Antidote questions are gift points — if you've seen the pairing before. The exam tests the classic reversals, the one-line trigger that should make you think of each agent, and what you monitor after giving it. Here is the full chart used in the NCLEX Decoded system.
| Drug / toxin | Antidote | The exam point |
|---|---|---|
| Opioids | Naloxone | Short half-life — the client can re-sedate; keep monitoring respirations. |
| Benzodiazepines | Flumazenil | Use cautiously — can precipitate seizures in dependent clients. |
| Heparin | Protamine sulfate | Watch for hypotension with rapid IV push. |
| Warfarin | Vitamin K (phytonadione) | Slow onset — for active major bleeding, plasma/PCC products act faster. |
| Digoxin | Digoxin immune Fab | Given for life-threatening dysrhythmias, not just a high level. |
| Acetaminophen | Acetylcysteine | Most effective early; protects the liver. |
| Beta blockers | Glucagon | Bypasses the blocked beta receptor. |
| Calcium channel blockers | Calcium + high-dose insulin per protocol | A crashing CCB overdose is a call-for-help scenario, not a watch-and-wait. |
| Insulin / hypoglycemia (unconscious) | IV dextrose 50% or glucagon IM | Nothing by mouth for an unconscious client — ever. |
| Magnesium sulfate toxicity | Calcium gluconate | Triggers: respirations < 12, absent reflexes, urine output < 30 mL/hr. Stop the infusion first. |
| Hyperkalemia (cardiac protection) | Calcium gluconate | Stabilizes the heart membrane — it does not remove potassium. Insulin/dextrose shifts it; dialysis or binders remove it. |
| Organophosphate / cholinergic excess | Atropine (± pralidoxime) | SLUDGE signs point the way. |
| Iron | Deferoxamine | Classic in pediatric accidental ingestion questions. |
| Carbon monoxide | 100% oxygen | Cherry-red skin is a late, unreliable sign — treat on suspicion. |
| Malignant hyperthermia | Dantrolene | Triggered by succinylcholine/volatile anesthetics: rigidity, soaring temperature, rising CO₂. |
| Neuroleptic malignant syndrome | Dantrolene / bromocriptine | Stop the antipsychotic first. |
| Methemoglobinemia | Methylene blue | Chocolate-colored blood, cyanosis unresponsive to oxygen. |
Module 2 of the Core Bundle teaches each of these inside its drug class, with the labs to monitor before and after — so the pairing sticks to a picture, not a list.
Next Gen NCLEX questions are where exams are won and lost. Our free field guide walks through every NGN item type — case study, bow-tie, trend, cloze, matrix — with fully worked examples and the scoring explained in plain English.