nclex rn study advice: Meds!

roseonye · Oct 31, 2012

mine is the same date and i am using the kaplans ebook free on amazon. it breaks down the meds. am also using the ATI pharm book

KBICU · Nov 1, 2012

If there is a particular group of meds you have no clue about (ex psych, GI, etc) review those first because if you get a med question on these during NCLEX and get it wrong the computer will pick up on it and give you more on that topic. Go over quickly the meds you do know. You don't want to skip studying what your comfortable with but for ex I knew I was bad at the neuromuscular diseases so I made a point to take extra time to review them and it paid off because I had some questions on them. Also when doing practice questions on ATI or elsewhere write down things you come across that your unfamiliar with diseases meds conditions etc you never know what you will see on the actual exam. If you have any specific questions feel free to post them! Good luck :)

hodgieRN · Nov 2, 2012

This was from a different post, but this might give you some tips....

Try and group the medications based on the generic name b/c most of them have a similar base term. Dibucaine, lidocaine, benzocaine, tetracaine all cause numbness. Learn how they interact with the body. How do they cause numbness? What is happening on a cellular level in the neurons? Many of them have the same side effects, drug interactions, and mechanism of action. Where they vary is metabolism or elimination. Some may have a half life of 1 hr or 12 hrs. Know their classifications. Diazepam, midazolam, lorazepam, alprazolam are all benzodiazepines. They all have the same effects.

Know the difference between agonist, antigonist, anticholenergic, cholenergic, adreneric etc. Knowing what a beta2 agonist does can help you identify how a med reacts with the body. These terms close specify the mechanism of action and I was really bad a mixing up agonists or adrenergics b/c it all sounded the same. I zeroed in on the beta2 part and didn't play attention to whether it was blocked or enhanced, which I payed for on the exam.

Next, study the tables in the book. It will list all the drugs together in one group. Stare at it. Identify the names and catch how they are similar. Almotriptan, frovatriptan, naratriptan, eletriptan, rizatriptan all end in triptan and all of them are selective serotonin receptor agonists. Most of these drugs are very similar minus a couple of specifications. If one of the listed drugs are different, make a note (sometimes they like throwing that curve ball).

They are mostly looking for use, mechanism of action, side effects, half life, or drug interactions. They love asking drug interactions. What med can you not take with grapefruit or what happens if these two are given together.

Study toxicity levels. What happens if someone takes too much of a tricyclic antidepressant? Some drug only work after a therapeutic levels is reached, but there are factors that can lead to toxicity. Renal failure, liver failure, infection can all lead to toxicity and the side effects become enhanced or dangerous.

MedChica · Nov 2, 2012

Hi Everyone,
I'm signed up for the November 19th exam and have read from a lot of the recent exam takers that there are *many* meds questions.
Does anyone have any strategies for studying/reviewing meds?? I'm doing my last cram session and would appreciate any insights!
Thanks!!

Well, I'm a VN...LOL

But meds are meds.

Don't try to remember the drugs one at a time. You've got to group and look for similarities.

Concentrate on prefixes and suffixes.

For instance:

If it's -olol, -sartan, -pril, etc...? It's a B/P med.

Then it's just a matter of understanding how each class affects b/p.

-- You wouldn't give a beta blocker (olol) to someone with a 60 pulse, would you? No, it would drop them too low BECAUSE...-olol's decrease and strengthen the heart rate.

-- If someone's coughing after taking lisinopril (ACE inhibitor, -pril)...is that a problem? Yeah.

Like someone else said, understanding beta receptors and all that jazz does help where meds are concerned. Some beta blockers (-olol's...like metoprolol, a beta 1) are safer to use on some pts with certain disorders (like asthma and DM) versus others (like propanolol...a beta 1 + 2).

**Propanolol masks symptoms of low blood sugar and shouldn't be used with pts who've respiratory issues and bronchospasms.

Sometimes, whole classes can share adverse affects.

Anti-HTNs? You know that you're going to have to watch for (first dose) orthostatic hypotension.

Cholesterol meds, like, Fibs- and -statins? You know that you're going to have to watch out for muscle/bone and liver issues.

Most antibiotics (-mycins and such) and some NSAIDs are ototoxic.

Of course, knowing the suffixes/prefixes is good but there are some drug classes where this can't be done. Like, some classes of diuretics and the Calcium Blockers, i.e., verapamil and nifedipine and all that good stuff?

Like, Fosamax. It's for the bones. Must be given same time, every day. Empty stomach. Hold food/drink for 60 minutes.

Like, Clonidine...which is a class all it's own. It's a B/P med.

What I do is concentrate on the most 'troublesome' drug first. Where Calcium blockers are concerned? That would be Verapamil and nifedipine. Lots of contraindications for that.

Then there are the 'commonly used' meds that you'd know by name, like, Digoxin and Lasix and Spirilactalone (sp?).

- SPiractalone (sp?) SPares potassium. No need for potassium pills(or bananas).

- Lasix doesn't, so no need for potassium pills(or bananas). However, lasix does makes the pt pee a river no matter how badly their renal system's functioning. It's your heavy duty diuretic, which makes the pt do some heavy duty peeing.

- Digoxin...? Pt needs potassium pills (or food), lest dig toxicity develop. HyPERkalemia...watch for Dysrrhthymias. Watch the B/P. Administer same time; every day. Know dig levels.

You can go ahead and lump -thiazides in with the above. Why? With the exception of digoxin, they're all diuretics. (though -thiazides are frequently used as anti-HTN meds. Found to be most effective for black people, I might add).

What do you need to know about the - thiazides? Potassium. Give it! Also, the -thiazides only make the pt pees when their urinary system ISN'T compromised...unlike Lasix.

Most of the meds can be learned by grouping. You will know some classes better than others. For instance, I spend less time on ear and eye and more time on meds that affected the respiratory, circulatory/hematologic and urinary system because an NCLEX question is more likely to come from this area AND most of my pts have issues and takes meds from these areas.

For ear and eye meds, I merely concentrated on what jumped out to me.

I also covered the Maternity meds very well.

It seems daunting, but...once you get the hang of it? It's not that bad.

88nursinglove88 · Nov 2, 2012

Well, I'm a VN...LOL
But meds are meds.
Don't try to remember the drugs one at a time. You've got to group and look for similarities.
Concentrate on prefixes and suffixes.
For instance:
If it's -olol, -sartan, -pril, etc...? It's a B/P med.
Then it's just a matter of understanding how each class affects b/p.
-- You wouldn't give a beta blocker (olol) to someone with a 60 pulse, would you? No, it would drop them too low BECAUSE...-olol's decrease and strengthen the heart rate.
-- If someone's coughing after taking lisinopril (ACE inhibitor, -pril)...is that a problem? Yeah.
Like someone else said, understanding beta receptors and all that jazz does help where meds are concerned. Some beta blockers (-olol's...like metoprolol, a beta 1) are safer to use on some pts with certain disorders (like asthma and DM) versus others (like propanolol...a beta 1 + 2).
**Propanolol masks symptoms of low blood sugar and shouldn't be used with pts who've respiratory issues and bronchospasms.
Sometimes, whole classes can share adverse affects.
Anti-HTNs? You know that you're going to have to watch for (first dose) orthostatic hypotension.
Cholesterol meds, like, Fibs- and -statins? You know that you're going to have to watch out for muscle/bone and liver issues.
Most antibiotics (-mycins and such) and some NSAIDs are ototoxic.
Of course, knowing the suffixes/prefixes is good but there are some drug classes where this can't be done. Like, some classes of diuretics and the Calcium Blockers, i.e., verapamil and nifedipine and all that good stuff?
Like, Fosamax. It's for the bones. Must be given same time, every day. Empty stomach. Hold food/drink for 60 minutes.
Like, Clonidine...which is a class all it's own. It's a B/P med.
What I do is concentrate on the most 'troublesome' drug first. Where Calcium blockers are concerned? That would be Verapamil and nifedipine. Lots of contraindications for that.
Then there are the 'commonly used' meds that you'd know by name, like, Digoxin and Lasix and Spirilactalone (sp?).
- SPiractalone (sp?) SPares potassium. No need for potassium pills(or bananas).
- Lasix doesn't, so no need for potassium pills(or bananas). However, lasix does makes the pt pee a river no matter how badly their renal system's functioning. It's your heavy duty diuretic, which makes the pt do some heavy duty peeing.
- Digoxin...? Pt needs potassium pills (or food), lest dig toxicity develop. HyPERkalemia...watch for Dysrrhthymias. Watch the B/P. Administer same time; every day. Know dig levels.
You can go ahead and lump -thiazides in with the above. Why? With the exception of digoxin, they're all diuretics. (though -thiazides are frequently used as anti-HTN meds. Found to be most effective for black people, I might add).
What do you need to know about the - thiazides? Potassium. Give it! Also, the -thiazides only make the pt pees when their urinary system ISN'T compromised...unlike Lasix.
Most of the meds can be learned by grouping. You will know some classes better than others. For instance, I spend less time on ear and eye and more time on meds that affected the respiratory, circulatory/hematologic and urinary system because an NCLEX question is more likely to come from this area AND most of my pts have issues and takes meds from these areas.
For ear and eye meds, I merely concentrated on what jumped out to me.
I also covered the Maternity meds very well.
It seems daunting, but...once you get the hang of it? It's not that bad.

Loved.this. thank you for posting it!

WorldTravelingYogi · Nov 6, 2012

If there is a particular group of meds you have no clue about (ex psych, GI, etc) review those first because if you get a med question on these during NCLEX and get it wrong the computer will pick up on it and give you more on that topic...

This information is completely false. If you get a topic wrong the system will not give you more of that topic. Please go to the NCSBN web site to the link at the bottom of this post and read the top of page 45. Which states:

Similar Items

Occasionally, a candidate may receive an item that seems to be very similar to an item received earlier in the examination. This could happen for a variety of reasons. For example, several items could be about similar symptoms, diseases or disorders, yet address different phases of the nursing process. Alternatively, a pretest (unscored) item could be about content similar to an operational (scored) item. It is incorrect to assume that a second item, which is similar in content to a previously administered item, is administered because the candidate answered the first item incorrectly. The candidate is instructed to always select the answer believed to be correct for each item administered. All examinations conform to their respective test plan.

https://www.ncsbn.org/2010_NCLEX_RN_Detailed_Test_Plan_Candidate.pdf

KBICU · Nov 7, 2012

Not what I've heard/seen. Regardless it's still important to review information you are not comfortable with because you never know what questions your going to get. Also i see that is the 2010 test plan, the test plan changes every few years so OP check out the most recent one for the most updated info.

WorldTravelingYogi · Nov 7, 2012

Not what I've heard/seen. Regardless it's still important to review information you are not comfortable with because you never know what questions your going to get. Also i see that is the 2010 test plan, the test plan changes every few years so OP check out the most recent one for the most updated info.

That is the most recent one. NCLEX was updated in 2010 and will change again in 2013. They update the test every 3 years so the 2010 Detailed Test Plan I referenced is the most up to date.

I agree you need to review areas of difficulty my point was that you do not get more questions on a topic if you get that topic wrong. That is a myth that has been posted a lot lately. Call the NCSBN directly if you don't believe me.

KBICU · Nov 7, 2012

Never said I don't believe you. Based on the description of what CAT testing is it states that the questions given are based on the individuals capacity to answer the preceeding questions. You get questions based on your ability. The more you answer correct the less you get.

https://www.ncsbn.org/2013_NCLEX_RN_Test_Plan.pdf

WorldTravelingYogi · Nov 7, 2012

Never said I don't believe you. Based on the description of what CAT testing is it states that the questions given are based on the individuals capacity to answer the preceeding questions. You get questions based on your ability. The more you answer correct the less you get.
https://www.ncsbn.org/2013_NCLEX_RN_Test_Plan.pdf

That is true. It is based on Bloom's Taxonomy of Learning. There are 4 levels of questions. Two types below the passing line and two types above the passing line. So they start you in the middle and let's say your first question is a comprehension question and you get it right. Well then the next question will be an application question which is harder. Then if you get that right you will get an analysis question which is even harder. That is what the CAT testing is.

However the CAT testing does not give you more maternity questions if you got a materinity question wrong. How ever the test is divided into 8 different areas with a certain percentage of questions in each area. So it is possible to get a maternity question in"Reduction of Risk" and then another one in "Pharmacological and Parenteral Therapies."

That was the part I referenced in my thread. By the way the test plan you referenced is for the new NCLEX that will be implemented in the spring of 2013. That test is not yet in use. I don't know if it will change much but they are still using the test they revised in 2010.

KBICU · Nov 7, 2012

When I said it would give you more questions on a topic, I didn't mean maternity etc - pharm risk potential etc are the categories of the nclex. The test attempts to assess your knowledge while still fulfilling the test requirements - max of 265 questions but a minimum of 75. it will give you as many questions as it takes to determine your knowledge or lack thereof in any given section. I understand that the new test plan is for the spring it says it right next to the link. OP, I have taken the NCLEX and gave you the opinion you originally asked for. Hope you got something out of this. Good luck on your test! :)