🎯 High-Yield Points for This Topic
- Master the basic dosage calculation formula: (Dose Required ÷ Stock Strength) × Stock Volume
- Gentamicin and other aminoglycosides are ototoxic and nephrotoxic — new tinnitus means stop and notify
- IV potassium chloride must always be diluted and infused slowly — never given as a push or bolus
- Warfarin: INR above therapeutic range plus bleeding signs is an emergency requiring the dose to be withheld
- Digoxin: always check apical pulse (hold if <60 bpm) and serum potassium before administering
[Infographic: NCK Pharmacology Key Concepts — High-Alert Medications, Dosage Calculations]
Practice Questions
['Question 1
A patient is prescribed amoxicillin 500 mg orally three times daily. The pharmacy supplies a suspension of 250 mg/5 mL. How many mL should the nurse administer per dose?
✓ Correct: 10 mL
Using the formula (Dose Required ÷ Stock Strength) × Stock Volume: (500 mg ÷ 250 mg) × 5 mL = 10 mL. The nurse should administer 10 mL per dose, three times daily.
Using the formula (Dose Required ÷ Stock Strength) × Stock Volume: (500 mg ÷ 250 mg) × 5 mL = 10 mL. The nurse should administer 10 mL per dose, three times daily.
Question 2
A patient receiving gentamicin reports new ringing in the ears and difficulty hearing. What should the nurse do?
✓ Correct: Withhold the next dose and notify the physician immediately
Gentamicin is ototoxic and nephrotoxic. New tinnitus and hearing changes are early signs of ototoxicity and may be irreversible if the drug is continued. The nurse must withhold the dose and notify the physician immediately for reassessment.
Gentamicin is ototoxic and nephrotoxic. New tinnitus and hearing changes are early signs of ototoxicity and may be irreversible if the drug is continued. The nurse must withhold the dose and notify the physician immediately for reassessment.
Question 3
A nurse is preparing to administer IV potassium chloride. Which action is essential for SAFE administration?
✓ Correct: Always dilute and administer via infusion pump, never as a bolus
Undiluted or rapidly administered IV potassium chloride can cause fatal cardiac arrhythmias. It must always be properly diluted and administered slowly via an infusion pump, with cardiac monitoring for higher concentrations, and is never given as an IV push or bolus.
Undiluted or rapidly administered IV potassium chloride can cause fatal cardiac arrhythmias. It must always be properly diluted and administered slowly via an infusion pump, with cardiac monitoring for higher concentrations, and is never given as an IV push or bolus.
Question 4
A patient on warfarin therapy has an INR of 6.5 and is bleeding from the gums. What is the nurse\'s PRIORITY action?
✓ Correct: Withhold warfarin and notify the physician immediately
An INR of 6.5 is significantly above the therapeutic range (typically 2–3) and, combined with active bleeding, indicates dangerous over-anticoagulation. The nurse must withhold the next dose and notify the physician immediately; vitamin K or other reversal agents may be required.
An INR of 6.5 is significantly above the therapeutic range (typically 2–3) and, combined with active bleeding, indicates dangerous over-anticoagulation. The nurse must withhold the next dose and notify the physician immediately; vitamin K or other reversal agents may be required.
Question 5
Before administering digoxin to a patient, which assessment is ESSENTIAL?
✓ Correct: Apical pulse and serum potassium
Digoxin should be held if the apical heart rate is below 60 bpm, and hypokalaemia increases the risk of digoxin toxicity. Checking both the apical pulse and serum potassium before each dose is a non-negotiable safety check.
Digoxin should be held if the apical heart rate is below 60 bpm, and hypokalaemia increases the risk of digoxin toxicity. Checking both the apical pulse and serum potassium before each dose is a non-negotiable safety check.
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Pharmacology on the NCK exam blends mathematical accuracy (dosage calculations) with clinical safety reasoning (knowing which findings mean "hold this drug"). Both skills are tested consistently and require regular timed practice to build speed and accuracy under exam pressure.
[Clinical Concept Map: Pharmacology — Drug Classes, Adverse Effects, Safety Checks]
Frequently Asked Questions
Are calculators allowed for dosage calculation questions on the NCK exam? ⌄
Policies can vary by examination centre and cycle, so always confirm current rules with your institution. Regardless, practising calculations by hand builds the underlying understanding examiners are testing for.
Which drug classes are most heavily tested on NCK pharmacology papers? ⌄
Antibiotics, cardiac drugs (digoxin, antihypertensives), anticoagulants, and electrolytes (especially potassium) are consistently high-yield, alongside basic dosage calculation across all drug classes.