4
ANS: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain
level. Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in
the epidural,” and “decrease in the amount of itching from the opioid used in the epidural” are
incorrect.
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this
question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
that the medication will do which of the following?
1. Prevent spontaneous delivery.
2. Stop the uterine contractions.
3. Promote maturation of the fetal lungs.
4. Accelerate the growth rate of the fetus.
ANS: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
betamethasone to allow time for the lungs of the fetus to mature.
,5
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in
mind, eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the
strategic
,6
words “twenty-ninth week of gestation.” Specific knowledge about the medication and knowledge of
the problems encountered by premature infants will assist in answering this question. Review the
action of this medication if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St.
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
, 7
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
which sign of magnesium toxicity?
1. Proteinuria
2. Hyperactive deep tendon reflexes
3. Respiratory rate of 10 breaths/min
4. Serum magnesium level of 5 mEq/L
ANS: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of
deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood
pressure.
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a
CNS depressant. Begin to answer this question by eliminating “proteinuria” and “hyperactive deep
tendon reflexes,” which are signs of preeclampsia. Select between the last two options using
medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Review this medication and the normal magnesium level if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
many weeks of gestation?
1. 4
ANS: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain
level. Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in
the epidural,” and “decrease in the amount of itching from the opioid used in the epidural” are
incorrect.
Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the
medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this
question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
that the medication will do which of the following?
1. Prevent spontaneous delivery.
2. Stop the uterine contractions.
3. Promote maturation of the fetal lungs.
4. Accelerate the growth rate of the fetus.
ANS: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
increases the surfactant level and lung maturity in the fetus, which reduces the incidence of
respiratory distress syndrome. Delivery must be delayed for at least 48 hours after administration of
betamethasone to allow time for the lungs of the fetus to mature.
,5
Test-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in
mind, eliminate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the
strategic
,6
words “twenty-ninth week of gestation.” Specific knowledge about the medication and knowledge of
the problems encountered by premature infants will assist in answering this question. Review the
action of this medication if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed.). St.
Louis: Saunders. OBJ: Client Needs: Physiological Integrity
, 7
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Planning
4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for
which sign of magnesium toxicity?
1. Proteinuria
2. Hyperactive deep tendon reflexes
3. Respiratory rate of 10 breaths/min
4. Serum magnesium level of 5 mEq/L
ANS: 3
Rationale: Magnesium toxicity is a risk associated with magnesium sulfate therapy. Signs of magnesium
toxicity relate to central nervous system (CNS) depression and include respiratory depression, loss of
deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart rate and blood
pressure.
Magnesium is excreted through the kidneys. If renal impairment is present, magnesium toxicity can
develop very quickly. Therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Test-Taking Strategy: To answer this question accurately, you must recall that magnesium sulfate is a
CNS depressant. Begin to answer this question by eliminating “proteinuria” and “hyperactive deep
tendon reflexes,” which are signs of preeclampsia. Select between the last two options using
medication knowledge and recalling that the therapeutic serum levels of magnesium are 4 to 7 mEq/L.
Review this medication and the normal magnesium level if this question was difficult.
PTS: 1
DIF: Level of Cognitive Ability: Analyzing
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Pharmacology
MSC: Integrated Process: Nursing Process—Assessment
5. A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal
clinic. The nurse recalls that zidovudine (AZT) therapy will be initiated when the fetus has reached how
many weeks of gestation?
1. 4
