nclex pharm

by cjdmomma cjdmomma Member Nurse

Specializes in Oncology.

This will be quick.

How many pharm questions did you actually get on your exam? When I do practice tests and questions, I miss quite a few drug questions, but really how many does one get? I know my cardio, psych, and some ob ones....

Be honest, looking it even worth wasting brain space (for the test!) On pharm? I see books like, the toto 300 drugs and it boggles the mind....

Edited by cjdmomma



Has 1 years experience. 152 Posts

I personally did not have more than 2 or 3 pharm questions on the NCLEX but I know others who had 20+! So no two people will have the same number of questions in the same category. What I thought was helpful in studying is studying the CLASS of drugs, their suffixes and any MAJOR contraindications or patient teaching things. They don't expect you to know everything, but they do expect you to know the major ones that can cause a pt. harm. But only you know what you feel comfortable with - if you're particular weak in other areas, maybe spend some time there and come back to pharma if you're still nervous.



24 Posts

this may be helpful, pharm covers 16-19% of the test. so is it important? YES, very. but pharm also covers dosage cal, IV therapy, meds, med administration, delegation of meds. so if you break that down you "should" only get 3 or 4 "med" questions. BUT..... it also means that all 16-19% could be medication question.

when I took it the first time the question gave a hint. like, pt is taking med XXX for CHF, or the nurse would know to question which med for the renal pt.

I am getting very familiar with categories of meds and what the sound like. LOL, PRIL, ONE, INE, CILIN, and such the knowing the basic info for them.

learn side effects vs adverse reactions. like side effects are expected and manageable, adverse reactions need attention.

pt stung by a bee and suddenly has trouble breathing, what do you do, admin Epi. breathing trouble is an adverse reaction.

hope this helps.



17 Posts

Just thought this would help


Pharmacology - Know Indication/Action/Effect


-ase = thrombolytic

-azepam = benzodiazepine

-azine = antiemetic; phenothiazide

-azole = proton pump inhibitor, antifungal

-barbital = barbiturate

-coxib = cox 2 enzyme blockers

-cep/-cef = anti-infectives

-caine = anesthetics

-cillin = penicillin

-cycline = antibiotic

-dipine = calcium channel blocker

-floxacin = antibiotic

-ipramine = Tricyclic antidepressant

-ine = reverse transcriptase inhibitors, antihistamines

-kinase = thrombolytics

-lone, pred- = corticosteroid

-mab = monoclonal antibiotics

-micin = antibiotic, aminoglycoside

-navir = protease inhibitor

nitr-, -nitr- = nitrate/vasodilator

-olol = beta antagonist

-oxin = cardiac glycoside

-osin = Alpha blocker

-parin = anticoagulant

-prazole = PPI’s

-phylline = bronchodilator

-pril = ACE inhibitor

-statin = cholesterol lowering agent

-sartan = angiotensin II blocker

-sone = glucocorticoid, corticosteroid

-stigmine = cholinergics

-terol = Beta 2 Agonist

-thiazide = diuretic

-tidine = antiulcer

-trophin = Pituitary Hormone

-vir = anti-viral, protease inhibitors

-zosin = Alpha 1 Antagonist

-zolam = benzo/sedative

-zine = antihistamine

Pharm Facts

•Don’t give non-selective beta-blockers to patients w/respiratory problems

•Vitamin C can cause false +ive occult blood

•Avoid the ‘G’ herbs (ginsing, ginger, ginko, garlic) when on anti-clotting drugs (coumadin, ASA, Plavix, etc)

•ASA toxicity can cause ringing of the ears

•No narcotics to any head-injury victims

•Mg2+ toxicity is treated with Calcium Gluconate

•Do not give Calcium-Channel Blockers with Grapefruit Juice

•Oxytocin is never administered through the primary IV

•Lithium patients must consume extra sodium to prevent toxicity

•MAOI Patients should avoid tyramine:

oAacados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream.

•Don’t give atropine for glaucoma – it increases IOP

•Don’t give ant-acids with food -- b/c it delays gastric emptying.

•Don’t give Stadol to Methadone/Heroin Preggo’s -- cause instant withdrawal symptoms

•Insulin – clear before cloudy

•Don’t give meperidine (Demerol) to pancreatitis patients

•Always verify bowel sounds when giving Kayexelate

•Hypercalcemia = hypophosphatemia (and vice versa)

•Radioactive Dye – urine excretion

•Signs of toxic ammonia levels is asterixis (hands flapping)

•D10W can be substituted for TPN (temporary use)

•Dopamine and Lasix are incompatible

•Hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants)

•Common symptom of aluminum hydroxide – constipation

•Thiazide diuretics may induce hyperglycemia

•Take iron with Vit C – it enhances absorbtion – Do not take with milk

•B1 - For Alcoholic Patients (to prevent Wernicke’s encephalopathy & Korsakoff’s synd)

•B6 - For TB Patients

•B9 - For Pregnant Patients

•B12 - Pernicious anemia, Vegetarians.

•Complications of Coumadin - 3H’s - Hemorrhage, hematuria & hepatitis

•FFP is administered to DIC b/c of the clotting Fx

•Mannitol (osmtic diuretic [Head injury]) crystallizes at room temp – use a filter needle

•Antianxiety medication is pharmacologically similar to alcohol –used for weaning Tx

•Administrate Glucagon when pt is hypoglycemia and unresponsive

•Phenazopyridine ( Pyridium)--Urine will appear orange

•Rifampicin -- Red-urine, tears, sweat)

•Hot and Dry = sugar high (hyperglycemia)

•Cold and clammy = need some candy (hypoglycemia)

•Med of choice for V-tach is lidocaine

•Med of choice for SVT = adenosine or adenocard

•Med of choice for Asystole = atropine

•Med of choice for CHF is Ace inhibitor.

•Med of choice for anaphylactic shock is Epinephrine

•Med of choice for Status Epilepticus is Valium.

•Med of choice for bipolar is lithium.

•Give ACE inhibitors w/food to prevent stomach upset

•Administer diuretics in the morning

•Give Lipitor at 1700 since the enzymes work best during the evenin

•Common Tricyclic Meds - 3 syllabes (pamelor, elavil)

•Common MAOI’s - 2 syllables (nardil, marplan)

•TPN has a dedicated line & cannot be mixed ahead of time

•RHoGAM -- Given at 28 weeks & 72 hrs postpartum

•Do not administer erythromycin to Multiple Sclerosis pt

•Benadryl and Xanax taken together will cause additive effects.

•Can't take Lasix if allergic to Sulfa drugs.

•Acetaminophen can be used for headache when the client is using nitroglycerin.

•Dilantin - can not give with dextrose. Only give with NS.

Addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotn) Cushing is fat ( hyperglycemic, you get moon face big cheeks, and you retain a lot of Na and fluid)

•Never Give via IVP:










oRapid: lispro – onset

oShort: Regular – onset ½ - 1 hr. Peak: 2-3hr. Duration: 4-6 hr

oInt: NPH or Lente – onset: 2 hr. Peak 6-12 hr. Duration: 16-24hr

oLong: Ultralente – onset 4-6 hr. Peak: 12-16 hr. Duration: >24hr

oV.Long: Lantus – onset 1 hr. Peak: None. Duration: 24 hr continuous

•Anticholergic Side Effects:

oCan’t See

oCan’t Pee

oCan’t Spit

oCan’t Sh*t

•Hypocalcemia – CATS




oSpasms & Stridor

•Hyper Kalemia Causes: ‘MACHINE’

oMedicationa (ace inhibitors, NSAIDS)

oAcidosis (metabolic & repiratory)

oCellular destruction (burns, traumatic injuy)

oHypoaldosteronism, Hemolysis

oNephrons, renal failure

oExcretion (impaired)

•Signs of increased K ‘ Murder’

oMuscle weaknes

oUrine – olyguria, anuria

oRespiratory distress

oDecreaed cardiac contractility

oECG Changes

oReflexes – hyperreflexia, or flaccid

•Substance Poisoning and Antidotes

oMethanol -- Ethanol

oCO2 -- Oxygen

oDopamine -- Phentolamine

oBenzo’s (Versed) -- Flumazenil

oLead -- Succimer, Calcium Disodium

oIron -- Deferoxamine

oCoumadin -- Vitamin K

oHeparin -- Protamine Sulfate

oThorazine -- Cogentine

oWild Mushrooms - Atropine

oRat Poison - Vit K

•Parkland Formula: 4cc * Kg * BSA Burned = Total Volume Necessary

o1st 8hrs – ½ total volume

o2nd 8hrs – ¼ total volume

o3rd 8 hrs – ¼ total volumes

from the OP of this link

Goodluck everyone!



Specializes in Oncology. 105 Posts

Wonderful! Thank you!