HESI Hints & NCLEX Gems

What is the correct order of Maslow’s Hierarchy of Needs?

Physiologic → Safety → Love and Belonging → Esteem → Self-actualization.

What are the steps of the Nursing Process in order?

Assessment → Diagnosis (Analysis) → Planning → Implementation → Evaluation.

What do the ABCs stand for?

Airway, Breathing, Circulation.

What is the normal Hgb for males?

14–18.

What is the normal Hgb for females?

12–16.

What is the normal Hct for males?

42–52%.

What is the normal Hct for females?

37–47%.

What is the normal RBC count for males?

4.7–6.1 million.

What is the normal RBC count for females?

4.2–5.4 million.

What is the normal WBC count?

4.5–11k.

What is the normal platelet count?

150–400k.

What is the normal PT time (warfarin)?

11–12.5 sec (therapeutic range is 1.5–2 × normal).

What is the normal APTT for heparin?

0–70 sec (therapeutic range is 1.5–2.5 × normal).

What is the normal BUN?

10–20.

What is the normal Creatinine?

0.5–1.2.

What is the normal Glucose?

70–110.

What is newborn bilirubin?

1–12.

What is newborn phenylalanine?

Not specified; noted as "Phenylalanine Newborn."

What is the normal sodium (Na+) range?

136–145.

What is the normal potassium (K+) range?

3.5–5.

What EKG changes occur in hypokalemia?

Prominent U waves, depressed ST segment, flat T waves.

What EKG changes occur in hyperkalemia?

Tall T-waves, prolonged PR interval, wide QRS.

What is the normal calcium (Ca++) range?

9–10.5.

What are signs of hypocalcemia?

Muscle spasms, convulsions, cramps/tetany, +Trousseau's, +Chvostek’s, prolonged ST interval, prolonged QT segment.

What is the normal magnesium range?

1.5–2.5.

What is the normal chloride (Cl–) range?

96–106.

What is the normal phosphorus range?

3–4.5.

What is the normal albumin range?

3.5–5.

What is the normal urine specific gravity?

1.005–1.030.

What is a normal Hgb A1c?

4–6%.

What is the therapeutic range for Dilantin?

10–20.

What is the therapeutic range for Lithium?

0.5–1.5.

What is normal pH?

7.35–7.45.

What is normal CO₂?

35–45 (respiratory driver; high = acidosis).

What is normal HCO₃?

21–28 (metabolic driver; high = alkalosis).

What is normal PaO₂?

80–100.

What is normal O₂ saturation?

95–100%.

What is the antidote for Digoxin?

Digiband.

What is the antidote for Coumadin/Warfarin?

Vitamin K.

What is the antidote for benzodiazepines?

Flumazenil (Tomazicon).

What is the antidote for magnesium sulfate toxicity?

Calcium gluconate.

What is the antidote for Heparin?

Protamine sulfate.

What is the antidote for Tylenol overdose?

Mucomist (17 doses + loading dose).

What is the antidote for opiates?

Narcan (Naloxone).

What is the antidote for cholinergic meds (myasthenic bradycardia)?

Atropine.

What is the antidote for methotrexate?

Leucovorin.

Which tasks can ONLY an RN perform?

Blood products, clotting factors, sterile dressing changes and procedures, assessments requiring clinical judgment, and is ultimately responsible for all delegated duties.

What can UAP perform?

Non-sterile procedures.

What are universal (standard) precautions?

Hand hygiene, gloves, gowns for splashes, masks/eye protection for splashes, no recapping needles, use mouthpiece/Ambu bag for resuscitation, avoid care with skin lesions.

What infections require droplet precautions (mask)?

Sepsis, scarlet fever, strep, fifth disease, pertussis, pneumonia, influenza, diphtheria, epiglottitis, rubella, rubeola, meningitis, mycoplasma, adenovirus, rhinovirus.

What other precaution does RSV require?

Contact precautions.

What precautions does TB require?

Respiratory isolation.

What are contact precautions?

Universal + goggles, mask, and gown.

What patients should not be roomed with immunosuppressed patients?

Infection patients.

What color do body fluids turn with rifampin?

Rust/orange/red.

What color does urine turn with Pyridium?

Orange/red/pink.

What differentiates myasthenic crisis from cholinergic crisis?

Myasthenic crisis = weakness + vital sign changes (needs more meds).
Cholinergic crisis = weakness + NO vital sign changes (reduce meds).

How do you initially treat diabetic coma vs insulin shock?

Give glucose first; if no improvement, give insulin.

What does fruity breath indicate?

Diabetic ketoacidosis.

What does “If it comes out of your ass it’s acidosis” mean?

Diarrhea causes metabolic acidosis.

What does vomiting cause in acid-base balance?

Metabolic alkalosis.

What does salty-tasting skin indicate?

Cystic fibrosis.

When should Lipitor be taken?

In the evening; avoid grapefruit juice.

What does stroke do to the tongue and uvula?

Tongue points toward lesion; uvula deviates away.

When should digoxin be held?

HR < 60.

What should a patient do after the first ACE inhibitor dose?

Stay in bed for 3 hours.

What juice should be avoided with calcium channel blockers?

Grapefruit juice.

What type of hazard is anthrax?

Multi-vector biohazard.

How do you prevent pulmonary air embolism?

Trendelenburg (HOB down) + left side.

What is the primary concern in head trauma and seizures?

Maintain airway.

How do you treat duodenal vs gastric ulcers?

Duodenal ulcer: feed (pain relieved by food).
Gastric ulcer: starve.

What are signs of acute pancreatitis?

Fetal position, Turner's sign (flank bruising), Cullen’s sign (umbilical bruising), board-like abdomen, guarding, autodigestion by trypsin.

When should tube feeding be held?

Residual > 100 mL.

What does RACE and PASS refer to?

Fire safety procedures.

How often should restraints be checked?

Every 30 minutes; ensure 2 finger space.

What is Guillain–Barré progression?

Weakness ascending from legs upward → respiratory arrest.

When is a trough level drawn?

~30 min before next dose.

When is a peak level drawn?

30–60 minutes after drug administration.

When do most suicides occur during treatment?

After the beginning of improvement when energy levels increase.

What food interaction do MAOIs have?

Tyramine foods can cause a hypertensive crisis.

Name three MAOIs.

Nardil, Marplan, and Parnate.

How long of a medication gap is required before starting MAOIs after SSRIs or TCAs?

A 2-week gap.

What is the therapeutic range for lithium?

0.5–1.5.

What are main side effects of phenothiazines (typical antipsychotics)?

EPS and photosensitivity.

What do atypical antipsychotics treat?

Positive and negative symptoms, with less EPS.

What conditions are benzodiazepines especially useful for?

Alcohol withdrawal and status epilepticus.

What is Antabuse used for?

Alcohol deterrence by causing illness when alcohol is consumed.

What are symptoms of alcohol withdrawal (Delirium Tremens)?

Tachycardia, tachypnea, anxiety, nausea, tremors, hallucinations, paranoia; begins 12–36 hours after last drink.

What are symptoms of opiate withdrawal?

Watery eyes, runny nose, dilated pupils, N/V/D, cramps.

What are symptoms of stimulant withdrawal?

Depression, fatigue, anxiety, disturbed sleep.

Hypoventilation leads to what acid-base condition?

Acidosis (too much CO₂).

Hyperventilation leads to what acid-base condition?

Alkalosis (low CO₂).

What precaution applies to a limb after a mastectomy?

No BP or IV on the affected side.

What pupil finding suggests opiate overdose?

Pinpoint pupils.

What type of brain lesion causes decerebrate posturing?

Midbrain lesions.

What type of brain lesion causes decorticate posturing?

Cortex lesions.

What is the minimum urine output indicating adequate heart and kidney function?

30 mL/hr.

What is another term for kidney stone?

Cholelithiasis.

What does flank pain indicate in kidney stones?

Stone in kidney or upper ureter.