12 POINTS TO ANSWERING PHARMACOLOGY QUESTIONS

The purpose of this lecture is to give you a framework for answering any
pharmacology question that you are presented with whether that be in the
NCLEX or during nursing school or simply as a nurse on the floor to help you
understand medications that you may be unfamiliar with. As I said, we're
going to give you twelve points, and these twelve points regardless of
whether you know the question, you know the medication, you know the
patient, applying one or all of these points in that situation will help you be
able to confidently answer the question or care for the patient.

First and foremost, point number one is patient safety. The reason this is the
first point is because the NCLEX is very concerned with you being a safe
nurse. That's really what the whole entire NCLEX is about is determining
whether you're going to be a safe nurse and capable and competent of taking
care of patients on the floor. Patient safety is number one. As you read the
question and as you read the different answer options, think about will this
option be the safest option for my patient? You can automatically always
exclude options that will put your patient in harm, so number one is going to
be patient safety always.

Number Two: Focus on side effects. Now, when you're studying medications,
one of the main areas that you need to focus on is side effects and nursing
considerations of course, but when you're focusing on your medications and
you're studying, focus on studying the side effects with these major
medication classes. What I would suggest is focusing on the top three side
effects for each medication class. Now, as you do this, you're going to greatly
increase your chances of answering a question correctly and you're going to
greatly increase your understanding of these medications and how they
work. Focus on the three major side effects, again back to kind of patient
safety as you're studying different medications.

Now, number three goes very closely in line with the other two points that
we've already talked about. The third point for answering pharmacology
questions is to know your ABCs. Again, that's airway, breathing and
circulation. The ABCs will never go away throughout your entire career as a
nurse. Always, always, always focus on airway first, breathing and
circulation. The reason for this is because we need to make sure patients
are alive, breathing and circulating very well. When you're answering
pharmacology question, situations will arise when you can pull out the ABCs
and answer the question very easily once you put that framework into play.

Number four is prefixes and suffixes. We focused on this a lot throughout our
different lectures and throughout the different handouts and podcast and
everything, but learn the most common prefixes and suffixes for different
medication classes. This will cut your study time tremendously as well as
help you be able to learn many more medications. When you learn prefixes
and suffixes, a large amount of medications within a specific class will end in
the same suffix or will have the same prefix. Once you're able to identify
those, you're going to learn more medications and learn them quicker and
be able to broadly apply side effects and nursing considerations for a large
group of medications.

Okay, the fifth point is to look for patient clues. As you're reading the
question, does the question provide information about the patient's original
diagnosis? Use these types of clues and the question about the patient, their
history, and their condition. These clues will guide you to the medications
they will be taking. Once you know the patient's history, once you know kind
of about them and their condition, you should be able to use these clues to
kind of piece together a puzzle of what medications they'll be taking, what
side effects you'll be looking for, so always look for these types of patient
clues. Don't just look at the list of medications in the answer options, and
freak out because you don't know any of them. Look at the patient's clues
and history within the question and then be able to identify and pull the
information you need to answer correctly.
Number six is general patient reaction. Look for clues in the patient's
reaction. For example, if the patient reporting dizziness. If the patient reports
dizziness, this is generally going to be a sign that you need to assess blood
pressure. You need to use your general assessment skills to answer
pharmacology questions. As a nurse and throughout nursing school, you've
learned general assessment skills, so use these assessment skills to look at
what the patient may be experiencing and then what may be you need to
assess. Okay, if that makes sense? If the patient is reporting, like we said,
dizziness, you need to assess blood pressure, kind of figure that out. Being
able to identify these patient clues and the reaction to the medication, that's
going to give you a good heads-up for how you need to move forward and
what you need to assess from there.
Number seven is generic. The NCLEX is going to provide you both generic
and trade names, but it's going to focus on simply on generic names of
medications. During your study time, focus on learning generic names. Now,
the generic names of medications may be a little bit hard to pronounce, they
might be a little bit longer, but they're going to provide you a lot of clues. First
of all, these generic names are what you need to know for the NCLEX as we
just said. Second of all, the generic names are what are going to actually
include these prefixes and suffixes to the type of medication that it is.

Really doing your studies like metoprolol, trade name Lopressor, so

Lopressor doesn't really give you any sort of clues as to what kind of
medication it is. Metoprolol, however, with the "olol" tells us that it's a beta
blocker, and knowing that it's a beta blocker, we can then extract from that.
Just by the suffix "olol," we can extract from that some of the different
reasons it's going to be given, some of the side effects that we're going to be
looking for. Study the generic names and begin to learn them and begin to
apply them in your studies and as you're taking different tests.

Okay, point number eight is random, random, random. Regardless of how

much you study, regardless of how much you know, regardless of if you're
the best pharmacology nursing student in the history of the world, you're
going to get some incredibly random medication that you've never heard of.
When this happens, and I'm saying when this happens because it will
happen on a pharmacology test or in the actual NCLEX itself, take a deep
breath, relax, and use your nursing judgment. Just think critically and think
patient safety, so go back to everything that we've talked about before, apply
some of these other points.

Even if that happens, if you're completely unable to draw any clues from the
question, if you can't find any suffixes or prefixes, if there are no clear patient
safety concerns, just relax. This is one question out of the entire course of
your NCLEX, so just relax. It's going to happen. Don't let these types of
questions affect how you perform on the next question. The second you hit
the next button on the NCLEX, forget the previous question and move
forward. Each question is a chance to answer correctly and move closer to
getting that passing mark, okay.
Number nine is medical diagnosis. Does the question identify a specific
medical diagnosis? If you have that working medical diagnosis, use your
knowledge to determine what signs and symptoms the patient will have, what
medications they will require to manage these symptoms, and what are the
main side effects of those medications. Again, for example if we know that
the patient is suffering from a myocardial infarction, we know that the patient
.... that's an ischemic disorder of the heart, so our entire goal of this is to
restore blood flow, restore oxygen to that area of the heart that's suffering.

Most of you probably know the mnemonic MONA. Now, why are we giving
these different medications? We're giving morphine, oxygen, nitroglycerin,
and aspirin. Each of these medications play a role in the side effects and the
condition of this heart attack that the patient is experiencing. For example,
we're giving the oxygen because the patient is ischemic. We're giving the
nitroglycerin because of vasodilator. We're giving the morphine to decrease
oxygen demands of the heart. We're giving the aspirin to thin the blood.

Each of these medications and interventions is given for a specific reason

for this disease, so think about the medical diagnosis. Even if you don't know
the medications that are going to be given, think about the medical diagnosis.
If you don't know the medications but you understand the medical diagnosis,
think about what the patient is going to require to treat those, those signs
and symptoms of that specific disease, and with that in mind, you run a good
chance of being able to answer the question correctly.

Okay. Point number ten is freebies. If you're already familiar with the
medication, simply use your knowledge, the nursing process and critical
thinking to answer the question. You'll get a couple questions that are on the
NCLEX that are just so beyond incredibly easy that you can't believe it's a
real question. In this case, don't overthink it, simply use your nursing
knowledge and your critical thinking to say ... If you know one of the answers
is correct, it doesn't matter if the other answers are correct or wrong. If you
know one of them is correct, go with it and don't start to second guess
yourself.
Okay, number eleven, we've talked about this a lot, is med classes. Learn to
recognize common side effects of major medication classes and the
appropriate interventions for each of these side effects. The NCLEX, like we
said, is very focused on patient safety, so what it's going to do is it's going to
give you a lot of side effect type questions and understand if you're able to
apply the appropriate nursing intervention.

Again, going back to blood pressure. For lightheadedness, etc., assess

blood pressure. That's what they want to know. They want to know can you
identify the most critical side effect and can you apply the appropriate nursing
intervention to that. To learn this and to do this, the best way again focus on
medication classes and you'll be able to apply a broad range of general
interventions to a large amount of medications.

Number twelve. Again, we're going to kind of talk about medical diagnosis
again. Why is the medication given? Try to identify the relationship between
the medical, the medication and the patient diagnosis. If you have this
general, the underlying diagnosis, you can identify why the medication was
given. Okay, so once you know that, once you know why the medication is
given, you can then select the appropriate answer given what the reason the
medication is given for. Okay, so these are twelve points to help you be able
to answer any pharmacology question that you're given whether on a nursing
exam, in the NCLEX, or in your work as a nurse on the floor.

This will help you greatly. Use these points, print out the cheat sheet, and
kind of work through this as you're confronted with medication questions, and
without a doubt, you'll be able to answer with confidence many nursing
questions.