Silvestri: Saunders Comprehensive Review for the NCLEX-
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RN® Examination, 9th Edition
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Silvestri: Saunders Comprehensive Review for the NCLEX- z! z! z! z! z! z!
RN® Examination, 9thEdition z!z! z!
Pharmacology z!
Test Bank z!
MULTIPLE CHOICE z!
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that t
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he client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication i
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
s prescribed for:
z! z!
1. Pain relief z!
2. Increasing uterine contractions z! z!
3. Decreasing uterine contractions z! z!
4. Promoting fetal lung maturity z! z! z!
ANS: 1 z !
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lun
z! z! z! z! z! z! z! z! z! z! z!
g maturity” are not actions of this medication.
z! z! z! z! z! z! z!
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Re
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
member that this medication is used for pain relief. Review the action of this medication if you had diffic
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ulty with this question and are unfamiliar with this medication.
z! z! z! z! z! z! z! z! z!
PTS: 1
DIF: Level of Cognitive Ability: Understanding z! z! z! z!
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
z! z! z! z! z! z! z! z! z! z! z! z!
OBJ: Client Needs: Physiological Integrity z! z! z!
TOP: Content Area: Pharmacology
z! z ! z! z!
MSC: Integrated Process: Nursing Process—Planning
z! z! z! z!
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
administration following cesarean birth. If the client develops respiratory depression and requires
z! z! z! z! z! z! z! z! z! z! z! z!
naloxone (Narcan) as an antidote, the client may complain of which of the following?
z! z! z! z! z! z! z! z! z! z! z! z! z!
1. Increase in her pain level z! z! z! z!
2. Decrease in her pain level z! z! z! z!
3. Increase in the amount of itching from the opioid used in the epidural
z! z! z! z! z! z! z! z! z! z! z! z!
,Silvestri: Saunders Comprehensive Review for the NCLEX-
z! z! z! z! z! z!
RN® Examination, 9th Edition
z! z! z !
4. Decrease in the amount of itching from the opioid used in the epidural
z! z! z! z! z! z! z! z! z! z! z! z!
, Silvestri: Saunders Comprehensive Review for the NCLEX- z! z! z! z! z! z!
RN® Examination, 9th Edition z! z! z !
ANS: 1 z !
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, wh
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ich reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z
Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in the epi
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dural,” and “decrease in the amount of itching from the opioid used in the epidural” are incorrect.
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medicat
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ions used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote fo
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
r an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question was
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding z! z! z! z!
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. z! z! z! z! z! z! z! z! z! z! z! z!
OBJ: Client Needs: Physiological Integrity z! z! z!
TOP: Content Area: Pharmacology
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MSC: Integrated Process: Nursing Process—Assessment
z! z! z! z!
3. A client experiencing preterm labor at the twenty-
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ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betam
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ethasone (Celestone). The nurse understands that the medication will do which of the following?
z! z! z! z! z! z! z! z! z! z! z! z! z!
1. Prevent spontaneous delivery. z! z!
2. Stop the uterine contractions. z! z! z!
3. Promote maturation of the fetal lungs. z! z! z! z! z!
4. Accelerate the growth rate of the fetus. z! z! z! z! z! z!
ANS: 3 z !
Rationale: Betamethasone (Celestone) is classified as an anti- z! z! z! z! z! z! z!
inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which r
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
educes the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours afte
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
r administration of betamethasone to allow time for the lungs of the fetus to mature.
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eli
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
minate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words “tw
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enty-
ninth week of gestation.” Specific knowledge about the medication and knowledge of the problems enco
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
untered by premature infants will assist in answering this question. Review the action of this medication
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if this question was difficult.
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PTS: 1
DIF: Level of Cognitive Ability: Understanding
z! z! z! z!
, Silvestri: Saunders Comprehensive Review for the NCLEX-
z! z! z! z! z! z!
RN® Examination, 9th Edition
z! z! z !
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-
z! z! z! z! z! z! z! z! z! z!
child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
z! z! z! z! z! z! z! z! z!
z! z! z! z! z! z!
RN® Examination, 9th Edition
z! z! z !
Silvestri: Saunders Comprehensive Review for the NCLEX- z! z! z! z! z! z!
RN® Examination, 9thEdition z!z! z!
Pharmacology z!
Test Bank z!
MULTIPLE CHOICE z!
1. The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that t
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
he client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication i
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
s prescribed for:
z! z!
1. Pain relief z!
2. Increasing uterine contractions z! z!
3. Decreasing uterine contractions z! z!
4. Promoting fetal lung maturity z! z! z!
ANS: 1 z !
Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lun
z! z! z! z! z! z! z! z! z! z! z!
g maturity” are not actions of this medication.
z! z! z! z! z! z! z!
Test-
Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Re
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
member that this medication is used for pain relief. Review the action of this medication if you had diffic
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ulty with this question and are unfamiliar with this medication.
z! z! z! z! z! z! z! z! z!
PTS: 1
DIF: Level of Cognitive Ability: Understanding z! z! z! z!
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders.
z! z! z! z! z! z! z! z! z! z! z! z!
OBJ: Client Needs: Physiological Integrity z! z! z!
TOP: Content Area: Pharmacology
z! z ! z! z!
MSC: Integrated Process: Nursing Process—Planning
z! z! z! z!
2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
administration following cesarean birth. If the client develops respiratory depression and requires
z! z! z! z! z! z! z! z! z! z! z! z!
naloxone (Narcan) as an antidote, the client may complain of which of the following?
z! z! z! z! z! z! z! z! z! z! z! z! z!
1. Increase in her pain level z! z! z! z!
2. Decrease in her pain level z! z! z! z!
3. Increase in the amount of itching from the opioid used in the epidural
z! z! z! z! z! z! z! z! z! z! z! z!
,Silvestri: Saunders Comprehensive Review for the NCLEX-
z! z! z! z! z! z!
RN® Examination, 9th Edition
z! z! z !
4. Decrease in the amount of itching from the opioid used in the epidural
z! z! z! z! z! z! z! z! z! z! z! z!
, Silvestri: Saunders Comprehensive Review for the NCLEX- z! z! z! z! z! z!
RN® Examination, 9th Edition z! z! z !
ANS: 1 z !
Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, wh
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ich reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level.
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z
Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in the epi
! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
dural,” and “decrease in the amount of itching from the opioid used in the epidural” are incorrect.
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
Test-
Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medicat
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ions used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote fo
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
r an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question was
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
difficult.
PTS: 1
DIF: Level of Cognitive Ability: Understanding z! z! z! z!
REF:
Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. z! z! z! z! z! z! z! z! z! z! z! z!
OBJ: Client Needs: Physiological Integrity z! z! z!
TOP: Content Area: Pharmacology
z! z ! z! z!
MSC: Integrated Process: Nursing Process—Assessment
z! z! z! z!
3. A client experiencing preterm labor at the twenty-
z! z! z! z! z! z! z!
ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betam
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
ethasone (Celestone). The nurse understands that the medication will do which of the following?
z! z! z! z! z! z! z! z! z! z! z! z! z!
1. Prevent spontaneous delivery. z! z!
2. Stop the uterine contractions. z! z! z!
3. Promote maturation of the fetal lungs. z! z! z! z! z!
4. Accelerate the growth rate of the fetus. z! z! z! z! z! z!
ANS: 3 z !
Rationale: Betamethasone (Celestone) is classified as an anti- z! z! z! z! z! z! z!
inflammatory and corticosteroid. It increases the surfactant level and lung maturity in the fetus, which r
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
educes the incidence of respiratory distress syndrome. Delivery must be delayed for at least 48 hours afte
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
r administration of betamethasone to allow time for the lungs of the fetus to mature.
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
Test-
Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eli
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
minate “prevent spontaneous delivery” and “stop the uterine contractions.” Note the strategic words “tw
z! z! z! z! z! z! z! z! z! z! z! z! z!
enty-
ninth week of gestation.” Specific knowledge about the medication and knowledge of the problems enco
z! z! z! z! z! z! z! z! z! z! z! z! z! z!
untered by premature infants will assist in answering this question. Review the action of this medication
z! z! z! z! z! z! z! z! z! z! z! z! z! z! z!
if this question was difficult.
z! z! z! z! z!
PTS: 1
DIF: Level of Cognitive Ability: Understanding
z! z! z! z!
, Silvestri: Saunders Comprehensive Review for the NCLEX-
z! z! z! z! z! z!
RN® Examination, 9th Edition
z! z! z !
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-
z! z! z! z! z! z! z! z! z! z!
child nursing (3rd ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity
z! z! z! z! z! z! z! z! z!
