Medication Administration and Pharmacology for Nurses
What the exam tests
This domain covers safe prescribing support, medication calculation, administration routes, high-alert drugs, adverse reactions, and documentation within the nurse’s legal scope.
Core rules
- Verify the right patient using two identifiers, right drug, dose, route, time, reason, documentation, and response. Check allergy status and interactions.
- Read the prescription carefully; question illegible, incomplete, or unsafe orders. A verbal emergency order is read back, documented, and countersigned per policy.
- Calculate doses independently and have a second nurse check high-alert drugs such as insulin, heparin, opioids, chemotherapy, and concentrated electrolytes.
- Use an insulin syringe for insulin; never “eyeball” units. Check blood glucose before and after hypoglycemia treatment.
- Know the difference between adverse drug reaction, side effect, medication error, and anaphylaxis. Stop the drug, maintain airway, call for help, and give adrenaline for anaphylaxis per protocol.
- Store medications at the correct temperature, separate look-alike/sound-alike products, and secure controlled drugs with a witness and balance record.
Worked example
The order is morphine 4 mg IV. Stock is 10 mg/mL. The nurse calculates 4 ÷ 10 = 0.4 mL, checks the patient’s identity, allergy band, respiratory rate, and last opioid dose, and has a second nurse verify the calculation. Reasoning: opioids are high-alert; respiratory depression risk makes assessment and independent double-check essential. The nurse documents the dose, site, time, and response.
Traps
Writing “U” for units; misplacing a decimal point; crushing modified-release tablets; mixing incompatible IV drugs in one line; and documenting a dose before it is given. Also do not treat a mild rash after an antibiotic as a reason to continue without reporting.