01.01 12 Points to Answering Pharmacology Questions

• Client Safety
  • The NCLEX® is concerned about whether or not you will be a SAFE nurse.
  • Always think about what option will lead to your client being safe. You can automatically exclude options that will put your client in harm.
• Focus on Side Effects
  • Learn the top 3 side effects with major medication classes.
  • If you know the class and the major side effects associated with that class, you greatly increase your chances of answering correctly.
• ABCs
  • Airway, Breathing, Circulation.
  • The ABCs will never go away.
  • Focus on the nursing process and the ABCs with each and every question including side effects.
• Prefixes and Suffixes
  • Learn the most common prefixes and suffixes. This will cut down your total study time tremendously.
• Look for Client Clues
  • Does the question provide information about the client’s original diagnosis?
  • Use general clues in the question about the client, their history, and their condition.
    • These clues will guide you to the medications they will be taking.
• General Client Reaction
  • Look for clues in the client’s reaction.
    • For example, if the client reports dizziness, this is a clue that you should assess blood pressure.
  • Use your assessment skills to answer pharmacology questions.
• Generic
  • Only generic names will be used on the actual NCLEX®.
    • Although these names can be a bit harder to pronounce, they will provide clues (prefix/suffix) into the type of medication it is which will guide you in choosing the correct answer.
• Random, Random, Random
  • Regardless of how much you study, you will get that insanely random medication that no one has ever heard of.
    • In this case, just take a deep breath, relax, and use your nursing judgment, critical thinking, and think of client safety.
• Medical Diagnosis 
  • Does the question identify a medical diagnosis?
    • If you have a working medical diagnosis, use your knowledge to determine what signs and symptoms the client will have, what medications they will require to manage those symptoms, and what are the main side effects of those medications. 
• Freebies 
  • If you are already familiar with the medication, simply use your knowledge, the nursing process, and critical thinking to answer the question. 
• Med Classes 
  • Learn to recognize common side effects with major medication classes and the appropriate nursing intervention for each of these side effects. 
• Why is the Medication Given? 
  • Why is the medication being given?
  • Try to identify a relationship between the medication and the client’s diagnosis.
  • If you have the underlying diagnosis you can generally identify what medication will be given for that condition.

The purpose of this lecture is to give you a framework for answering any pharmacology question that you are presented with whether that be in the NCLEX or during nursing school or simply as a nurse on the floor to help you understand medications that you may be unfamiliar with. As I said, we’re going to give you twelve points, and these twelve points regardless of whether you know the question, you know the medication, you know the patient, applying one or all of these points in that situation will help you be able to confidently answer the question or care for the patient.

First and foremost, point number one is patient safety. The reason this is the first point is that the NCLEX is very concerned with you being a safe nurse. That’s really what the whole entire NCLEX is about is determining whether you’re going to be a safe nurse and capable and competent of taking care of patients on the floor. Patient safety is number one. As you read the question and as you read the different answer options, think about will this option be the safest option for my patient? You can automatically always exclude options that will put your patient in harm, so number one is going to be patient safety always.

Number Two: Focus on side effects. Now, when you’re studying medications, one of the main areas that you need to focus on is side effects and nursing considerations of course, but when you’re focusing on your medications and you’re studying, focus on studying the side effects of these major medication classes. What I would suggest is focusing on the top three side effects for each medication class. Now, as you do this, you’re going to greatly increase your chances of answering a question correctly and you’re going to greatly increase your understanding of these medications and how they work. Focus on the three major side effects, again back to kind of patient safety as you’re studying different medications.

Now, number three goes very closely in line with the other two points that we’ve already talked about. The third point for answering pharmacology questions is to know your ABCs. Again, that’s airway, breathing and circulation. The ABCs will never go away throughout your entire career as a nurse. Always, always, always focus on the airway first, breathing and circulation. The reason for this is because we need to make sure patients are alive, breathing and circulating very well. When you’re answering pharmacology questions, situations will arise when you can pull out the ABCs and answer the question very easily once you put that framework into play.

Number four is prefixes and suffixes. We focused on this a lot throughout our different lectures and throughout the different handouts and podcast and everything, but learn the most common prefixes and suffixes for different medication classes. This will cut your study time tremendously as well as help you be able to learn many more medications. When you learn prefixes and suffixes, a large number of medications within a specific class will end in the same suffix or will have the same prefix. Once you’re able to identify those, you’re going to learn more medications and learn them quickly and be able to broadly apply side effects and nursing considerations for a large group of medications.

Okay, the fifth point is to look for patient clues. As you’re reading the question, does the question provide information about the patient’s original diagnosis? Use these types of clues and the question about the patient, their history, and their condition. These clues will guide you to the medications they will be taking. Once you know the patient’s history, once you know kind of about them and their condition, you should be able to use these clues to kind of piece together a puzzle of what medications they’ll be taking, what side effects you’ll be looking for, so always look for these types of patient clues. Don’t just look at the list of medications in the answer options, and freak out because you don’t know any of them. Look at the patient’s clues and history within the question and then be able to identify and pull the information you need to answer correctly.

Number six is general patient reaction. Look for clues in the patient’s reaction. For example, if the patient reporting dizziness. If the patient reports dizziness, this is generally going to be a sign that you need to assess blood pressure. You need to use your general assessment skills to answer pharmacology questions. As a nurse and throughout nursing school, you’ve learned general assessment skills, so use these assessment skills to look at what the patient may be experiencing and then what may be you need to assess. Okay, if that makes sense? If the patient is reporting, like we said, dizziness, you need to assess blood pressure, kind of figure that out. Being able to identify these patient clues and the reaction to the medication, that’s going to give you a good heads-up for how you need to move forward and what you need to assess from there.

Number seven is generic. The NCLEX is going to provide you both generic and trade names, but it’s going to focus on simply on generic names of medications. During your study time, focus on learning generic names. Now, the generic names of medications may be a little bit hard to pronounce, they might be a little bit longer, but they’re going to provide you a lot of clues. First of all, these generic names are what you need to know for the NCLEX as we just said. Second of all, the generic names are what are going to actually include these prefixes and suffixes to the type of medication that it is.

Really doing your studies like metoprolol, trade name Lopressor, so Lopressor doesn’t really give you any sort of clues as to what kind of medication it is. Metoprolol, however, with the “-olol” tells us that it’s a beta-blocker, and knowing that it’s a beta-blocker, we can then extract from that. Just by the suffix “-olol,” we can extract from that some of the different reasons it’s going to be given, some of the side effects that we’re going to be looking for. Study the generic names and begin to learn them and begin to apply them in your studies and as you’re taking different tests.

Okay, point number eight is random, random, random. Regardless of how much you study, regardless of how much you know, regardless of if you’re the best pharmacology nursing student in the history of the world, you’re going to get some incredibly random medication that you’ve never heard of. When this happens, and I’m saying when this happens because it will happen on a pharmacology test or in the actual NCLEX itself, take a deep breath, relax, and use your nursing judgment. Just think critically and think about patient safety, so go back to everything that we’ve talked about before, apply some of these other points.

Even if that happens, if you’re completely unable to draw any clues from the question, if you can’t find any suffixes or prefixes, if there are no clear patient safety concerns, just relax. This is one question out of the entire course of your NCLEX, so just relax. It’s going to happen. Don’t let these types of questions affect how you perform on the next question. The second you hit the next button on the NCLEX, forget the previous question and move forward. Each question is a chance to answer correctly and move closer to getting that passing mark, okay.

Number nine is medical diagnosis. Does the question identify a specific medical diagnosis? If you have that working medical diagnosis, use your knowledge to determine what signs and symptoms the patient will have, what medications they will require to manage these symptoms, and what are the main side effects of those medications. Again, for example if we know that the patient is suffering from a myocardial infarction, we know that the patient …. that’s an ischemic disorder of the heart, so our entire goal of this is to restore blood flow, restore oxygen to that area of the heart that’s suffering.

Most of you probably know the mnemonic MONA. Now, why are we giving these different medications? We’re giving morphine, oxygen, nitroglycerin, and aspirin. Each of these medications play a role in the side effects and the condition of this heart attack that the patient is experiencing. For example, we’re giving the oxygen because the patient is ischemic. We’re giving the nitroglycerin because of vasodilator. We’re giving the morphine to decrease oxygen demands of the heart. We’re giving the aspirin to thin the blood.

Each of these medications and interventions is given for a specific reason for this disease, so think about the medical diagnosis. Even if you don’t know the medications that are going to be given, think about the medical diagnosis. If you don’t know the medications but you understand the medical diagnosis, think about what the patient is going to require to treat those, those signs and symptoms of that specific disease, and with that in mind, you run a good chance of being able to answer the question correctly.

Okay. Point number ten is freebies. If you’re already familiar with the medication, simply use your knowledge, the nursing process and critical thinking to answer the question. You’ll get a couple questions that are on the NCLEX that are just so beyond incredibly easy that you can’t believe it’s a real question. In this case, don’t overthink it, simply use your nursing knowledge and your critical thinking to say … If you know one of the answers is correct, it doesn’t matter if the other answers are correct or wrong. If you know one of them is correct, go with it and don’t start to second guess yourself.

Okay, number eleven, we’ve talked about this a lot, is med classes. Learn to recognize common side effects of major medication classes and the appropriate interventions for each of these side effects. The NCLEX, like we said, is very focused on patient safety, so what it’s going to do is it’s going to give you a lot of side effect type questions and understand if you’re able to apply the appropriate nursing intervention.

Again, going back to blood pressure. For lightheadedness, etc., assess blood pressure. That’s what they want to know. They want to know can you identify the most critical side effect and can you apply the appropriate nursing intervention to that. To learn this and to do this, the best way again focus on medication classes and you’ll be able to apply a broad range of general interventions to a large amount of medications.

Number twelve. Again, we’re going to kind of talk about medical diagnosis again. Why is the medication given? Try to identify the relationship between the medical, the medication and the patient diagnosis. If you have this general, the underlying diagnosis, you can identify why the medication was given. Okay, so once you know that, once you know why the medication is given, you can then select the appropriate answer given what the reason the medication is given for. Okay, so these are twelve points to help you be able to answer any pharmacology question that you’re given whether on a nursing exam, in the NCLEX, or in your work as a nurse on the floor.

This will help you greatly. Use these points, print out the cheat sheet, and kind of work through this as you’re confronted with medication questions, and without a doubt, you’ll be able to answer with confidence many nursing questions.