Pharmacology and Medication Administration
What this domain tests
Pharmacology and Medication Administration tests the rights of administration, dosage calculation, high-alert medications, adverse effects, and client teaching. Expect calculation items and questions about when to hold a drug.
Core rules
- Rights: right client (two identifiers), drug, dose, route, time, reason, documentation, and the right to refuse. Verify allergies before every dose.
- Calculate consistently: dose ordered divided by dose available times quantity. Convert units first: 1 g = 1,000 mg; 1 mg = 1,000 mcg.
- High-alert medications such as insulin, heparin, opioids, chemotherapy, and concentrated electrolytes require independent double-checks and pump verification.
- Do not crush extended-release or enteric-coated tablets unless the prescription allows it; do not open capsules without guidance.
- Antidotes: naloxone for opioids, flumazenil for benzodiazepines, protamine sulfate for heparin, vitamin K for warfarin, calcium gluconate for magnesium sulfate.
Worked example
The order is 0.5 g cephalexin PO. The pharmacy supplies 250 mg capsules. How many capsules? Convert 0.5 g to 500 mg; 500 mg divided by 250 mg equals 2 capsules. Reasoning: units must match before dividing; the answer is two capsules, not five.
Traps
- Confusing mg and mcg, a 1,000-fold error.
- Giving a medication because it is due without checking the indication or vital signs, such as holding digoxin for an apical pulse below 60.
- Crushing sustained-release tablets for a client with dysphagia.
- Documenting a dose before it is actually given.