CMSRN Medications Cheat Sheet
Review these high-yield medication classes before test day. Focus on nursing considerations and red-flag side effects you will see on the medical-surgical floor.
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Cardiovascular Medications
Beta-Blockers (-olol) — Monitor heart rate and blood pressure; hold for bradycardia; watch for bronchospasm in asthma patients. ACE Inhibitors (-pril) — Monitor for dry persistent cough, hyperkalemia, and angioedema; check renal function before administration. Calcium Channel Blockers (-dipine, diltiazem) — Assess for peripheral edema and hypotension; monitor heart rate with diltiazem and verapamil. Diuretics (loop, thiazide) — Monitor daily weights, strict intake and output, and potassium levels; push IV furosemide slowly to prevent ototoxicity.
Anticoagulants & Antiplatelets
Heparin — Monitor aPTT; watch for Heparin-Induced Thrombocytopenia (HIT); keep protamine sulfate available as the reversal agent. Warfarin — Monitor PT/INR; maintain consistent dietary vitamin K intake; keep vitamin K available as the reversal agent. Direct Oral Anticoagulants (apixaban, rivaroxaban) — No routine coagulation monitoring required; assess for occult bleeding; contraindicated in severe renal impairment. Clopidogrel — Assess for bleeding and bruising; discontinue 5 to 7 days before scheduled surgery.
Endocrine Medications
Rapid-Acting Insulin (lispro, aspart) — Administer right before meals; peak action is fast, creating a high risk for immediate hypoglycemia. Long-Acting Insulin (glargine, detemir) — Provides basal coverage with no distinct peak; do not mix with other insulins in the same syringe. Corticosteroids (-sone) — Taper doses slowly to prevent adrenal crisis; monitor for hyperglycemia, immunosuppression, and fluid retention. Levothyroxine — Administer early morning on an empty stomach; monitor for signs of hyperthyroidism like tachycardia and weight loss.
Respiratory Medications
Short-Acting Beta Agonists (albuterol) — Use as rescue inhaler; expect tachycardia and tremors as common side effects. Inhaled Corticosteroids (fluticasone) — Use for maintenance; instruct patient to rinse mouth after use to prevent oral candidiasis. Anticholinergics (ipratropium) — Use with caution in patients with glaucoma or benign prostatic hyperplasia; monitor for dry mouth and urinary retention.
Neurological & Pain Medications
Opioids (morphine, hydromorphone) — Monitor respiratory rate and oxygen saturation; assess bowel function; keep naloxone readily available. NSAIDs (ibuprofen, ketorolac) — Take with food to prevent GI bleeding; monitor renal function; contraindicated in severe heart failure. Anticonvulsants (phenytoin) — Monitor drug levels for toxicity (nystagmus, ataxia); provide meticulous oral care to prevent gingival hyperplasia.
Antibiotics
Penicillins & Cephalosporins — Assess for cross-sensitivity allergies; monitor for anaphylaxis during the first dose. Aminoglycosides (gentamicin) — Monitor peak and trough levels; assess for nephrotoxicity (BUN/creatinine) and ototoxicity (tinnitus, hearing loss). Fluoroquinolones (ciprofloxacin) — Watch for tendon rupture, especially in older adults; avoid taking with antacids or dairy products.
Exam Facts & Study Resources
Exam Structure — You must answer 125 scored questions. Passing Score — You need a 95 standard scaled score (about 71 percent correct) to pass. Exam Domains — Patient/Care Management is the largest section at 32 percent (40 items). Practice Material — Test your knowledge with our 5213 practice questions.
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