Nursing Pharmacology Tests

PeaceRN · Dec 20, 2000

Our facility requires newly hired nurses to pass a pharmacology test before they can pass medications. They have 3 chances to pass the test (3 different versions) and are terminated if they fail the 3rd test. Approximately 1/3 of the questions are calculations. The remaining 2/3 are adult medication questions about drug reactions, administration, and nursing concerns. The nurses receive a generic study guide listing possible drugs included on the tests. As a pediatric educator, I find it difficult to believe failure to pass an adult drug test will predict a nurses ability to competently perform on a pediatric unit. The test has been protrayed as a critical thinking test, however specific drugs are used in the testing questions. Are there other facilities who use this type of screening test to "weed out" nurses?

MartyL · May 30, 2001

We use the NLN tests which still give us a 96% fail rate because of the specific drugs that are tested. The best way to come up with a fair test is to develop one yourself, do a validity and reliability study on it and use it at your facility. Have drugs that are commonly used at your facility on the test, and of course, calculations should be included. Realistic calculations like if you have 15cc/hr of drug Xmg mixed in Ycc, how many mg/min is being administered? If you use dial-a-flows or run fluids off an IV pump, include the VTBI/Time x tubing factor calculations.

Good luck!

fiestynurse · May 31, 2001

These types of tests should only be used as an assessment tool in the orientation needs of the new hiree. They are really looked down upon as a hiring or "weeding out" devise. The giving of medications is only one small aspect of what a nurse does on a day to day basis. We all passed our boards and are licensed, that should be enough. This is an insult to nurses and we should not tolerate it!! Check with your Board of Nursing because it may even be illegal! Do they do this to new MDs? Pharmacists? Hell no! All the facilities in my area have stopped doing this because of the numerous complaints from nurses.

lkubin · May 31, 2001

We use the NLN test at our facility as well. New staff have to take the test and pass before they are "officially" hired. I don't know where the idea that the NLN test is so great and valid, but our failure rate is incredible! We have recently learned that other facilities in our area that also use this test have lowered their passing grade to 65% just so their people could pass.

I do believe that testing is necessary because there are so many people who have difficulties with calculations, and it is SO VERY IMPORTANT to get this right. Just passing boards isn't enough; too many people squeak by in school and on boards that you never know if they are competent with calculations or not.

We used to just give the calculations portion of the test and leave out the drug specific questions, until we were informed by NLN that we can no longer do that. I would like to develop our own test so we can test what we really want to know, but right now Administration is not listening to me.

fiestynurse · Jun 1, 2001

Even though I am totally against using these tests as a hiring tool, if institutions insist on using them, I do recommend using a well studied standardized test like the NLN tests. Organizations have run into legal problems when they start developing their own tests, this is probably why Administration is not listening to that suggestion. I find it hard to believe that nurses can get through a nursing program and pass boards and not be competent in drug calculations! Personally, in a patient care situation I would have another nurse double check my calculations anyway. These hiring tests for nurses are coming under much scrutiny lately.

night owl · Jan 14, 2002

I can see giving these tests to someone who has been out of nursing for a while or who in his/her last employment experience had a problems with medication errors, but to use as a hiring tool based on pharmacology knowledge to all nurses to me is incredible. If the failure rate is high, perhaps the facility can offer a pharmacology review class with their newly hired nurses and not let them pass meds UNTIL they get it right, but to terminate them right off the bat IS an insult.