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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 $17.99
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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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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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  • January 23, 2025
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  • test bank for saunders comprehensive review for th
  • 9th edition by linda anne silvestri and angela sil
  • test bank
  • saunders comprehensive review for the nclex rn ex

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Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, 9th
s s s s s s s s



Edition
s




Pharmacology

sTest Bank s




MULTIPLE CHOICE s




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



2. Increasing uterine contractions s s




3. Decreasing uterine contractions s s



4. Promoting fetal lung maturity s s s




ANS: 1 s s




Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to 3
s s s s s s s s s s s s s s s s s s s s


hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain
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relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lung
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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 if you
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had difficulty with this question and are unfamiliar with this medication.
s s s s s s s s s s s




PTS: 1
DIF: Level of Cognitive Ability: Understanding
s s s s


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
s s s s s s s s s s s


OBJ:
s Client Needs: Physiological Integrity
s s s


TOP: Content Area: Pharmacology s s


MSC: s Integrated Process: Nursing Process—Planning s s s




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



2. Decrease in her pain level s s s s



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: 1 s s




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 pain
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level. Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in
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the epidural,” and “decrease in the amount of itching from the opioid used in the 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 an
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antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this
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question was difficult.
s s s




PTS: 1
DIF: Level of Cognitive Ability: Understanding
s s s s


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
s s s s s s s s s s s


OBJ:
s Client Needs: Physiological Integrity s s s


TOP: Content Area: Pharmacology s s


MSC: s Integrated Process: Nursing Process—Assessment s s s




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




2. Stop the uterine contractions.
s s s



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




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




ANS: 3 s s




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 respiratory
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distress syndrome. Delivery must be delayed for at least 48 hours after administration of betamethasone to
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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 mind,
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eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words
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“twenty-ninth week of gestation.” Specific knowledge about the medication and knowledge of the
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problems encountered by premature infants will assist in answering this question. Review the action of
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this medication if this question was difficult.
s s s s s s s




PTS: 1
DIF: Level of Cognitive Ability: Understanding s s s s


REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St. s s s s s s s s s s s s s s


Louis: Saunders.
s OBJ: Client Needs: Physiological Integrity
s s s s

, TOP: Content Area: Pharmacology s s


MSC: Integrated Process: Nursing Process—Planning
s s s s




4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
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which sign of magnesium toxicity?
s s s s s



1. Proteinuria
2. Hyperactive deep tendon reflexes s s s



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




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




ANS: 3 s s




Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
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toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of
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deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart 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 a
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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 medication
s s s s s s s s s s s s s s s


knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L. Review this
s s s s s s s s s s s s s s s s s


medication and the normal magnesium level if this question was difficult.
s s s s s s s s s s s




PTS: 1
DIF: Level of Cognitive Ability: Analyzing s s s s


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


OBJ: Client Needs: Physiological Integrity s s s


TOP: Content Area: Pharmacology
s s s


MSC: Integrated Process: Nursing Process—Assessment
s s s s




5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
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clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
s s s s s s s s s s s s s s s s s


many weeks of gestation?
s s s s



1. 4
2. 14
3. 24
4. 34

ANS: 2 s s




Rationale: The pregnant women with HIV infection will be prescribed oral AZT in the fourteenth week of
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gestation. Before this time, the fetus is at risk because of the teratogenic effects of the medication. In
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, addition, a bolus of AZT is given intravenously during labor, and the neonate is treated for six weeks after
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birth.
s




Test-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological
s s s s s s s s s s s s


therapy for clients who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of
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medications and chemicals during the period of organogenesis will assist you in selecting the correct
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answer. Review treatment measures for the pregnant client with HIV infection if you had difficulty with
s s s s s s s s s s s s s s s s


this question.
s s




PTS: 1
DIF: Level of Cognitive Ability: Understanding s s s s


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
s s s s s s s s s s s


OBJ:
s Client Needs: Physiological Integrity s s s


TOP: Content Area: Pharmacology s s


MSC: s Integrated Process: Nursing Process—Planning s s s




6. The nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a
s s s s s s s s s s s s s s s


newborn. The nurse plans to explain to the parents that the purpose of the medication is to:
s s s s s s s s s s s s s s s s s



1. Help the newborn to see more clearly.
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2. Guard against infection acquired during intrauterine life.
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3. Ensure the sterility of the conjunctiva in the newborn.
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4. Protect the newborn from contracting an eye infection during birth.
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ANS: 4 s s




Rationale: The use of eye prophylaxis with an agent such as erythromycin protects the newborn from
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contracting a conjunctival infection during birth. This infection, called ophthalmia neonatorum, results
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from maternal vaginal infection with chlamydia or gonorrhea. This prophylaxis is mandatory in the
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United States. “Help the newborn to see more clearly,” “guard against infection acquired during
s s s s s s s s s s s s s s


intrauterine life,” and “ensure the sterility of the conjunctiva in the newborn” do not describe the
s s s s s s s s s s s s s s s s


purposes of this medication.
s s s s




Test-Taking Strategy: Familiarity with the purpose of this medication is needed to answer this question.
s s s s s s s s s s s s s s


Remember erythromycin protects the newborn from contracting a conjunctival infection during birth.
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Review the purpose of this medication if you had difficulty with this question.
s s s s s s s s s s s s




PTS: 1
DIF: Level of Cognitive Ability: Applying s s s s


REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
s s s s s s s s s s s


OBJ:
s Client Needs: Health Promotion and Maintenance s s s s s


TOP: Content Area: Pharmacology s s


MSC: s Integrated Process: Teaching and Learning s s s s




7. The nurse has a routine prescription to administer an injection of phytonadione (vitamin K) to the
s s s s s s s s s s s s s s s


newborn. Before giving the medication, the nurse explains to the client that this medication will:
s s s s s s s s s s s s s s s

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