What happens if you don't pass the med calculation test during orientation?


I just joined so I'm brand new to this and apologize if this topic was already discussed in detail. I was hired for an RN position and relocating to Texas. I'm assuming I will have a med test during orientation, but have not had one in 7yrs. I passed my boards without a problem and passed the med test 7yrs ago at my first hospital, but that seems like a long time ago. I hate to be negative but what happens if I don't pass the med portion of the orientation? Has that happened to anyone? I hate to relocate and get an apartment with the possiblity of not being able to start working. I also don't want to ask HR. I have been brushing up on past nursing books but my start date is quickly approaching. Thanks

MrChicagoRN, RN

2,589 Posts

Specializes in Leadership, Psych, HomeCare, Amb. Care. Has 30 years experience.

There is always anxiety about starting a new job; even more so if it involves relocating.

I took one after not working inside a hospital for 17 years. It was pretty basic. Simple meds calculations & recognizing proper routes etc.

It costs a lot to recruit, hire,and train. If someone did fail, they'd likely coach them and give them the test again. They didn't hire you to see you fail.


4 Posts

That makes sense. Thank you so much for your comment.

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant. Has 14 years experience.

This is going to depend on the policy of the hospital. I would strongly doubt that if you don't pass the med test you would be terminated on the spot. Both times I have had to take an orientation medication exam, you were given another shot at the test the next day. I can understand why you may not want to ask, but this may be the only way to put you mind at rest over this issue.


71 Posts

Specializes in labor and delivery.

they really want you to pass, they hired you so they will do everything they can to see that you pass. I wouldn't worry about it too much.

allnurses Guide

llg, PhD, RN

13,469 Posts

Specializes in Nursing Professional Development. Has 46 years experience.

I have worked in Staff Development for about 20 years -- in several different hospitals. For each of these hospitals, the policy was pretty much the same.

People who fail the med test are given remediation (a little extra education on the topic) -- and then took another version of the test. If they fail the 2nd test... they are remediated again and given a 3rd (and final) chance. If they can't pass the 3rd test, they lose their jobs -- but I have never known anybody who failed the 3rd time. The educators work with you to help you learn the skills you need.

I've only known a couple of people who really struggled to pass the 3rd test -- and they struggled to learn everything else, too. (CPR, infection control, common procedures, etc.) and they didn't last in their jobs for very long. Most people who fail the first time buckle down and study, work with the educators, do some practice questions, and pass on their 2nd attempt.

I recommend that you ask about review/study resources prior to starting the job if you continue to be worried about it. A lot of hospitals will recommend a particular book, etc. My hospital has a handout that people are given to review on their first day of employment (to take the test at the end of the week). If an orientee asked for it ahead of time, we would be happy to send it. It wouldn't hurt to ask -- particularly if you indicate that you want to be sure to be ready for the test (as opposed to suggesting that you are terrified because you have a terrible history with making lots of medication mistakes.)


157 Posts

Specializes in Geriatrics, med/surg, LTC surveyor. Has 26 years experience.

I have recently taken two med tests since I signed up with agencies. I brushed up on my basic calculations. That was the biggest concern for me since all of our meds usually come to us precalculated. There were alot of IV calculations and gm's to mg's etc. I was provided with a drug book though. That helped alot. Good Luck. I have a girlfriend who didn't pass and they kept her.

Specializes in Mental Health, Medical Research, Periop.

I agree with everyone here. I know its hard not to worry, but try not to. Im thinking they will let you retake the test. Congrats on your new job!


4 Posts

Wow, this is wonderful information! Thank you so much!

military spouse

577 Posts

Has 20 years experience.

I once took a med test that was more challenging than others that I had taken. Fortunately, they let us work in groups and an ICU nurse was able to figure out some of the more complicated questions :) The test included both calculations and drug information.

The med calculation test I took as a new hire was so, so easy. I do more complicated dosage calculations on the job regularly than were in the test. I think doing a few practice problems in advance will help you feel less anxious about it.


519 Posts

Specializes in Telemetry, OB, NICU. Has 4 years experience.

In my hospital, they let you retake it and help you if you ask for it.