NCLEX Last-Minute Crash Course Review

Comprehensive practice vocabulary flashcards covering prioritization, delegation, safety, pharmacology, maternity, and med-surg for the NCLEX exam.

ABC Prioritization

The hierarchy of nursing needs addressing Airway first, then Breathing, and finally Circulation before any other concerns.

Psychosocial Needs

Needs that come last in prioritization; physical health conditions always take priority over mental health concerns.

Unstable Patients

Patients who require immediate attention, including those with new-onset symptoms (confusion, chest pain), acute conditions (stroke, sepsis), post-operative status within $24$ hours, hemorrhage, or altered level of consciousness.

E.A.T. (Mnemonic)

Tasks that a Registered Nurse (RN) must never delegate: Evaluate, Assess, and Teach.

LPN Scope of Practice

Includes caring for stable patients, administering oral, subcutaneous, and intramuscular medications (no IV push), reinforcing education, and performing routine procedures like wound care and catheter insertion.

UAP Scope of Practice

Includes non-complex tasks such as ADLs (bathing, feeding), ambulation, measuring stable vital signs, recording intake and output, and collecting specimens.

PPE Donning Order

The sequence for putting on equipment: 1. Gown, 2. Mask (or respirator), 3. Goggles/Face Shield, 4. Gloves (Mnemonic: "Googles Make Gowns Great").

PPE Doffing Order

The sequence for removing equipment: 1. Gloves, 2. Goggles/Face Shield, 3. Gown, 4. Mask (Mnemonic: Alphabetical Order).

Airborne Precautions

Required for Measles, Chickenpox (Varicella), Disseminated Shingles, and TB; needs a private negative pressure room and an N95 respirator (Mnemonic: "My Chicken Hez TB").

Droplet Precautions

Required for sepsis, flu, meningitis, and pneumonia; requires a surgical mask and maintaining a $3-6\,ft$ distance.

Contact Precautions

Required for MRSA, VRE, C. difficile, and RSV; requires gown and gloves for all interactions.

C. difficile Hygiene

Hand hygiene must be performed using soap and water; alcohol-based sanitizers do not kill the spores.

Digoxin Toxicity

Occurs at levels above $2.0\,ng/mL$; signs include vision changes (yellow-green halos), nausea, and bradycardia.

Lithium toxicity

Occurs at levels above $1.5\,mEq/L$; signs include extreme thirst, tremors, confusion, and excessive urination.

ABCD for Beta Blockers

A mnemonic for major side effects/risks: Asthma (bronchospasm), Bradycardia, CHF (worsening), and Diabetes (masks hypoglycemia signs).

ACE Inhibitors Black Box Warning

Risk of angioedema (swelling of face, lips, tongue), which is a medical emergency.

Naloxone

The antidote for Opioid overdose.

Vitamin K

The antidote for Warfarin overdose.

Protamine Sulfate

The antidote for Heparin toxicity.

Calcium Gluconate

The antidote for Magnesium Sulfate toxicity.

Basic Dosage Formula

$D / H \times Q = X$, where D is Desired dose, H is Have on hand, Q is Quantity, and X is amount to administer.

IV Drip Rate Formula

$(\text{Total Volume (mL)} \times \text{Drop Factor (gtt/mL)}) / \text{Total Time (min)} = \text{gtt/min}$.

Mean Arterial Pressure (MAP)

$\text{MAP} = (\text{SBP} + (2 \times \text{DBP})) / 3$.

Restraint Safety

Last resort option; requires provider order, must be tied to the bed frame (not side rails), and requires checks every $2$ hours (check skin/circulation every $15-30\,min$).

Crutch Fit

$2-3$ finger gap between crutch top and armpit with $30^{\circ}$ elbow flexion; weight is placed on hands to avoid axillary nerve damage.

Gait Stair Mnemonic

"Up with the Good, Down with the Bad" (Good leg leads going up; crutches and bad leg lead going down).

ROME Rule

ABG interpretation mnemonic: Respiratory Opposite (pH and $CO_2$ move in opposite directions), Metabolic Equal (pH and $HCO_3$ move in same direction).

Normal Potassium ($K^+$)

$3.5 - 5.0\,mEq/L$.

VEAL CHOP

FHR pattern mnemonic: Variable/Cord compression, Early/Head compression, Accelerations/Oxygenation, Late/Placental insufficiency.

Uterine Tachysystole

Contractions lasting $>90$ seconds or occurring less than $2$ minutes apart; requires immediate intervention.

Postpartum Hemorrhage (PPH)

Blood loss exceeding $500\,mL$ (vaginal) or $1,000\,mL$ (C-section); primary intervention is fundal massage.

Boggy Uterus

A soft, non-contracting uterus often shifted due to a full bladder; requires fundal massage and bladder emptying.

Left-Sided Heart Failure

Fails to pump to the body, causing pulmonary congestion; symptoms include crackles, dyspnea, and orthopnea.

Right-Sided Heart Failure

Fails to pump to the lungs, causing systemic congestion; symptoms include peripheral edema, JVD, and ascites.

FAST (Stroke recognition)

Face drooping, Arm weakness, Speech difficulty, and Time to call $911$.

tPA Timing

Must be administered within $3 - 4.5$ hours of symptom onset for ischemic strokes after ruling out hemorrhage via CT scan.

Diabetic Ketoacidosis (DKA)

Primarily Type 1 diabetes; characterized by BG $250-500+\,mg/dL$, Kussmaul breathing, fruity breath, and metabolic acidosis.

Hyperosmolar Hyperglycemic Syndrome (HHS)

Primarily Type 2 diabetes; characterized by BG $600+\,mg/dL$, severe dehydration, and altered mental status with NO ketones.

Non-Therapeutic Communication

Blocks expression; includes asking "Why?", giving false reassurance, minimizing feelings, or comparing experiences.

Hallucination Management

Acknowledge feelings, do not argue or validate the hallucination, and redirect the patient to reality-based activities.