NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
ComprehensivegReviewgforgthegNCLEX-RN®gExamination,g5thgEdition
Pharmacologyg
TestgBank
MULTIPLEgCHOICE
1. Thegnursegisgcaringgforgagclientginglabor.gThegnursegreviewsgthegphysician’sgprescriptionsgandgnotesgthat
gthegclientghasgagprescriptiongforgbutorphanolgtartrateg(Stadol).gThegnursegunderstandsgthatgthisgmedicati
ongisgprescribedgfor:
1. Paingrelief
2. Increasingguterinegcontractions
3. Decreasingguterinegcontractions
4. Promotinggfetalglunggmaturity
ANS:g 1
Rationale:gThegclientginglaborgmaygbeggivengparenteralganalgesiagduringgthegfirstgstagegofglabor,gupgtog2g
tog3ghoursgbeforegtheganticipatedgdelivery.gButorphanolgtartrategisgagmedicationgthatgmaygbegprescribedgf
orgpaingrelief.g“Increasingguterinegcontractions,”g“decreasingguterinegcontractions,”gandg“promotinggfetal
glunggmaturity”garegnotgactionsgofgthisgmedication.
Test-
TakinggStrategy:gKnowledgegofgthegactiongofgbutorphanolgtartrategisgrequiredgtoganswergthisgquestion.gR
emembergthatgthisgmedicationgisgusedgforgpaingrelief.gReviewgthegactiongofgthisgmedicationgifgyoughadgdif
ficultygwithgthisgquestiongandgaregunfamiliargwithgthisgmedication.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF:
Lehne,gR.g(2010).gPharmacologygforgnursinggcareg(7thged.).gSt.gLouis:gSaunder
s.gOBJ: ClientgNeeds:gPhysiologicalgIntegrity
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Planning
2. Thegpostpartumgnursegisgcaringgforgagclientgwithgangepiduralgcathetergingplacegforgopioidganalgesi
cgadministrationgfollowinggcesareangbirth.gIfgthegclientgdevelopsgrespiratorygdepressiongandgrequi
resgnaloxoneg(Narcan)gasgangantidote,gthegclientgmaygcomplaingofgwhichgofgthegfollowing?
1. Increaseginghergpainglevel
2. Decreaseginghergpainglevel
,NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
3. Increasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural
4. Decreasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural
,NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
ANS:g 1
Rationale:gRemembergthatgopioidsgaregusedgforgepiduralganalgesia.gNaloxonegisgangopioidgantagonist,gw
hichgreversesgthegeffectsgofgopioids.gIfgitgisggiven,gthegclientgmaygcomplaingofgangincreaseginghergpaingle
vel.gThereforeg“decreaseginghergpainglevel,”g“increasegingthegamountgofgitchinggfromgthegopioidgusedgingt
hegepidural,”gandg“decreasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural”garegincorrect.
Test-
TakinggStrategy:gToganswergthisgquestiongaccurately,gyougmustgknowgthatgopioidganalgesicsgaregthegmedic
ationsgusedgwithgepiduralganalgesiagtogrelievegpain.gThereforegifgnaloxonegisgadministeredgasgangantidoteg
forgangopioidganalgesic,gthegclient’sgpaingwillgincrease.gReviewgthegeffectsgofgnaloxonegifgthisgquestiongw
asgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF:
Lehne,gR.g(2010).gPharmacologygforgnursinggcareg(7thged.).gSt.gLouis:gSaunder
s.gOBJ: ClientgNeeds:gPhysiologicalgIntegrity
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Assessment
3. Agclientgexperiencinggpretermglaborgatgthegtwenty-
ninthgweekgofggestationghasgbeengadmittedgtogtheghospital.gThegclientghasgagprescriptiongtogreceivegbeta
methasoneg(Celestone).gThegnursegunderstandsgthatgthegmedicationgwillgdogwhichgofgthegfollowing?
1. Preventgspontaneousgdelivery.
2. Stopgtheguterinegcontractions.
3. Promotegmaturationgofgthegfetalglungs.
4. Accelerategtheggrowthgrategofgthegfetus.
ANS:g 3
Rationale:gBetamethasoneg(Celestone)gisgclassifiedgasganganti-
inflammatorygandgcorticosteroid.gItgincreasesgthegsurfactantglevelgandglunggmaturitygingthegfetus,gwhichgr
educesgthegincidencegofgrespiratorygdistressgsyndrome.gDeliverygmustgbegdelayedgforgatgleastg48ghoursgaf
tergadministrationgofgbetamethasonegtogallowgtimegforgtheglungsgofgthegfetusgtogmature.
Test-
TakinggStrategy:gOptionsgthatgaregcomparablegorgalikegaregnotglikelygtogbegcorrect.gWithgthisgingmind,ge
liminateg“preventgspontaneousgdelivery”gandg“stopgtheguterinegcontractions.”gNotegthegstrategicgwordsg“
twenty-
ninthgweekgofggestation.”gSpecificgknowledgegaboutgthegmedicationgandgknowledgegofgthegproblemsgenc
ounteredgbygprematureginfantsgwillgassistgingansweringgthisgquestion.gReviewgthegactiongofgthisgmedicati
ongifgthisgquestiongwasgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF: McKinney,gE.,gJames,gS.,gMurray,gS.,g&gAshwill,gJ.g(2009).gMaternal-
childgnursingg(3rdged.).gSt.gLouis:gSaunders. OBJ: ClientgNeeds:gPhysiologicalgIntegrity
, NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Planning
4. Agclientgwithgpreeclampsiagisgreceivinggmagnesiumgsulfate.gThegnursegassessesgthegclientgcloselygf
orgwhichgsigngofgmagnesiumgtoxicity?
1. Proteinuria
2. Hyperactivegdeepgtendongreflexes
3. Respiratorygrategofg10gbreaths/min
4. Serumgmagnesiumglevelgofg5gmEq/L
ANS:g 3
Rationale:gMagnesiumgtoxicitygisgagriskgassociatedgwithgmagnesiumgsulfategtherapy.gSignsgofgmagnesiu
mgtoxicitygrelategtogcentralgnervousgsystemg(CNS)gdepressiongandgincludegrespiratorygdepression,glossgof
gdeepgtendongreflexes,gandgsuddengdropgingfetalgheartgrategand/orgmaternalgheartgrategandgbloodgpressure.
Magnesiumgisgexcretedgthroughgthegkidneys.gIfgrenalgimpairmentgisgpresent,gmagnesiumgtoxicitygcangdevel
opgverygquickly.gTherapeuticgserumglevelsgofgmagnesiumgareg4gtog7gmEq/L.
Test-
TakinggStrategy:gToganswergthisgquestiongaccurately,gyougmustgrecallgthatgmagnesiumgsulfategisgagCNSg
depressant.gBegingtoganswergthisgquestiongbygeliminatingg“proteinuria”gandg“hyperactivegdeepgtendongre
flexes,”gwhichgaregsignsgofgpreeclampsia.gSelectgbetweengtheglastgtwogoptionsgusinggmedicationgknowled
gegandgrecallinggthatgthegtherapeuticgserumglevelsgofgmagnesiumgareg4gtog7gmEq/L.gReviewgthisgmedicat
iongandgthegnormalgmagnesiumglevelgifgthisgquestiongwasgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gAnalyzing
REF: Lowdermilk,gD.,gPerry,gS.,g&gCashion,gK.g(2010).gMaternitygnursingg(8thged.).gSt.gLouis:gMosby.
OBJ:
ClientgNeeds:gPhysiologicalgIntegritygTOP:
ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Assessment
5. Agpregnantgclientgwhoghasghumangimmunodeficiencygvirusg(HIV)ginfectiongisgbeinggseengingthegantenat
algclinic.gThegnursegrecallsgthatgzidovudineg(AZT)gtherapygwillgbeginitiatedgwhengthegfetusghasgreachedg
howgmanygweeksgofggestation?
1. 4
2. 14
3. 24
4. 34
ANS:g 2
Rationale:gThegpregnantgwomengwithgHIVginfectiongwillgbegprescribedgoralgAZTgingthegfourteenthgweek
gofggestation.gBeforegthisgtime,gthegfetusgisgatgriskgbecausegofgthegteratogenicgeffectsgofgthegmedication.gI
n
g g g g g g
ComprehensivegReviewgforgthegNCLEX-RN®gExamination,g5thgEdition
Pharmacologyg
TestgBank
MULTIPLEgCHOICE
1. Thegnursegisgcaringgforgagclientginglabor.gThegnursegreviewsgthegphysician’sgprescriptionsgandgnotesgthat
gthegclientghasgagprescriptiongforgbutorphanolgtartrateg(Stadol).gThegnursegunderstandsgthatgthisgmedicati
ongisgprescribedgfor:
1. Paingrelief
2. Increasingguterinegcontractions
3. Decreasingguterinegcontractions
4. Promotinggfetalglunggmaturity
ANS:g 1
Rationale:gThegclientginglaborgmaygbeggivengparenteralganalgesiagduringgthegfirstgstagegofglabor,gupgtog2g
tog3ghoursgbeforegtheganticipatedgdelivery.gButorphanolgtartrategisgagmedicationgthatgmaygbegprescribedgf
orgpaingrelief.g“Increasingguterinegcontractions,”g“decreasingguterinegcontractions,”gandg“promotinggfetal
glunggmaturity”garegnotgactionsgofgthisgmedication.
Test-
TakinggStrategy:gKnowledgegofgthegactiongofgbutorphanolgtartrategisgrequiredgtoganswergthisgquestion.gR
emembergthatgthisgmedicationgisgusedgforgpaingrelief.gReviewgthegactiongofgthisgmedicationgifgyoughadgdif
ficultygwithgthisgquestiongandgaregunfamiliargwithgthisgmedication.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF:
Lehne,gR.g(2010).gPharmacologygforgnursinggcareg(7thged.).gSt.gLouis:gSaunder
s.gOBJ: ClientgNeeds:gPhysiologicalgIntegrity
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Planning
2. Thegpostpartumgnursegisgcaringgforgagclientgwithgangepiduralgcathetergingplacegforgopioidganalgesi
cgadministrationgfollowinggcesareangbirth.gIfgthegclientgdevelopsgrespiratorygdepressiongandgrequi
resgnaloxoneg(Narcan)gasgangantidote,gthegclientgmaygcomplaingofgwhichgofgthegfollowing?
1. Increaseginghergpainglevel
2. Decreaseginghergpainglevel
,NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
3. Increasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural
4. Decreasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural
,NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
ANS:g 1
Rationale:gRemembergthatgopioidsgaregusedgforgepiduralganalgesia.gNaloxonegisgangopioidgantagonist,gw
hichgreversesgthegeffectsgofgopioids.gIfgitgisggiven,gthegclientgmaygcomplaingofgangincreaseginghergpaingle
vel.gThereforeg“decreaseginghergpainglevel,”g“increasegingthegamountgofgitchinggfromgthegopioidgusedgingt
hegepidural,”gandg“decreasegingthegamountgofgitchinggfromgthegopioidgusedgingthegepidural”garegincorrect.
Test-
TakinggStrategy:gToganswergthisgquestiongaccurately,gyougmustgknowgthatgopioidganalgesicsgaregthegmedic
ationsgusedgwithgepiduralganalgesiagtogrelievegpain.gThereforegifgnaloxonegisgadministeredgasgangantidoteg
forgangopioidganalgesic,gthegclient’sgpaingwillgincrease.gReviewgthegeffectsgofgnaloxonegifgthisgquestiongw
asgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF:
Lehne,gR.g(2010).gPharmacologygforgnursinggcareg(7thged.).gSt.gLouis:gSaunder
s.gOBJ: ClientgNeeds:gPhysiologicalgIntegrity
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Assessment
3. Agclientgexperiencinggpretermglaborgatgthegtwenty-
ninthgweekgofggestationghasgbeengadmittedgtogtheghospital.gThegclientghasgagprescriptiongtogreceivegbeta
methasoneg(Celestone).gThegnursegunderstandsgthatgthegmedicationgwillgdogwhichgofgthegfollowing?
1. Preventgspontaneousgdelivery.
2. Stopgtheguterinegcontractions.
3. Promotegmaturationgofgthegfetalglungs.
4. Accelerategtheggrowthgrategofgthegfetus.
ANS:g 3
Rationale:gBetamethasoneg(Celestone)gisgclassifiedgasganganti-
inflammatorygandgcorticosteroid.gItgincreasesgthegsurfactantglevelgandglunggmaturitygingthegfetus,gwhichgr
educesgthegincidencegofgrespiratorygdistressgsyndrome.gDeliverygmustgbegdelayedgforgatgleastg48ghoursgaf
tergadministrationgofgbetamethasonegtogallowgtimegforgtheglungsgofgthegfetusgtogmature.
Test-
TakinggStrategy:gOptionsgthatgaregcomparablegorgalikegaregnotglikelygtogbegcorrect.gWithgthisgingmind,ge
liminateg“preventgspontaneousgdelivery”gandg“stopgtheguterinegcontractions.”gNotegthegstrategicgwordsg“
twenty-
ninthgweekgofggestation.”gSpecificgknowledgegaboutgthegmedicationgandgknowledgegofgthegproblemsgenc
ounteredgbygprematureginfantsgwillgassistgingansweringgthisgquestion.gReviewgthegactiongofgthisgmedicati
ongifgthisgquestiongwasgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gUnderstanding
REF: McKinney,gE.,gJames,gS.,gMurray,gS.,g&gAshwill,gJ.g(2009).gMaternal-
childgnursingg(3rdged.).gSt.gLouis:gSaunders. OBJ: ClientgNeeds:gPhysiologicalgIntegrity
, NCLEX-RN® Examination, 5th Edition Pharmacology Test Bank
g g g g g g
TOP: ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Planning
4. Agclientgwithgpreeclampsiagisgreceivinggmagnesiumgsulfate.gThegnursegassessesgthegclientgcloselygf
orgwhichgsigngofgmagnesiumgtoxicity?
1. Proteinuria
2. Hyperactivegdeepgtendongreflexes
3. Respiratorygrategofg10gbreaths/min
4. Serumgmagnesiumglevelgofg5gmEq/L
ANS:g 3
Rationale:gMagnesiumgtoxicitygisgagriskgassociatedgwithgmagnesiumgsulfategtherapy.gSignsgofgmagnesiu
mgtoxicitygrelategtogcentralgnervousgsystemg(CNS)gdepressiongandgincludegrespiratorygdepression,glossgof
gdeepgtendongreflexes,gandgsuddengdropgingfetalgheartgrategand/orgmaternalgheartgrategandgbloodgpressure.
Magnesiumgisgexcretedgthroughgthegkidneys.gIfgrenalgimpairmentgisgpresent,gmagnesiumgtoxicitygcangdevel
opgverygquickly.gTherapeuticgserumglevelsgofgmagnesiumgareg4gtog7gmEq/L.
Test-
TakinggStrategy:gToganswergthisgquestiongaccurately,gyougmustgrecallgthatgmagnesiumgsulfategisgagCNSg
depressant.gBegingtoganswergthisgquestiongbygeliminatingg“proteinuria”gandg“hyperactivegdeepgtendongre
flexes,”gwhichgaregsignsgofgpreeclampsia.gSelectgbetweengtheglastgtwogoptionsgusinggmedicationgknowled
gegandgrecallinggthatgthegtherapeuticgserumglevelsgofgmagnesiumgareg4gtog7gmEq/L.gReviewgthisgmedicat
iongandgthegnormalgmagnesiumglevelgifgthisgquestiongwasgdifficult.
PTS: 1
DIF: LevelgofgCognitivegAbility:gAnalyzing
REF: Lowdermilk,gD.,gPerry,gS.,g&gCashion,gK.g(2010).gMaternitygnursingg(8thged.).gSt.gLouis:gMosby.
OBJ:
ClientgNeeds:gPhysiologicalgIntegritygTOP:
ContentgArea:gPharmacology
MSC:g IntegratedgProcess:gNursinggProcess—Assessment
5. Agpregnantgclientgwhoghasghumangimmunodeficiencygvirusg(HIV)ginfectiongisgbeinggseengingthegantenat
algclinic.gThegnursegrecallsgthatgzidovudineg(AZT)gtherapygwillgbeginitiatedgwhengthegfetusghasgreachedg
howgmanygweeksgofggestation?
1. 4
2. 14
3. 24
4. 34
ANS:g 2
Rationale:gThegpregnantgwomengwithgHIVginfectiongwillgbegprescribedgoralgAZTgingthegfourteenthgweek
gofggestation.gBeforegthisgtime,gthegfetusgisgatgriskgbecausegofgthegteratogenicgeffectsgofgthegmedication.gI
n
