RN Pharmacology for Nursing
REVIEW MODULE EDITION 8.0
Contributors
Honey C. Holman, MSN, RN
Debborah Williams, MSN, RN
Sheryl Sommer, PhD, RN, CNE
Consultants
Janean Johnson, MSN, RN, CNE
Tracey Bousquet, BSN, RN
Brenda S. Ball, MEd, BSN, RN
Penny Fauber, PhD, MS, BSN, RN
Cindy Morris, DNP, RN, IBCLC
Jenni L. Hoffman, DNP,
LaKeisha Wheless, MSN, RN FNP-C, CLNC, FAANP
Mendy G. McMichael, DNP, RN Jessica L. Johnson, DNP, MSN, BSN, RN
Pamela Roland, MSN, MBA, RN Lisa Kongable, MA, ARNP, PMHCNS, CNE
Peggy Leehy, MSN, RN Melanie P. Schrader, PhD, RN
Robin Hertel, EdS, MSN, RN, CMSRN Virginia Tufano, EdD, MSN, RN
INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2019 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical, or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
RN PHARMACOLOGY FOR NURSING I
, Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Tiffany Pavlik, Shannon Tierney
Coordination of content review: Honey C. Holman, Debborah Williams
Copy editing: Kelly Von Lunen, Bethany Phillips, Kya Rodgers, Joshua Hoeven
Layout: Spring Lenox, Maureen Bradshaw, Bethany Phillips
Illustrations: Randi Hardy
Online media: Brant Stacy, Ron Hanson, Britney Fuller, Barry Wilson
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
informational and educational purposes only and may be modified or updated by the publisher at any time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
products and procedures described or the correctness, sufficiency, or completeness of stated information, opinions, or
recommendations. The publisher does not recommend or endorse any specific tests, providers, products, procedures,
processes, opinions, or other information that may be mentioned in this publication. Treatments and side effects described
in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
and government regulations often change the accepted standard in this field. When consideration is being given to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
specific determination should be made only with the aid of legal counsel. Some images in this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
II CONTENT MASTERY SERIES
, User’s Guide
Welcome to the Assessment Technologies Institute® RN ACTIVE LEARNING SCENARIOS
Pharmacology for Nursing Review Module Edition 8.0. The AND APPLICATION EXERCISES
mission of ATI’s Content Mastery Series® Review Modules
Each chapter includes opportunities for you to test your
is to provide user-friendly compendiums of nursing
knowledge and to practice applying that knowledge. Active
knowledge that will:
Learning Scenario exercises pose a nursing scenario
●● Help you locate important information quickly.
and then direct you to use an ATI Active Learning
●● Assist in your learning efforts.
Template (included at the back of this book) to record
●● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
●● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more content into less space and have done so in a you with opportunities to practice answering the kinds of
way that will make it even easier for you to find and questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION NCLEX® CONNECTIONS
This Review Module is organized into units covering To prepare for the NCLEX-RN, it is important to
pharmacological principles (Unit 1) and medications understand how the content in this Review Module
affecting the body systems and physiological processes is connected to the NCLEX-RN test plan. You can find
(Units 2 to 13). Chapters within these units conform to one information on the detailed test plan at the National
of two organizing principles for presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
●● Nursing concepts org. When reviewing content in this Review Module,
●● Medications regularly ask yourself, “How does this content fit into
the test plan, and what types of questions related to this
Nursing concepts chapters begin with an overview
content should I expect?”
describing the central concept and its relevance to nursing.
Subordinate themes are covered in outline form to To help you in this process, we’ve included NCLEX
demonstrate relationships and present the information in Connections at the beginning of each unit and with each
a clear, succinct manner. question in the Application Exercises Answer Keys. The
NCLEX Connections at the beginning of each unit point
Medications chapters include an overview describing a
out areas of the detailed test plan that relate to the content
disorder or group of disorders. Medications used to treat
within that unit. The NCLEX Connections attached to the
these disorders are grouped according to classification.
Application Exercises Answer Keys demonstrate how each
A specific medication can be selected as a prototype or
exercise fits within the detailed content outline.
example of the characteristics of medications in this
These NCLEX Connections will help you understand how
classification. These sections include information about
the detailed content outline is organized, starting with
how the medication works and its therapeutic uses.
major client needs categories and subcategories and
Next, you will find information about complications,
followed by related content areas and tasks. The major
contraindications/precautions, and interactions, as well as
client needs categories are:
nursing interventions and client education to help prevent ●● Safe and Effective Care Environment
and/or manage these issues. Finally, the chapter includes ◯◯ Management of Care
information on nursing administration of the medication ◯◯ Safety and Infection Control
and evaluation of the medication’s effectiveness. ●● Health Promotion and Maintenance
●● Psychosocial Integrity
●● Physiological Integrity
◯◯ Basic Care and Comfort
◯◯ Pharmacological and Parenteral Therapies
◯◯ Reduction of Risk Potential
◯◯ Physiological Adaptation
An NCLEX Connection might, for example, alert you that
content within a unit is related to:
●● Pharmacological and Parenteral Therapies
◯◯ Adverse Effects/Contraindications/Side Effects/
Interactions
■■ Identify a contraindication to the administration of
a medication to the client.
RN PHARMACOLOGY FOR NURSING USER’S GUIDE III
, QSEN COMPETENCIES ICONS
As you use the Review Modules, you will note the Icons are used throughout the Review Module to draw
integration of the Quality and Safety Education for your attention to particular areas. Keep an eye out for
Nurses (QSEN) competencies throughout the chapters. these icons.
These competencies are integral components of the
curriculum of many nursing programs in the United States This icon is used for NCLEX Connections.
and prepare you to provide safe, high-quality care as a
newly licensed nurse. Icons appear to draw your attention This icon indicates gerontological considerations,
to the six QSEN competencies. or knowledge specific to the care of older
adult clients.
Safety: The minimization of risk factors that could
cause injury or harm while promoting quality care This icon is used for content related to safety
and maintaining a secure environment for clients, self, and is a QSEN competency. When you see this
and others. icon, take note of safety concerns or steps that
nurses can take to ensure client safety and a
Patient-Centered Care: The provision of caring and
safe environment.
compassionate, culturally sensitive care that addresses
clients’ physiological, psychological, sociological, spiritual, This icon is a QSEN competency that indicates
and cultural needs, preferences, and values. the importance of a holistic approach to
providing care.
Evidence-Based Practice: The use of current knowledge
from research and other credible sources, on which to base This icon, a QSEN competency, points out the
clinical judgment and client care. integration of research into clinical practice.
Informatics: The use of information technology as a This icon is a QSEN competency and highlights
communication and information-gathering tool that the use of information technology to support
supports clinical decision-making and scientifically based nursing practice.
nursing practice.
This icon is used to focus on the QSEN
Quality Improvement: Care related and organizational competency of integrating planning processes to
processes that involve the development and meet clients’ needs.
implementation of a plan to improve health care services
This icon highlights the QSEN competency of care
and better meet clients’ needs.
delivery using an interprofessional approach.
Teamwork and Collaboration: The delivery of client care
This icon appears at the top-right of pages
in partnership with multidisciplinary members of the
and indicates availability of an online media
health care team to achieve continuity of care and positive
supplement, such as a graphic, animation, or
client outcomes.
video. If you have an electronic copy of the
Review Module, this icon will appear alongside
clickable links to media supplements. If you have
a hard copy version of the Review Module, visit
www.atitesting.com for details on how to access
these features.
FEEDBACK
ATI welcomes feedback regarding this Review Module.
Please provide comments to .
As needed updates to the Review Modules are identified,
changes to the text are made for subsequent printings
of the book and for subsequent releases of the electronic
version. For the printed books, print runs are based
on when existing stock is depleted. For the electronic
versions, a number of factors influence the update
schedule. As such, ATI encourages faculty and students to
refer to the Review Module addendums for information on
what updates have been made. These addendums, which
are available in the Help/FAQs on the student site and the
Resources/eBooks & Active Learning on the faculty site,
are updated regularly and always include the most current
information on updates to the Review Modules.
IV USER’S GUIDE CONTENT MASTERY SERIES
REVIEW MODULE EDITION 8.0
Contributors
Honey C. Holman, MSN, RN
Debborah Williams, MSN, RN
Sheryl Sommer, PhD, RN, CNE
Consultants
Janean Johnson, MSN, RN, CNE
Tracey Bousquet, BSN, RN
Brenda S. Ball, MEd, BSN, RN
Penny Fauber, PhD, MS, BSN, RN
Cindy Morris, DNP, RN, IBCLC
Jenni L. Hoffman, DNP,
LaKeisha Wheless, MSN, RN FNP-C, CLNC, FAANP
Mendy G. McMichael, DNP, RN Jessica L. Johnson, DNP, MSN, BSN, RN
Pamela Roland, MSN, MBA, RN Lisa Kongable, MA, ARNP, PMHCNS, CNE
Peggy Leehy, MSN, RN Melanie P. Schrader, PhD, RN
Robin Hertel, EdS, MSN, RN, CMSRN Virginia Tufano, EdD, MSN, RN
INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2019 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical, or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
RN PHARMACOLOGY FOR NURSING I
, Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Tiffany Pavlik, Shannon Tierney
Coordination of content review: Honey C. Holman, Debborah Williams
Copy editing: Kelly Von Lunen, Bethany Phillips, Kya Rodgers, Joshua Hoeven
Layout: Spring Lenox, Maureen Bradshaw, Bethany Phillips
Illustrations: Randi Hardy
Online media: Brant Stacy, Ron Hanson, Britney Fuller, Barry Wilson
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
informational and educational purposes only and may be modified or updated by the publisher at any time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
products and procedures described or the correctness, sufficiency, or completeness of stated information, opinions, or
recommendations. The publisher does not recommend or endorse any specific tests, providers, products, procedures,
processes, opinions, or other information that may be mentioned in this publication. Treatments and side effects described
in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
and government regulations often change the accepted standard in this field. When consideration is being given to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
specific determination should be made only with the aid of legal counsel. Some images in this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
II CONTENT MASTERY SERIES
, User’s Guide
Welcome to the Assessment Technologies Institute® RN ACTIVE LEARNING SCENARIOS
Pharmacology for Nursing Review Module Edition 8.0. The AND APPLICATION EXERCISES
mission of ATI’s Content Mastery Series® Review Modules
Each chapter includes opportunities for you to test your
is to provide user-friendly compendiums of nursing
knowledge and to practice applying that knowledge. Active
knowledge that will:
Learning Scenario exercises pose a nursing scenario
●● Help you locate important information quickly.
and then direct you to use an ATI Active Learning
●● Assist in your learning efforts.
Template (included at the back of this book) to record
●● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
●● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more content into less space and have done so in a you with opportunities to practice answering the kinds of
way that will make it even easier for you to find and questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION NCLEX® CONNECTIONS
This Review Module is organized into units covering To prepare for the NCLEX-RN, it is important to
pharmacological principles (Unit 1) and medications understand how the content in this Review Module
affecting the body systems and physiological processes is connected to the NCLEX-RN test plan. You can find
(Units 2 to 13). Chapters within these units conform to one information on the detailed test plan at the National
of two organizing principles for presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
●● Nursing concepts org. When reviewing content in this Review Module,
●● Medications regularly ask yourself, “How does this content fit into
the test plan, and what types of questions related to this
Nursing concepts chapters begin with an overview
content should I expect?”
describing the central concept and its relevance to nursing.
Subordinate themes are covered in outline form to To help you in this process, we’ve included NCLEX
demonstrate relationships and present the information in Connections at the beginning of each unit and with each
a clear, succinct manner. question in the Application Exercises Answer Keys. The
NCLEX Connections at the beginning of each unit point
Medications chapters include an overview describing a
out areas of the detailed test plan that relate to the content
disorder or group of disorders. Medications used to treat
within that unit. The NCLEX Connections attached to the
these disorders are grouped according to classification.
Application Exercises Answer Keys demonstrate how each
A specific medication can be selected as a prototype or
exercise fits within the detailed content outline.
example of the characteristics of medications in this
These NCLEX Connections will help you understand how
classification. These sections include information about
the detailed content outline is organized, starting with
how the medication works and its therapeutic uses.
major client needs categories and subcategories and
Next, you will find information about complications,
followed by related content areas and tasks. The major
contraindications/precautions, and interactions, as well as
client needs categories are:
nursing interventions and client education to help prevent ●● Safe and Effective Care Environment
and/or manage these issues. Finally, the chapter includes ◯◯ Management of Care
information on nursing administration of the medication ◯◯ Safety and Infection Control
and evaluation of the medication’s effectiveness. ●● Health Promotion and Maintenance
●● Psychosocial Integrity
●● Physiological Integrity
◯◯ Basic Care and Comfort
◯◯ Pharmacological and Parenteral Therapies
◯◯ Reduction of Risk Potential
◯◯ Physiological Adaptation
An NCLEX Connection might, for example, alert you that
content within a unit is related to:
●● Pharmacological and Parenteral Therapies
◯◯ Adverse Effects/Contraindications/Side Effects/
Interactions
■■ Identify a contraindication to the administration of
a medication to the client.
RN PHARMACOLOGY FOR NURSING USER’S GUIDE III
, QSEN COMPETENCIES ICONS
As you use the Review Modules, you will note the Icons are used throughout the Review Module to draw
integration of the Quality and Safety Education for your attention to particular areas. Keep an eye out for
Nurses (QSEN) competencies throughout the chapters. these icons.
These competencies are integral components of the
curriculum of many nursing programs in the United States This icon is used for NCLEX Connections.
and prepare you to provide safe, high-quality care as a
newly licensed nurse. Icons appear to draw your attention This icon indicates gerontological considerations,
to the six QSEN competencies. or knowledge specific to the care of older
adult clients.
Safety: The minimization of risk factors that could
cause injury or harm while promoting quality care This icon is used for content related to safety
and maintaining a secure environment for clients, self, and is a QSEN competency. When you see this
and others. icon, take note of safety concerns or steps that
nurses can take to ensure client safety and a
Patient-Centered Care: The provision of caring and
safe environment.
compassionate, culturally sensitive care that addresses
clients’ physiological, psychological, sociological, spiritual, This icon is a QSEN competency that indicates
and cultural needs, preferences, and values. the importance of a holistic approach to
providing care.
Evidence-Based Practice: The use of current knowledge
from research and other credible sources, on which to base This icon, a QSEN competency, points out the
clinical judgment and client care. integration of research into clinical practice.
Informatics: The use of information technology as a This icon is a QSEN competency and highlights
communication and information-gathering tool that the use of information technology to support
supports clinical decision-making and scientifically based nursing practice.
nursing practice.
This icon is used to focus on the QSEN
Quality Improvement: Care related and organizational competency of integrating planning processes to
processes that involve the development and meet clients’ needs.
implementation of a plan to improve health care services
This icon highlights the QSEN competency of care
and better meet clients’ needs.
delivery using an interprofessional approach.
Teamwork and Collaboration: The delivery of client care
This icon appears at the top-right of pages
in partnership with multidisciplinary members of the
and indicates availability of an online media
health care team to achieve continuity of care and positive
supplement, such as a graphic, animation, or
client outcomes.
video. If you have an electronic copy of the
Review Module, this icon will appear alongside
clickable links to media supplements. If you have
a hard copy version of the Review Module, visit
www.atitesting.com for details on how to access
these features.
FEEDBACK
ATI welcomes feedback regarding this Review Module.
Please provide comments to .
As needed updates to the Review Modules are identified,
changes to the text are made for subsequent printings
of the book and for subsequent releases of the electronic
version. For the printed books, print runs are based
on when existing stock is depleted. For the electronic
versions, a number of factors influence the update
schedule. As such, ATI encourages faculty and students to
refer to the Review Module addendums for information on
what updates have been made. These addendums, which
are available in the Help/FAQs on the student site and the
Resources/eBooks & Active Learning on the faculty site,
are updated regularly and always include the most current
information on updates to the Review Modules.
IV USER’S GUIDE CONTENT MASTERY SERIES
