Saunders Comprehensive Review for the Nclex-rn Examination 7th Edition
Examination (elaborations)
Test Bank for Saunders Comprehensive Review for NCLEX-RN Exam, 5e, Silvestri
Examination Bank for Saunders Comprehensive Review for NCLEX-RN Exam, 5e, Silvestri Silvestri: Saunders Comprehensive Review for the NCLEX-RN® Examination, fifth Edition Pharmacology Examination Bank MULTIPLE Choice 1. The nurse is caring for a client in labor. The nurse reviews the medico's prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for: 1. Pain relief 2. Increasing uterine contractions 3. Decreasing uterine contractions 4. Promoting fetal lung maturity ANS: one Rationale: The customer in labor may exist given parenteral analgesia during the first stage of labor, up to 2 to three hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain relief. "Increasing uterine contractions," "decreasing uterine contractions," and "promoting fetal lung maturity" are not actions of this medication. Exam-Taking Strategy: Cognition of the action of butorphanol tartrate is required to respond this question. Call up that this medication is used for pain relief. Review the activity of this medication if you had difficulty with this question and are unfamiliar with this medication. PTS: 1 DIF: Level of Cognitive Ability: Understanding REF: Lehne, R. (2010). Pharmacology for nursing intendance (seventh ed.). St. Louis: Saunders. OBJ: Customer Needs: Physiological Integrity Height: Content Area: Pharmacology MSC: Integrated Process: Nursing Procedure—Planning two. The postpartum nurse is caring for a customer with an epidural catheter in place for opioid analgesic administration following cesarean nascency. If the client develops respiratory low and requires naloxone (Narcan) as an antidote, the client may mutter of which of the following? i. Increase in her pain level ii. Decrease in her hurting level 3. Increase in the amount of itching from the opioid used in the epidural 4. Decrease in the corporeality of itching from the opioid used in the epidural ANS: 1 Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which reverses the furnishings of opioids. If it is given, the client may complain of an increment in her pain level. Therefore "decrease in her hurting level," "increase in the amount of itching from the opioid used in the epidural," and "subtract in the corporeality of itching from the opioid used in the epidural" are incorrect. Test-Taking Strategy: To reply this question accurately, you must know that opioid analgesics are the medications used with epidural analgesia to relieve hurting. Therefore if naloxone is administered every bit an antidote for an opioid analgesic, the client's pain will increase. Review the effects of naloxone if this question was hard. PTS: ane DIF: Level of Cerebral Ability: Agreement REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity Peak: Content Area: Pharmacology MSC: Integrated Process: Nursing Procedure—Assessment iii. A client experiencing preterm labor at the xx-ninth week of gestation has been admitted to the infirmary. The client has a prescription to receive betamethasone (Celestone). The nurse understands that the medication will do which of the following? i. Prevent spontaneous delivery. 2. Stop the uterine contractions. 3. Promote maturation of the fetal lungs. 4. Accelerate the growth rate of the fetus. ANS: three 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 later administration of betamethasone to allow time for the lungs of the fetus to mature. Examination-Taking Strategy: Options that are comparable or alike are not likely to be correct. With this in mind, eliminate "preclude spontaneous delivery" and "stop the uterine contractions." Annotation the strategic words "20-ninth week of gestation." Specific noesis nearly 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 TOP: Content Expanse: Pharmacology MSC: Integrated Procedure: Nursing Procedure—Planning 4. A client with preeclampsia is receiving magnesium sulfate. The nurse assesses the client closely for which sign of magnesium toxicity? one. Proteinuria 2. Hyperactive deep tendon reflexes iii. Respiratory rate of 10 breaths/min 4. Serum magnesium level of 5 mEq/L ANS: 3 Rationale: Magnesium toxicity is a hazard associated with magnesium sulfate therapy. Signs of magnesium toxicity relate to central nervous arrangement (CNS) low and include respiratory low, loss of deep tendon reflexes, and sudden drop in fetal heart rate and/or maternal heart charge per unit and blood pressure. Magnesium is excreted through the kidneys. If renal damage is nowadays, magnesium toxicity can develop very quickly. Therapeutic serum levels of magnesium are 4 to vii mEq/L. Test-Taking Strategy: To answer this question accurately, you must remember 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 ii options using medication noesis and recalling that the therapeutic serum levels of magnesium are 4 to vii 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). Motherhood nursing (8th ed.). St. Louis: Mosby. OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology MSC: Integrated Process: Nursing Process—Assessment v. A significant client who has human immunodeficiency virus (HIV) infection is existence 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 2. 14 3. 24 4. 34 ANS: two Rationale: The significant women with HIV infection will be prescribed oral AZT in the fourteenth week of gestation. Earlier this time, the fetus is at risk because of the teratogenic effects of the medication. In add-on, a bolus of AZT is given intravenously during labor, and the neonate is treated for half-dozen weeks after birth. Examination-Taking Strategy: To answer this question accurately, you must be familiar with pharmacological therapy for clients who are HIV-positive. Knowing that the fetus is most vulnerable to the effects of medications and chemicals during the period of organogenesis will assist you in selecting the correct answer. Review treatment measures for the pregnant client with HIV infection if you had difficulty with this question.
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