 ikto ik7
ikmEq/L. ikReview ikthis ikmedication ikand ikthe iknormal ikmagnesium iklevel ikif ikthis ikquestion ikwas ikdifficult.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikAnalyzing
REF: Lowdermilk, ikD., ikPerry, ikS., ik& ikCashion, ikK. ik(2010). ikMaternity iknursing ik(8th iked.). ikSt. ikLouis: ikMosby.
OBJ: Client ikNeeds: ikPhysiological
ikIntegrity ikTOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikNursing ikProcess—Assessment
5. A ikpregnant ikclient ikwho ikhas ikhuman ikimmunodeficiency ikvirus ik(HIV) ikinfection ikis ikbeing ikseen ikin ikthe
ikantenatal ikclinic. ikThe iknurse ikrecalls ikthat ikzidovudine ik(AZT) iktherapy ikwill ikbe ikinitiated ikwhen ikthe ikfetus
ikhas ikreached ikhow ikmany ikweeks ikof ikgestation?
1. 4
2. 14
3. 24
4. 34
ANS: i k i k 2
Rationale: ikThe ikpregnant ikwomen ikwith ikHIV ikinfection ikwill ikbe ikprescribed ikoral ikAZT ikin ikthe ikfourteenth
ikweek ikof ikgestation. ikBefore ikthis iktime, ikthe ikfetus ikis ikat ikrisk ikbecause ikof ikthe ikteratogenic ikeffects ikof ikthe
ikmedication. ikIn
, addition, ika ikbolus ikof ikAZT ikis ikgiven ikintravenously ikduring iklabor, ikand ikthe ikneonate ikis iktreated ikfor iksix
ikweeks ikafter ikbirth.
Test-Taking ikStrategy: ikTo ikanswer ikthis ikquestion ikaccurately, ikyou ikmust ikbe ikfamiliar ikwith
ikpharmacological iktherapy ikfor ikclients ikwho ikare ikHIV-positive. ikKnowing ikthat ikthe ikfetus ikis ikmost
ikvulnerable ikto ikthe ikeffects ikof ikmedications ikand ikchemicals ikduring ikthe ikperiod ikof ikorganogenesis ikwill
ikassist ikyou ikin ikselecting ikthe ikcorrect ikanswer. ikReview iktreatment ikmeasures ikfor ikthe ikpregnant ikclient ikwith
ikHIV ikinfection ikif ikyou ikhad ikdifficulty ikwith ikthis ikquestion.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikUnderstanding
REF: Lehne, ikR. ik(2010). ikPharmacology ikfor iknursing ikcare ik(7th iked.). ikSt. ikLouis:
ikSaunders. ikOBJ: Client ikNeeds: ikPhysiological ikIntegrity
TOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikNursing ikProcess—Planning
6. The iknurse ikhas ika ikroutine ikprescription ikto ikinstill ikerythromycin ikointment ik(Ilotycin) ikinto ikthe ikeyes
ikof ika iknewborn. ikThe iknurse ikplans ikto ikexplain ikto ikthe ikparents ikthat ikthe ikpurpose ikof ikthe
ikmedication ikis ikto:
1. Help ikthe iknewborn ikto iksee ikmore ikclearly.
2. Guard ikagainst ikinfection ikacquired ikduring ikintrauterine iklife.
3. Ensure ikthe iksterility ikof ikthe ikconjunctiva ikin ikthe iknewborn.
4. Protect ikthe iknewborn ikfrom ikcontracting ikan ikeye ikinfection ikduring ikbirth.
ANS: i k i k 4
Rationale: ikThe ikuse ikof ikeye ikprophylaxis ikwith ikan ikagent iksuch ikas ikerythromycin ikprotects ikthe iknewborn
ikfrom ikcontracting ika ikconjunctival ikinfection ikduring ikbirth. ikThis ikinfection, ikcalled ikophthalmia
ikneonatorum, ikresults ikfrom ikmaternal ikvaginal ikinfection ikwith ikchlamydia ikor ikgonorrhea. ikThis
ikprophylaxis ikis ikmandatory ikin ikthe ikUnited ikStates. ik―Help ikthe iknewborn ikto iksee ikmore ikclearly,‖ ik―guard
ikagainst ikinfection ikacquired ikduring ikintrauterine iklife,‖ ikand ik―ensure ikthe iksterility ikof ikthe ikconjunctiva ikin
ikthe iknewborn‖ ikdo iknot ikdescribe ikthe ikpurposes ikof ikthis ikmedication.
Test-Taking ikStrategy: ikFamiliarity ikwith ikthe ikpurpose ikof ikthis ikmedication ikis ikneeded ikto ikanswer ikthis ikquestion.
ikRemember ikerythromycin ikprotects ikthe iknewborn ikfrom ikcontracting ika ikconjunctival ikinfection ikduring ikbirth.
Review ikthe ikpurpose ikof ikthis ikmedication ikif ikyou ikhad ikdifficulty ikwith ikthis ikquestion.
PTS: 1
DIF: Level ikof ikCognitive ikAbility: ikApplying
REF: Lehne, ikR. ik(2010). ikPharmacology ikfor iknursing ikcare ik(7th iked.). ikSt. ikLouis:
ikSaunders. ikOBJ: Client ikNeeds: ikHealth ikPromotion ikand ikMaintenance
TOP: Content ikArea: ikPharmacology
MSC: i k Integrated ikProcess: ikTeaching ikand ikLearning
7. The iknurse ikhas ika ikroutine ikprescription ikto ikadminister ikan ikinjection ikof ikphytonadione ik(vitamin ikK)
ikto ikthe iknewborn. ikBefore ikgiving ikthe ikmedication, ikthe iknurse ikexplains ikto ikthe ikclient ikthat ikthis
ikmedication ikwill:
