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Preparation for Nursing Pharmacology Test
PHARMACOLOGY REVIEW GUIDE
In order to successfully pass the 50 item pharmacology exam, nurses must achieve an overall score of 80%. However, nurses are only allowed to get 2 calculation questions wrong from the Drug Calculation section of the exam (3 errors in calculation questions means an automatic failure and the nurse must re-take the exam). For the calculation questions on the exam, the nurse must show all work that led to arriving at the answer. Only ONE retake is permitted. Time allotted for exam: 1 1/2 hour (90 min.). I. Categories of Medications Know the actions, use, serious side effects and specific nursing measures for administration of the following frequently ordered medications or categories of medications
Cardiovascular/Antiarrhythmics Beta Blockers eg. metoprolol (Lopressor); atenolol (Tenormin) ACE inhibitors – eg. enalapril (Vasotec) Digoxin (Lanoxin) Nitroglycerine: transdermal patch & paste Adrenergics – dopamine infusion (Intropin) Verapamil (Veracaps SR)
Antidiabetic Agents Insulins: Regular, & NPH Humalog, Humulin, Lantus Metformin (Glucophage) Glyburide (Diabeta) Insulin Pen use
Analgesics/Narcotics Hydromorphone (Dilaudid) Morphine sulfate & MS Contin Oxycodone-acetaminophen. (Percocet)
Diuretics Hydrochlorothiazide (Esidrix) Spironolactone (Aldactone) Furosemide (Lasix )
Hormones – levothyroxine (Synthroid) Agents for Depression/Sedation Fluoxetine (Prozac) Lorazepam (Ativan)
Anti-infectives/Anti-fungals Ampicillin Cefazolin (Ancef/Kefzol) Gentamicin sulfate (Garamycin) Vancomycin
Anti-inflammatory Agents Prednisone/methylprednisolone Dexamethasone (Decadron) NSAIDS – eg.Ibuprophen, Aleve Cox-2 Inhibitors- eg Celebrex
Anticoagulants/Hematologic Agents Heparin sodium Warfarin sodium (Coumadin) Enoxaparin sodium (Lovenox) Dalteparin sodium (Fragmin)
Antiulcer/Antiemetics Famotidine (Pepcid) Omeprazole (Prilosec) Ondansetron (Zofran) Flumazenil (Romazicon)
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Antiseizure Phenytoin sodium (Dilantin)
Antidotes Protamine Sulfate Naloxone HCl (Narcan) Vitamin K (Aquamephyton)
High Alert Medications: Identified by TJC (The Joint Commission) -- concentrated KCL, concentrated NaCl,, insulin, heparin
Herbal Interactions: anticoagulants and ginko biloba
II. Important to Know:
III. Conversions 1 kg = 1000 gm 1 liter = 1000 ml 1 oz = 30 ml 1 gm = 1000 mg 1 kg = 2.2 lbs 1 tbsp = 3 tsp 1 mg = 1000 mcg 1 tsp = 5 ml 1 inch = 2.54 cm
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includes unacceptable abbreviations, or does not conform to the patient’s condition, the nurse must contact the physician to correct the problem or clarify the order before administering the medication.
Correct: 4mg Incorrect: 4.0 mg
c. Never use a range of doses or times. Correct: Percocet 1 tab. po q4h Incorrect: Percocet 1-2 tabs q 3- 4 hours.
MISSED MEDICATION DOSES
Whenever a medication dose has been missed, the nurse should contact the physician to clarify what is best for the patient.
When a medication dose is missed eg. the patient is off the unit, the nurse should not assume that the patient can wait until the next dose is due. The decision about the missed dose belongs to the physician.
Certain previously-acceptable abbreviations CAN NO LONGER BE USED in the medical record.
The TJC and hospital policy now prohibits their use.
If these abbreviations appear in a medication order, the order must be clarified with the physician and rewritten correctly.
ug
QD/OD
QOD
sc or sq
QID
MS/MSO
MgSO
OS/OD/OU AS/AD/AU
Units International Units
Micrograms, mcg
Daily
Every other day
Subcutaneously
Four times a day
Morphine sulfate (morphine)
Magnesium sulfate
Left/right/both eyes Left/right/both ears
V. Some Helpful Hints: Exam candidates may bring one nursing drug reference book and a calculator (extra batteries recommended) to use during the exam. Example: Mosby’s Nursing Drug Reference by Linda Skidmore-Roth; Cost: approx. $38.00. No cell phones may be brought into the exam area or used during the test.
VI. Sample Conversions and Calculations : The problems below represent the types of calculations that will be presented on the nursing pharmacology exam. The answers are found at the end of this review guide.
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Conversions:
a. 2 tsp = _____ mL f. 2 oz = _____ mL b. 450 mcg = _____ mg g. 150 lbs = _____ kg c. .048 gm = _____ mg h. 65 kg = _____ lbs d. 475 mg = _____ gm i. 4.1 mg = _____ mcg e. 3 tablespoons = _____ mL j. 2.5 inches = _____ cm
Calculations: