Pharmacology and Medication Administration
Pharmacology questions reward precision. Know the rights of administration (right client, drug, dose, route, time, documentation, and the client's right to refuse and to be informed), and the checks that prevent error: verify the order, check allergies, confirm identity using at least two identifiers, and clarify illegible or incomplete orders rather than guessing.
Understand pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (agonist versus antagonist, therapeutic index, onset, peak, and duration). Know high-alert medications and their safeguards, common drug classes and their key adverse effects, and antidotes and reversal agents for poisons and overdoses. Calculation skills are tested: dose required divided by stock strength, multiplied by stock volume, with unit conversion and sensible rounding.
Routes and techniques matter: oral, sublingual, topical, inhaler, subcutaneous, intramuscular (site selection and needle length), intravenous (rate control and compatibility), and rectal. Know which drugs must not be crushed, which require monitoring of blood levels, and which need food or an empty stomach.
Traps: choosing a route that is unsafe for the client (e.g., oral medication in an unconscious client); mixing up units (mg versus mcg); ignoring a documented allergy or a raised drug level; and selecting 'hold the drug and document' when the correct action is to withhold and notify the prescriber. Watch for questions about adverse drug reaction reporting - it is a professional and often legal duty.
Rule of thumb - the calculation check: write the formula, convert units first, calculate, then ask whether the answer is plausible (a 10 mg dose should not require 10 tablets). Worked example: order 500 mg; stock 250 mg in 5 mL. (500 ÷ 250) × 5 = 10 mL.