NLN NEX High Yield Review

Vocabulary flashcards covering high-yield clinical reasoning, pharmacological safety, and pathophysiological concepts for the NLN NEX exam.

Hypoglycemia Management (Conscious Patient)

The administration of $15\text{--}20\,\text{g}$ of fast-acting oral carbohydrates (e.g., juice or glucose tablets) with a repeat blood glucose check in $15\,\text{min}$, used for awake patients able to swallow with blood glucose $< 70\,\text{mg/dL}$.

Pulseless Ventricular Tachycardia (VT)

A life-threatening, wide-complex cardiac rhythm without a perfusing pulse requiring immediate high-quality CPR and unsynchronized high-energy defibrillation.

Opioid-Induced Respiratory Depression

A severe adverse reaction characterized by somnolence, shallow respirations ($< 8\text{--}10\,\text{breaths/min}$), and pinpoint pupils; managed by stopping opioid administration, supporting airway and oxygenation, and giving IV naloxone.

Epiglottitis

A rapid, life-threatening upper airway inflammation in pediatric patients presenting with high fever, severe sore throat, drooling, muffled voice, tripod positioning, and stridor; requires avoiding throat stimulation and securing the airway in a controlled setting.

Multimodal Analgesia

A pain management strategy combining non-opioid medications (e.g., scheduled acetaminophen and NSAIDs) and regional techniques to maximize analgesia while minimizing opioid dosage and risks.

NG Tube Placement Verification

Radiographic confirmation (chest/abdominal X-ray showing the tube tip in the stomach) recognized as the gold standard before initiating enteral tube feedings.

Hyperkalemia Membrane Stabilization

The immediate IV administration of calcium gluconate to stabilize the cardiac membrane in patients with severe hyperkalemia ($> 6.5\,\text{mEq/L}$) presenting with ECG changes such as peaked T waves.

Symptomatic Hyponatremia Treatment

Prompt IV infusion of hypertonic saline ($3\%\,\text{NaCl}$) per protocol to raise serum sodium levels and reduce cerebral edema in patients presenting with severe hyponatremia ($< 120\,\text{mEq/L}$) and neurological impairment or seizures.

Cushing's Triad

A clinical triad consisting of worsening level of consciousness, bradycardia, and widening pulse pressure indicating dangerously elevated intracranial pressure (ICP); initially managed by elevating the head of the bed to $30^\circ$ with neutral midline positioning.

Hyperosmolar Hyperglycemic State (HHS)

A metabolic emergency in type 2 diabetes marked by extreme hyperglycemia ($> 600\,\text{mg/dL}$), high serum osmolality, severe dehydration, and minimal or absent ketoacidosis; initial fluid resuscitation requires isotonic crystalloids ($0.9\%\,\text{NaCl}$).

DKA Potassium Threshold for Insulin

The clinical safety requirement that serum potassium must be corrected to $> 3.3\,\text{mEq/L}$ prior to starting IV insulin infusion to avoid fatal hypokalemia and cardiac arrest.

Refeeding Syndrome

A potentially fatal metabolic condition caused by refeeding severely malnourished patients, marked by profound hypophosphatemia, hypokalemia, fluid overload, and cardiac arrhythmias; managed by reducing caloric intake and correcting electrolytes.

Tension Pneumothorax

A life-threatening chest emergency causing severe dyspnea, absent breath sounds on the affected side, tracheal deviation to the uninjured side, hypotension, and jugular venous distention; managed with emergent needle decompression.

Stage II Pressure Injury

Partial-thickness loss of skin with exposed dermis, presenting as a shallow open ulcer with a viable red-pink wound bed or an intact or ruptured serum-filled blister, free of slough and eschar.

Noninvasive Positive-Pressure Ventilation (BiPAP)

An intervention for acute hypercapnic respiratory failure in COPD patients designed to increase alveolar ventilation, reduce $\text{PaCO}_2$, and reduce the rate of endotracheal intubation.

Prealbumin (Transthyretin)

A protein marker with a short half-life ($\approx 2\,\text{days}$) that serves as the most sensitive laboratory index for evaluating acute or short-term changes in visceral protein nutritional status.

Calcium Alginate Dressing

A highly absorptive wound dressing derived from brown seaweed, suited for wounds with moderate-to-heavy seropurulent exudate and for packing deep wound cavities.

ARDS Lung-Protective Ventilation

A mechanical ventilation strategy utilizing low tidal volumes ($\le 6\,\text{mL/kg}$ predicted body weight) and positive end-expiratory pressure (PEEP) to lower ventilator-induced lung injury.

Target $\text{SpO}_2$ in COPD Chronic Hypercapnia

An arterial oxygen saturation target of $88\text{--}92\%$ using controlled oxygen delivery to maintain oxygenation without depressing the hypoxic respiratory drive and causing extreme $\text{PaCO}_2$ elevation.

Venturi Mask

An oxygen delivery device that supplies a predictable, fixed fraction of inspired oxygen ($\text{FiO}_2$) by entraining ambient air with a regulated oxygen flow.

Septic Shock Fluid Resuscitation

The rapid administration of at least $30\,\text{mL/kg}$ of IV isotonic crystalloids within the first 3 hours to restore intravascular volume and tissue perfusion in septic shock.

Norepinephrine

The primary first-line vasopressor indicated in septic shock to increase mean arterial pressure (MAP) to a goal of $\ge 65\,\text{mm Hg}$.

CLABSI Prevention Insertion Bundle

An evidence-based infection prevention bundle requiring maximal sterile barrier precautions (cap, mask, sterile gown, gloves, full body drape) and chlorhexidine skin antisepsis during central line placement.

Clostridioides difficile Isolation Precautions

Transmission-based Contact Precautions (gown and gloves) requiring mechanical handwashing with soap and water after care because alcohol-based rubs fail to destroy spores.

Hypokalemia ECG Changes

Characteristic electrocardiographic findings including flattened T waves, ST-segment depression, and prominent U waves caused by serum potassium levels $< 3.5\,\text{mEq/L}$.

Proliferative Phase of Wound Healing

The second phase of wound healing (occurring roughly days $3\text{--}21$) characterized by granulation tissue formation, angiogenesis, collagen synthesis, and re-epithelialization.

Duty to Warn and Protect

A legal exception to healthcare confidentiality requiring providers to notify clinical leadership, law enforcement, and the intended target when a patient discloses an explicit, violent threat toward an identifiable individual.

Hemophilia A

An X-linked recessive bleeding disorder resulting from factor VIII deficiency, characterized by spontaneous hemarthroses, normal platelet count, normal PT/INR, and a prolonged PTT.

APGAR Score

A clinical evaluation performed at 1 and 5 minutes after birth assessing Appearance, Pulse, Grimace, Activity, and Respiration, each scored 0 to 2 (total range $0\text{--}10$) to guide immediate neonatal stabilization.

Acute Coronary Syndrome (ACS) Initial Intervention

The prompt administration of chewable aspirin ($162\text{--}325\,\text{mg}$) in non-contraindicated patients presenting with acute chest pain to inhibit platelet aggregation and reduce mortality.