Pharmacology Tips

Some of the most dreaded test items on the NCLEX involve pharmacology. Learning hundreds of medications—generic names are used on NCLEX—for a wide range of conditions can seem overwhelming. Remember that the purpose of NCLEX is to ensure you can provide SAFE and efficient care to clients, so pharmacology is going to be a crucial part of your examination.

The 2023 NCLEX-RN Test Plan states that 16% (range 13-19%) of the test items cover Pharmacological and Parenteral Therapies. For LPN/LVN candidates, the 2023 NCLEX-PN category of Pharmacological Therapies is about 13% (range 10-16%).

How can you begin to get a handle on this challenging task? Where to begin? Is there a method or system that can save your sanity? Is there a list of drugs to memorize?

Nurse Plus is here to help. We can’t give you the names of medications on NCLEX (no one can), but we can offer you these ten tips to make studying pharmacology easier and less stressful.

10 Pharmacology Tips for NCLEX

1. ALWAYS make client safety your #1 priority! When going through practice questions, ask yourself which option is most likely to keep a client safe. For example, would you automatically administer a dose of lithium (therapeutic range 1.0-1.5 mEq/L) without checking the client’s latest lab results? Of course not! Keeping client safety as the main focus will help you select the BEST response.
2. NEVER forget the ABCs. “Airway, Breathing, Circulation” can matter with pharmacology, too. Side effects and blood transfusion reactions should be cues to consider when administering medications and/or blood or blood products. Observe a client for any adverse effects. Example: Antibiotics are the most common cause of medication-induced anaphylaxis.
3. GENERIC names are used on NCLEX. Forget “Lasix” and think “furosemide.” If it’s helpful, make flash cards with brand names on one side and the generic name on the other. For example, the generic drug ibuprofen has brand names such as Advil or Motrin. To ensure all candidates have the same information, NCLEX only provides generic names.
4. PREFIXES and SUFFIXES can be lifelines when it comes to identifying drug classes. The major drug classes that are most likely to appear on NCLEX have a prefix and/or suffix that provides a clue. If you learn the major classes, you will be closer to passing your NCLEX. A couple of examples: ACE inhibitors end in “-pril” and thrombolytics end in “-ase.”
5. FORMULAS — LEARN THEM! You should count on at least one test item asking you to calculate a dosage and/ or IV infusion rate when you sit for your NCLEX. Client safety demands that the nurse who administers a medication be certain that the client is receiving the proper dose. Memorize a simple calculation equation, such as the Universal Formula (“Desired Over Have”) for medications and the Drip Rate Formula for IV infusions. Then practice as many calculations as you can until it becomes second nature.
6. SIDE EFFECTS are part of medication administration. Learn the three most common side effects for each major drug class. If you think about the reason the medication is being prescribed and the body system it’s treating, you can determine what major side effects can be expected. For example, if you’re administering insulin—to regulate serum glucose levels—you will watch for hypoglycemia. For opioid administration, check for respiratory depression and constipation.
7. MEDICAL DIAGNOSIS can be a clue as to why a medication is prescribed. If the test item provides information about a client’s diagnosis, use your knowledge about the disease or condition. Think about the pathophysiology and what drug action is needed to manage the symptoms. Example: A client with heart failure may require a Beta blocker and a diuretic.
8. THE CLIENT SITUATION can often tell you exactly what you need to know. The stem of an NCLEX test item may briefly describe a client’s symptoms or diagnosis. Or an unfolding case study may provide details that point to the need for a specific class of medication. By using the knowledge from nursing school, knowing how medications work, and applying critical thinking, you’ll be able to select the correct (key) option. For example, a client with a flare-up of their inflammatory bowel disease might require a round of prednisone.
9. PERSONAL EXPERIENCE can be a bonus. Usually you’re warned not to consider any information other than what’s provided in a test item. But if you, a family member, or someone you know has a condition that requires medication, and monitoring for reactions or side effects, you’re already familiar with managing the drug therapy. Common conditions that you might know include asthma, diabetes, or hypertension.
10. RANDOM! RANDOM! Sometimes there may be a drug that you’re not familiar with, no matter how much you’ve studied. The NCLEX test item bank is vast, with thousands and thousands of questions. If this happens during your exam, you must answer the question in order to move to the next. Use the tips listed above to quickly determine if you can rule out one or more of the options before making a selection. Also, every NCLEX includes 15 questions that are being tested for inclusion on a future exam; it’s possible that the unfamiliar drug is one of those questions.

About the Author

Winona Suzanne Ball

Nursing Adviser, RN | MHS, Governors State University, IL
Full member of the American Nurses Association. Learn more