NCLEX REVIEW SHORT NOTECARDS

3-point crutch gait

BAD LEG FREE = affected leg bears NO weight; weight on crutches + good leg.

2-point crutch gait

TWO move together = opposite crutch + opposite foot together.

4-point crutch gait

FOUR take turns = one crutch/foot at a time; most stable.

Crutch weight

HANDS, NOT PITS. Weight goes through hand grips, never axillae.

Walker sequence

WALKER → WEIGHT → FOOT → FOOT.

New admission priority

ASSESS FIRST unless there is an obvious emergency.

Emergency assessment

ABCDE = Airway, Breathing, Circulation, Disability, Exposure.

Obvious life-threatening problem

ACT. Don't keep assessing something you already know is killing the client.

Evaluate Outcomes questions

Ask: "WHAT WOULD BETTER LOOK LIKE?" Pick improvement, not another nursing action.

Informed consent: provider

Provider EXPLAINS risks, benefits, alternatives, procedure.

Informed consent: nurse

Nurse WITNESSES signature + verifies understanding/voluntary consent.

Assault vs battery

Assault = THREAT. Battery = TOUCH/treatment without consent.

Client refuses procedure after consenting

STOP. A competent client can withdraw consent.

Delegation: RN

RN = ASSESS, TEACH, EVALUATE, unstable clients, nursing judgment.

Delegation: LPN

LPN = stable/predictable clients + routine care within scope.

Delegation: UAP

UAP = ADLs, hygiene, ambulation, I&O, routine tasks on stable clients.

Priority clients

UNSTABLE > stable; ACUTE > chronic; UNEXPECTED > expected; NEW change > baseline.

Airborne precautions

N95 + NEGATIVE pressure.

Droplet precautions

Surgical mask.

Contact precautions

Gown + gloves.

Protective environment

POSITIVE pressure.

Blood-contaminated surface

BLOOD → DISINFECT.

Female Foley sequence

Peri-care → sterile setup → drape → separate labia → cleanse → lube → insert → URINE → advance 2 more inches.

Ileal conduit stoma

PINK/RED + MOIST = good.

Ileal conduit urine

MUCUS = EXPECTED because conduit is intestine.

Ileal conduit memory

PINK → PEE → SKIN.

Cataract postop

Prevent ↑ IOP = avoid straining/pressure.

PCA pump

ONLY THE CLIENT PRESSES THE BUTTON.

MMR contraindications

LIVE vaccine = NO pregnancy + NO severe immunosuppression.

Osteoarthritis supplement

GLUCOSAMINE + CHONDROITIN.

Low magnesium

LOW Mg = HIGH activity → hyperreflexia, tremors, tetany, seizures.

High magnesium

Think SLOW/DOWN → ↓ reflexes, weakness, hypotension, bradycardia/respiratory depression.

Addisonian crisis

LOW BP + LOW glucose + HIGH K. "Everything low except K."

Addison treatment working

BP ↑, glucose ↑, K ↓ toward normal.

Pancreatitis priority

PANCREAS MAD? DON'T FEED IT → NPO/rest pancreas.

Pancreatitis pain position

Lean forward or fetal position.

Cholecystitis

GREASE = GRIEF → fatty food → RUQ pain → right shoulder.

Mono

TIRED + THROAT + NODES + BIG SPLEEN.

Neutropenia

NO GERMS. FEVER = REPORT IT.

Ondansetron

WATCH QT → prolonged QT/Torsades risk.

Prochlorperazine

EPS/face-neck spasms → diphenhydramine or benztropine.

Antiemetic worked

Nausea/vomiting DECREASED or absent.

Platelet transfusion worked

BLEEDING DECREASES.

Opioid overdose

EVERYTHING DOWN → ↓ LOC, ↓ respirations, pinpoint pupils.

Opioid withdrawal

EVERYTHING UP → sweating, runny nose, diarrhea, aches, dilated pupils.

Mydriasis

BIG/dilated pupils.

Miosis

MINI pupils = constricted.

Schizophrenia positive symptoms

POSITIVE = ADDED → hallucinations, delusions, bizarre behavior/speech.

Schizophrenia negative symptoms

NEGATIVE = MISSING → affect, speech, energy, pleasure, motivation.

Command hallucination

SAFETY FIRST. Ask what the voices are telling the client to do.

Projection

MY feelings → put them on YOU.

Displacement

Feelings → SAFER TARGET.

Rationalization

Make an EXCUSE.

Reaction formation

Act OPPOSITE of true feelings.

Regression

GO BACKWARD developmentally.

Repression

UNCONSCIOUS blocking.

Suppression

CONSCIOUSLY choosing not to think about it.

Mania priority

SAFETY + SLEEP + FLUIDS + NUTRITION.

Anorexia

UNDERWEIGHT + lanugo + bradycardia.

Bulimia

Weight may be NORMAL + Russell sign + dental erosion.

Purging

POTASSIUM LEAVES → hypokalemia → dysrhythmia risk.

Eating disorder priority

BODY BEFORE BODY IMAGE → cardiac/electrolyte instability first.

Refeeding syndrome

STARVED BODY + FOOD TOO FAST = DANGER → slow/controlled feeding + monitor electrolytes.

Enteral feeding: when to hold

Aspiration/intolerance concern → STOP/HOLD and reassess per protocol.

Pediatric diarrhea priority

DIARRHEA → DEHYDRATION → REHYDRATE → WATCH RESPONSE.

Child mild/moderate dehydration

Can drink? ORS FIRST.

Child severe dehydration

Can't drink/severe? IV isotonic fluids.

Pediatric diarrhea fluids

ORS, NOT juice/soda/broth.

Pediatric dehydration improving

MORE PEE + better cap refill + moist mucosa/tears + stable HR.

Severe pediatric dehydration

NO PEE + POOR PERFUSION = BAD.

E. coli diarrhea

Bloody diarrhea + HUS risk; ATI guide says avoid antibiotics + antimotility meds.

End-of-life dyspnea

MORPHINE can relieve AIR HUNGER. Comfort > cure.

Approaching death

SYSTEMS SLOW DOWN → ↓ LOC, ↓ BP, ↓ urine, apnea/Cheyne-Stokes, cool/mottled skin.

Rheumatic fever

STREP → HEART + JOINTS + RASH + CHOREA.

Diaper candidiasis

CANDIDA LOVES MOISTURE → keep dry + topical antifungal.

Cystic fibrosis inheritance

AUTOSOMAL RECESSIVE.

Cystic fibrosis skin

SALTY skin/sweat.

Cystic fibrosis + pancreas

Pancreatic insufficiency → ↑ risk for diabetes.

Cystic fibrosis female fertility

Thick cervical mucus can cause fertility difficulty.

Cystic fibrosis cure?

NO cure; treatment manages symptoms/complications.

Placenta previa

PAINLESS bright-red bleeding = PREVIA. NO vaginal exam.

Placental abruption

PAINFUL bleeding + tender/rigid abdomen.

Preeclampsia severe warning signs

Severe headache + vision changes + RUQ/epigastric pain + severe BP.

Magnesium sulfate toxicity

↓ DTRs + respiratory depression + ↓ LOC.

Magnesium sulfate antidote

CALCIUM GLUCONATE.

Early fetal decelerations

HEAD compression = usually expected.

Variable fetal decelerations

CORD compression.

Late fetal decelerations

PLACENTA problem = uteroplacental insufficiency.

Cord prolapse

GET PRESSURE OFF CORD → lift presenting part + emergency response/delivery.

Postpartum hemorrhage + boggy uterus

MASSAGE FUNDUS FIRST.

Oxytocin + tachysystole/fetal intolerance

STOP oxytocin.

Newborn hypoglycemia

Think jittery/tremors, poor feeding, lethargy; check glucose.

DKA + insulin

Insulin pushes K INTO cells → watch for HYPOKALEMIA.

Hyperkalemia ECG

Think TALL/PEAKED T waves.

Hypokalemia

Weakness + dysrhythmias; think potassium is TOO LOW to power muscles/heart normally.

Hypocalcemia

TWITCHY → tetany + Chvostek + Trousseau.

Hypercalcemia

SLUGGISH → weakness, constipation, decreased reflexes.

Visible massive bleeding

DIRECT PRESSURE first.

Fall risk + diuretics

ORTHOSTATIC hypotension + URINARY URGENCY = fall risk.

TB precautions

AIRBORNE → negative-pressure room + N95.