1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
s s that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this
ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss medication is prescribed for: ss ss ss
1. Pain relief ss
2. Increasing uterine contractions ss ss
3. Decreasing uterine contractions ss ss
4. Promoting fetal lung maturity ss ss ss
ANS: 1
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
s s to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be
ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss prescribed for pain relief. ―Increasing uterine contractions,‖ ―decreasing uterine contractions,‖ and
ss ss ss ss ss ss ss ss ss ss
―promoting fetal lung maturity‖ are not actions of this medication.
ss ss ss ss ss ss ss ss ss ss
Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this
ss ss ss ss ss ss ss ss ss ss ss ss ss
ss question. Remember that this medication is used for pain relief. Review the action of this medication if
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss you had difficulty with this question and are unfamiliar with this medication.
ss ss ss ss ss ss ss ss ss ss ss
PTS: 1
DIF: Level of CognitiveAbility: Understanding
ss ss s ss
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis:
ss ss ss ss ss ss ss ss ss ss
ss Saunders. OBJ: ss Client Needs: Physiological Integrity ss ss ss
TOP: ContentArea: Pharmacology s ss
MSC: Integrated Process: Nursing Process—Planning ss ss ss
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid
ss ss s s ss ss ss ss ss ss s s s s ss s s ss ss
ss analgesic administration following cesarean birth. If the client develops respiratory depression
ss ss ss ss ss ss ss ss ss ss
ss and requires naloxone (Narcan) as an antidote, the client may complain of which of the
ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss following?
,1. Increase in her pain level
ss ss ss ss
2. Decrease in her pain level
ss ss ss ss
3. Increase in the amount of itching from the opioid used in the epidural
ss ss ss ss ss ss ss ss ss ss ss ss
4. Decrease in the amount of itching from the opioid used in the epidural
ss ss ss ss ss ss ss ss ss ss ss ss
, ANS: 1
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist,
ss ss ss ss ss ss ss ss ss ss ss ss ss
ss which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
s s level. Therefore ―decrease in her pain level,‖ ―increase in the amount of itching from the opioid used
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss in the epidural,‖ and ―decrease in the amount of itching from the opioid used in the epidural‖ are
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss incorrect.
Test-TakingStrategy:To answer this question accurately, you must know that opioid analgesics are the
s s ss ss ss ss ss ss ss ss ss ss ss ss
ss medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an
ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this
ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss ss
s s question was difficult. ss ss
PTS: 1
DIF: Level of CognitiveAbility: Understanding
ss ss s ss
REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis:
ss ss ss ss ss ss ss ss ss ss
ss Saunders. OBJ: ss Client Needs: Physiological Integrity ss ss ss
TOP: ContentArea: Pharmacology s ss
MSC: Integrated Process: Nursing Process—Assessment ss ss ss
3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the
s ss ss ss ss ss ss ss ss ss ss ss ss ss ss
ss hospital. The client has a prescription to receive betamethasone (Celestone). The nurse understands
ss ss ss ss ss ss ss ss ss ss ss ss
ss that the medication will do which of the following?
ss ss ss ss ss ss ss ss
1. Prevent spontaneous delivery. ss ss
2. Stop the uterine contractions. ss ss ss
3. Promote maturation of the fetal lungs. ss ss ss ss ss
4. Accelerate the growth rate of the fetus. ss ss ss ss ss ss
ANS: 3
Rationale: Betamethasone (Celestone) is classified as an anti-inflammatory and corticosteroid. It
ss ss ss ss ss ss ss ss ss ss