.Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th
b b b
Edition Pharmacology b
MULTIPLECHOICE
1. The nursebisbcaringbforbabclientbinblabor.bThebnursebreviewsbthebphysician’sbprescriptionsbandbnotesbthatbthebclibe
e
nthasbabprescriptionbforbbutorphanolbtartrateb(Stadol).bThebnursebunderstandsbthat thisbmedicationbisbprescribbe
e
dbfor:
1. Painbrelief
2. Increasingbuterinebcontractions
3. Decreasinguterinebcontractions
4. Promotingbfetalblungbmaturity
ANS:b 1
Rationale:bThebclientbinblaborbmaybebgivenbparenteralbanalgesiabduringbthebfirstbstagebofblabor,bupbtob2btob3bhobur
sbbeforebthebanticipatedbdelivery.bButorphanolbtartratebisba medication that maybbebprescribedbforbpainbrelie
e e e
f.b―Increasingbuterinebcontractions,‖b―decreasingbuterine contractions,‖bandb―promoting fetalblungbmaturity‖ba
e e
rebnotbactionsbofbthisbmedication.
Test-
TakingbStrategy:bKnowledgebofbthebactionbofbbutorphanolbtartratebisbrequiredbtobanswerbthisbquestion.bRemeb
mberbthatbthisbmedicationbisbused forbpainbrelief.bReviewbthebactionbofbthisbmedicationbifbyoubhadbdifficultybwitbhb
e
thisbquestion andbarebunfamiliarbwithbthisbmedication.
e
PTS: 1
DIF:
LevelofbCognitiveAbility:bUnderstandingb
REF:
Lehne,bR.b(2010).bPharmacologyforbnursingbcareb(7thbed.).bSt.bLouis:bSaunders.bOb
BJ: ClientbNeeds:bPhysiologicalbIntegrity
TOP: ContentArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Planning
e
2. The postpartumbnursebisbcaringbforba clientbwithbanbepiduralbcatheterbinbplacebforbopioidbanalgesicbadmbi
e e
nistrationbfollowingcesareanbbirth.bIfbthebclientbdevelopsbrespiratorydepressionbandbrequiresbnaloxobn
eb(Narcan)basbanbantidote,bthebclientbmaybcomplainbofbwhichbofbthebfollowing?
1. Increasebinbherbpainblevel
2. Decreasebinbherbpainblevel
3. Increasebinbthebamountbofbitchingbfrombthebopioidbused in thebepidural
e e
4. Decreasebinbthebamountbofbitchingbfrombthebopioidbused in thebepidural
e e
,.Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th b b b
Edition Pharmacology b
ANS:b 1
Rationale:bRememberbthatbopioidsbarebused forbepiduralbanalgesia.bNaloxonebisbanbopioidbantagonist,bwhichbr
e
eversesbthebeffectsbofbopioids.bIfbitbisbgiven,bthebclientbmaybcomplainbofban increase inbherbpainblevel.bThereforbeb
e e
―decreasebinbherbpainblevel,‖b―increasebinbthebamountbofbitching from thebopioid usedbinbthebepidural,‖bandb―dbecr
e e e
easebinbthebamountbofbitchingbfrombthebopioidbusedbinbthebepidural‖barebincorrect.
Test-
TakingbStrategy:bTobanswerthisquestionaccurately,byoumustknowthatopioidanalgesicsarethebmedicationb s
bused with epiduralbanalgesiabtobrelievebpain.bThereforebifbnaloxonebisbadministered asbanbantidotebforbanbopioibdb
e e e
analgesic,bthebclient’sbpainbwillbincrease.bReviewbthebeffectsbofbnaloxonebifbthisbquestionbwasbdifficult.
PTS:b b 1
DIF:
LevelofbCognitiveAbility:bUnderstandingb
REF:
Lehne,bR.b(2010).bPharmacologyforbnursingbcareb(7thbed.).bSt.bLouis:bSaunders.bOb
BJ: ClientbNeeds:bPhysiologicalbIntegrity
TOP: ContentArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Assessment
e
3. Aclientbexperiencing preterm laborbatbthebtwenty-
e e
ninthbweekbofbgestationbhasbbeenbadmittedbtobthebhospital.bThebclientbhasbabprescriptionbtobreceivebbetamethabs
oneb(Celestone).bThebnurseunderstandsbthatbthebmedicationbwillbdobwhichbofbthebfollowing?
1. Preventbspontaneousbdelivery.
2. Stopbthebuterine contractions.e
3. Promotebmaturation ofbthebfetalblungs.e
4. Accelerate thebgrowth ratebofbthebfetus.
e e
ANS:b 3
Rationale:bBetamethasoneb(Celestone)bisbclassifiedbasbanbanti-
inflammatorybandbcorticosteroid.bItbincreasesbthebsurfactantblevelbandblungbmaturitybinbthebfetus,bwhichbreducbe
sbthebincidencebofbrespiratorybdistressbsyndrome.bDeliverymustbbebdelayedbforbatbleast 48bhoursbafterbadminibst e
rationbofbbetamethasonebtoballowbtimebforbtheblungsbofbthebfetusbto mature. e
Test-
TakingbStrategy:bOptions thatbarebcomparableborbalikebarebnotblikelybtobbebcorrect.bWithbthisbinbmind,beliminabte
e
b―preventbspontaneousbdelivery‖bandb―stopbthebuterinebcontractions.‖bNotebthebstrategicbwordsb―twenty-
bninthweek ofbgestation.‖bSpecificbknowledgebaboutbthebmedicationbandbknowledgebofbthebproblemsbencountb
e
eredbbybprematurebinfantsbwillbassist in answeringbthisbquestion.bReviewbthebactionbofbthisbmedicationbifbthis qbu
e e e
estionbwasbdifficult.
PTS:b b 1
,.Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th
b b b
Edition Pharmacology b
DIF: LevelofbCognitiveAbility:bUnderstanding
REF: McKinney,bE.,bJames,bS.,bMurray,bS.,&Ashwill,bJ.b(2009).bMaternal-
childnursing (3rdbed.).bSt.bLouis:bSaunders.
e OBJ: ClientbNeeds:bPhysiologicalbIntegrity
, .Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th b b b
Edition Pharmacology b
TOP: ContentArea:bPharmacology
MSC:b IntegratedbProcess:bNursingbProcess—Planning
4. Aclientbwithbpreeclampsiabisbreceivingmagnesiumbsulfate.bThebnursebassessesbthebclientbcloselyforbwhbi
chbsignbofbmagnesiumbtoxicity?
1. Proteinuria
2. Hyperactivebdeepbtendon reflexes e
3. Respiratoryratebofb10bbreaths/min
4. Serum magnesium levelbofb5bmEq/L
e e
ANS:b 3
Rationale:bMagnesiumbtoxicityisabriskbassociatedbwithmagnesiumbsulfatebtherapy.bSignsofmagnesiumbtoxbi
citybrelatebtobcentralbnervousbsystemb(CNS)bdepression and includebrespiratorybdepression,blossbofbdeepbtendbo
e e
nbreflexes,bandbsudden dropbin fetalbheart rateband/orbmaternalbheartbratebandbbloodbpressure.
e e e
Magnesiumbisbexcreted throughbthebkidneys.bIfbrenalbimpairmentbisbpresent,bmagnesiumbtoxicitybcanbdevelopbvbe
e
ryquickly.bTherapeuticbserumblevelsbofbmagnesiumbareb4btob7bmEq/L.
Test-
TakingbStrategy:bTobanswerbthisbquestionbaccurately,byoubmustbrecallbthat magnesiumbsulfatebisbabCNSbdeprebs
e
sant.bBeginbtobanswerbthisbquestionbbybeliminatingb―proteinuria‖band ―hyperactive deepbtendonbreflexes,‖bwbhi
e e
chbarebsignsbofbpreeclampsia.bSelectbbetweenbtheblastbtwoboptionsbusingmedicationbknowledgebandbrecallinbgbt
hatbthebtherapeuticbserumblevelsbofbmagnesiumbareb4btob7bmEq/L.bReviewbthisbmedicationbandbthebnormalbmbagn
esiumblevelbifbthisbquestionbwasbdifficult.
PTS: 1
DIF:b b LevelofbCognitivebAbility:bAnalyzing
REF:b b Lowdermilk,bD.,bPerry,bS.,b&bCashion,bK.b(2010).bMaternitynursingb(8thbed.).bSt.bLouis:bMosby.
OBJ:
ClientbNeeds:bPhysiologicalbIntegritybTOP:
ContentbArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Assessment
e
5. Apregnant clientbwhobhasbhumanbimmunodeficiencyvirusb(HIV)binfection isbbeingbseenbinbthebantenatalbclinbi
e e
c.bThebnursebrecalls thatbzidovudineb(AZT)btherapybwillbbebinitiatedbwhenbthebfetusbhasbreachedbhowbmanybwbee
e
ksbofbgestation?
1. 4
2. 14
3. 24
4. 34
ANS:b 2
b b b b b b
RN® Examination, 5th
b b b
Edition Pharmacology b
MULTIPLECHOICE
1. The nursebisbcaringbforbabclientbinblabor.bThebnursebreviewsbthebphysician’sbprescriptionsbandbnotesbthatbthebclibe
e
nthasbabprescriptionbforbbutorphanolbtartrateb(Stadol).bThebnursebunderstandsbthat thisbmedicationbisbprescribbe
e
dbfor:
1. Painbrelief
2. Increasingbuterinebcontractions
3. Decreasinguterinebcontractions
4. Promotingbfetalblungbmaturity
ANS:b 1
Rationale:bThebclientbinblaborbmaybebgivenbparenteralbanalgesiabduringbthebfirstbstagebofblabor,bupbtob2btob3bhobur
sbbeforebthebanticipatedbdelivery.bButorphanolbtartratebisba medication that maybbebprescribedbforbpainbrelie
e e e
f.b―Increasingbuterinebcontractions,‖b―decreasingbuterine contractions,‖bandb―promoting fetalblungbmaturity‖ba
e e
rebnotbactionsbofbthisbmedication.
Test-
TakingbStrategy:bKnowledgebofbthebactionbofbbutorphanolbtartratebisbrequiredbtobanswerbthisbquestion.bRemeb
mberbthatbthisbmedicationbisbused forbpainbrelief.bReviewbthebactionbofbthisbmedicationbifbyoubhadbdifficultybwitbhb
e
thisbquestion andbarebunfamiliarbwithbthisbmedication.
e
PTS: 1
DIF:
LevelofbCognitiveAbility:bUnderstandingb
REF:
Lehne,bR.b(2010).bPharmacologyforbnursingbcareb(7thbed.).bSt.bLouis:bSaunders.bOb
BJ: ClientbNeeds:bPhysiologicalbIntegrity
TOP: ContentArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Planning
e
2. The postpartumbnursebisbcaringbforba clientbwithbanbepiduralbcatheterbinbplacebforbopioidbanalgesicbadmbi
e e
nistrationbfollowingcesareanbbirth.bIfbthebclientbdevelopsbrespiratorydepressionbandbrequiresbnaloxobn
eb(Narcan)basbanbantidote,bthebclientbmaybcomplainbofbwhichbofbthebfollowing?
1. Increasebinbherbpainblevel
2. Decreasebinbherbpainblevel
3. Increasebinbthebamountbofbitchingbfrombthebopioidbused in thebepidural
e e
4. Decreasebinbthebamountbofbitchingbfrombthebopioidbused in thebepidural
e e
,.Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th b b b
Edition Pharmacology b
ANS:b 1
Rationale:bRememberbthatbopioidsbarebused forbepiduralbanalgesia.bNaloxonebisbanbopioidbantagonist,bwhichbr
e
eversesbthebeffectsbofbopioids.bIfbitbisbgiven,bthebclientbmaybcomplainbofban increase inbherbpainblevel.bThereforbeb
e e
―decreasebinbherbpainblevel,‖b―increasebinbthebamountbofbitching from thebopioid usedbinbthebepidural,‖bandb―dbecr
e e e
easebinbthebamountbofbitchingbfrombthebopioidbusedbinbthebepidural‖barebincorrect.
Test-
TakingbStrategy:bTobanswerthisquestionaccurately,byoumustknowthatopioidanalgesicsarethebmedicationb s
bused with epiduralbanalgesiabtobrelievebpain.bThereforebifbnaloxonebisbadministered asbanbantidotebforbanbopioibdb
e e e
analgesic,bthebclient’sbpainbwillbincrease.bReviewbthebeffectsbofbnaloxonebifbthisbquestionbwasbdifficult.
PTS:b b 1
DIF:
LevelofbCognitiveAbility:bUnderstandingb
REF:
Lehne,bR.b(2010).bPharmacologyforbnursingbcareb(7thbed.).bSt.bLouis:bSaunders.bOb
BJ: ClientbNeeds:bPhysiologicalbIntegrity
TOP: ContentArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Assessment
e
3. Aclientbexperiencing preterm laborbatbthebtwenty-
e e
ninthbweekbofbgestationbhasbbeenbadmittedbtobthebhospital.bThebclientbhasbabprescriptionbtobreceivebbetamethabs
oneb(Celestone).bThebnurseunderstandsbthatbthebmedicationbwillbdobwhichbofbthebfollowing?
1. Preventbspontaneousbdelivery.
2. Stopbthebuterine contractions.e
3. Promotebmaturation ofbthebfetalblungs.e
4. Accelerate thebgrowth ratebofbthebfetus.
e e
ANS:b 3
Rationale:bBetamethasoneb(Celestone)bisbclassifiedbasbanbanti-
inflammatorybandbcorticosteroid.bItbincreasesbthebsurfactantblevelbandblungbmaturitybinbthebfetus,bwhichbreducbe
sbthebincidencebofbrespiratorybdistressbsyndrome.bDeliverymustbbebdelayedbforbatbleast 48bhoursbafterbadminibst e
rationbofbbetamethasonebtoballowbtimebforbtheblungsbofbthebfetusbto mature. e
Test-
TakingbStrategy:bOptions thatbarebcomparableborbalikebarebnotblikelybtobbebcorrect.bWithbthisbinbmind,beliminabte
e
b―preventbspontaneousbdelivery‖bandb―stopbthebuterinebcontractions.‖bNotebthebstrategicbwordsb―twenty-
bninthweek ofbgestation.‖bSpecificbknowledgebaboutbthebmedicationbandbknowledgebofbthebproblemsbencountb
e
eredbbybprematurebinfantsbwillbassist in answeringbthisbquestion.bReviewbthebactionbofbthisbmedicationbifbthis qbu
e e e
estionbwasbdifficult.
PTS:b b 1
,.Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th
b b b
Edition Pharmacology b
DIF: LevelofbCognitiveAbility:bUnderstanding
REF: McKinney,bE.,bJames,bS.,bMurray,bS.,&Ashwill,bJ.b(2009).bMaternal-
childnursing (3rdbed.).bSt.bLouis:bSaunders.
e OBJ: ClientbNeeds:bPhysiologicalbIntegrity
, .Silvestri: Saunders Comprehensive Review for the NCLEX-
b b b b b b
RN® Examination, 5th b b b
Edition Pharmacology b
TOP: ContentArea:bPharmacology
MSC:b IntegratedbProcess:bNursingbProcess—Planning
4. Aclientbwithbpreeclampsiabisbreceivingmagnesiumbsulfate.bThebnursebassessesbthebclientbcloselyforbwhbi
chbsignbofbmagnesiumbtoxicity?
1. Proteinuria
2. Hyperactivebdeepbtendon reflexes e
3. Respiratoryratebofb10bbreaths/min
4. Serum magnesium levelbofb5bmEq/L
e e
ANS:b 3
Rationale:bMagnesiumbtoxicityisabriskbassociatedbwithmagnesiumbsulfatebtherapy.bSignsofmagnesiumbtoxbi
citybrelatebtobcentralbnervousbsystemb(CNS)bdepression and includebrespiratorybdepression,blossbofbdeepbtendbo
e e
nbreflexes,bandbsudden dropbin fetalbheart rateband/orbmaternalbheartbratebandbbloodbpressure.
e e e
Magnesiumbisbexcreted throughbthebkidneys.bIfbrenalbimpairmentbisbpresent,bmagnesiumbtoxicitybcanbdevelopbvbe
e
ryquickly.bTherapeuticbserumblevelsbofbmagnesiumbareb4btob7bmEq/L.
Test-
TakingbStrategy:bTobanswerbthisbquestionbaccurately,byoubmustbrecallbthat magnesiumbsulfatebisbabCNSbdeprebs
e
sant.bBeginbtobanswerbthisbquestionbbybeliminatingb―proteinuria‖band ―hyperactive deepbtendonbreflexes,‖bwbhi
e e
chbarebsignsbofbpreeclampsia.bSelectbbetweenbtheblastbtwoboptionsbusingmedicationbknowledgebandbrecallinbgbt
hatbthebtherapeuticbserumblevelsbofbmagnesiumbareb4btob7bmEq/L.bReviewbthisbmedicationbandbthebnormalbmbagn
esiumblevelbifbthisbquestionbwasbdifficult.
PTS: 1
DIF:b b LevelofbCognitivebAbility:bAnalyzing
REF:b b Lowdermilk,bD.,bPerry,bS.,b&bCashion,bK.b(2010).bMaternitynursingb(8thbed.).bSt.bLouis:bMosby.
OBJ:
ClientbNeeds:bPhysiologicalbIntegritybTOP:
ContentbArea:bPharmacology
MSC:b Integrated Process:bNursingbProcess—Assessment
e
5. Apregnant clientbwhobhasbhumanbimmunodeficiencyvirusb(HIV)binfection isbbeingbseenbinbthebantenatalbclinbi
e e
c.bThebnursebrecalls thatbzidovudineb(AZT)btherapybwillbbebinitiatedbwhenbthebfetusbhasbreachedbhowbmanybwbee
e
ksbofbgestation?
1. 4
2. 14
3. 24
4. 34
ANS:b 2
