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Nursing Exam Cram Sheet for the NCLEX-RN
The final mountain that nursing students must summit before becoming a registered nurse is the NCLEX. Preparing for the NCLEX can be stressful as taking in colossal amounts of information has never been easy. This is where this cram sheet can help-- it contains condensed facts about the licensure exam and key nursing information. When exam time comes, you can write and transfer these vital information from your head to a blank sheet of paper provided by the testing center. ● Six hours —the maximum time allotted for the NCLEX is 6 hours. Take breaks if you need a time out or need to move around. ● 75/265 —the minimum number of questions you can answer is 75 and a maximum of 265. ● Read the question and answers carefully —do not jump into conclusions or make wild guesses. ● Look for keywords —Avoid answers with absolutes like always, never, all, every, only, must, except, none, or no. ● Don’t read into the question —Never assume anything that has not been specifically mentioned and don’t add extra meaning to the question. ● Eliminate answers that are clearly wrong or incorrect — to increase your probability of selecting the correct answer! ● Watch for grammatical inconsistencies —Subjects and verbs should agree. If the question is an incomplete sentence, the correct answer should complete the question in a grammatically correct manner. ● Remember ROME (respiratory opposite/metabolic equal) to remember that in respiratory acid/base disorders the pH is opposite to the other components. ● Use the Tic-Tac-Toe Method for interpreting ABGs. Read more about it here(http://bit.ly/abgtictactoe).
7. Chemistry Values ● Glucose : 70—110 mg/dL ● Specific Gravity : 1.010—1. ● BUN : 7-22 mg/dL ● Serum creatinine : 0.6—1.35 mg/dL ● LDH : 100-190 U/L ● Protein : 6.2—8.1 g/dL ● Albumin : 3.4—5.0 g/dL ● Bilirubin : <1.0 mg/dL ● Total Cholesterol : 130 —200 mg/dL ● Triglyceride : 40—50 mg/dL ● Uric acid : 3.5—7.5 mg/dL ● CPK : 21-232 U/L ● Rephrase the question —putting the question into your own words can pluck the unneeded info and reveal the core of the stem. ● Make an educated guess —if you can’t make the best answer for a question after carefully reading it, choose the answer with the most information. ● RBCs : 4.5—5.0 million ● WBCs : 5,000—10,0 00 ● Platelets : 200,000—400, ● Hemoglobin (Hgb): 12—16 gm (female); 14—18 gm (male). ● Hematocrit (Hct): 37—47 (female); 40 — 54 (male) ● Sodium : 135—145 mEq/L ● Potassium : 3.5—5.5 mEq/L ● Calcium : 8.5—10.9 mEq/L ● Chloride : 95—105 mEq/L ● Magnesium : 1.5—2.5 mEq/L ● Phosphorus : 2.5—4.5 mEq/L ● Heart rate : 80—100 bpm ● Respiratory rate : 12-20 rpm ● Blood pressure : 110-120/60 mmHg ● Temperature : 37 °C (98.6 °F) ● pH : 7.36—7. ● HCO3 : 24—26 mEq/L ● CO2 : 35—45 mEq/L ● PaO2 : 80%—100% ● SaO2 : >95% **3. Hematology values
- Serum electrolytes
- Acid-Base Balance
- Test Information
- Vital Signs
- ABG Values**
● Schedule I —no currently accepted medical use and for research use only (e.g., heroin, LSD, MDMA). ● Schedule II —drugs with high potential for abuse and requires written prescription (e.g., Ritalin, hydromorphone (Dilaudid), meperidine (Demerol), and fentanyl). ● Schedule III —requires new prescription after six months or five refills (e.g., codeine, testosterone, ketamine). ● Schedule IV —requires new prescription after six months (e.g., Darvon, Xanax, Soma, and Valium). ● Schedule V —dispensed as any other prescription or without prescription (e.g., cough preparations, Lomotil, Motofen).
13. Pregnancy Category of Drugs ● Category A—No risk in controlled human studies ● Category B—No risk in other studies. Examples: Amoxicillin, Cefotaxime. ● Carbamazepine (Tegretol): 4— 10 mcg/ml ● Digoxin (Lanoxin): 0.8—2.0 ng/ml ● Gentamycin (Garamycin): 5— mcg/ml (peak), <2.0 mcg/ml (valley) ● Lithium (Eskalith): 0.8—1.5 mEq/L ● Phenobarbital (Solfoton): 15— 40 mcg/mL ● Phenytoin (Dilantin): 10—20 mcg/dL ● Theophylline (Aminophylline): 10— 20 mcg/dL ● Tobramycin (Tobrex): 5— mcg/mL (peak), 0.5—2.0 mcg/mL (valley) ● Valproic Acid (Depakene): 50— 100 mcg/ml ● Vancomycin (Vancocin): 20— mcg/ml (peak), 5 to 15 mcg/ml (trough) ● Fetal Heart Rate : 120—160 bpm ● Variability : 6—10 bpm ● Amniotic fluid : 500—1200 ml ● Contractions : 2—5 minutes apart with duration of < 90 seconds and intensity of <100 mmHg. ● APGAR Scoring : A ppearance, P ulses, G rimace, A ctivity, R eflex Irritability. Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, and 2 for strongly positive. Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low. ● AVA : The umbilical cord has two arteries and one vein. ● Category C—Risk not ruled out. Examples: Rifampicin (Rifampin), Theophylline (Theolair). ● Category D—Positive evidence of risk. Examples: Phenytoin, Tetracycline. ● Category X—Contraindicated in Pregnancy. Examples: Isotretinoin (Accutane), Thalidomide (Immunoprin), etc. ● Pregnancy Category N—Not yet classified ● Sodium warfarin (Coumadin) PT: 10— 12 seconds (control). The antidote is Vitamin K. ● INR (Coumadin): 0.9—1. ● Heparin PTT: 30—45 seconds (control). The antidote is protamine sulfate. ● APTT: 23.3—31.9 seconds ● Fibrinogen level: 203—377 mg/dL ● 1 gram (g) = 1,000 mg ● 1 kilogram (kg) = 2.2 lbs ● 1 lb = 16 oz ● Convert C to F: C+40 multiply by 9/ and subtract 4 0 ● Convert F to C: F+40 multiply by 5/ and subtract 4 0 ● 1 teaspoon (t) = 5 ml ● 1 tablespoon (T) = 3 t = 15 ml ● 1 oz = 30 ml ● 1 cup = 8 oz ● 1 quart = 2 pints ● 1 pint = 2 cups ● 1 grain (gr) = 60 mg ● Stop infusion of Pitocin. ● Turn the client on her left side. ● Administer oxygen. ● If hypovolemia is present, push IV fluids. ● Antacids —reduces hydrochloric acid in the stomach. ● Antianemics —increases blood cell production. 12. STOP—Treatment for maternal hypotension **after an epidural anesthesia:
- Anticoagulant therapy
- Maternity Normal Values
- Therapeutic Drug Levels
- Medication Classifications
- Drug Schedules
- Conversions**
want to prepare the body by washing and wrapping the body in unsewn white cloth; postmortem examinations are discouraged unless required by law. May avoid pork and alcohol if Muslim. Islamic patients observe month long fast of Ramadan (begins approximately mid-October); people suffering from chronic illnesses, pregnant women, breast-feeding, or menstruating don’t fast. Females avoid eye contact with males; use same-sex family members as interpreters. ● Asian Americans —May value ability to endure pain and grief with silent stoicism; typically family oriented; extended family should be involved in care of dying patient; believes in “hot- cold” yin/yang often involved; sodium intake is generally high because of salted and dried foods; may believe prolonged eye contact is rude and an invasion of privacy; may not without necessarily understanding; may prefer to maintain a comfortable physical distance between the patient and the health care provider. ● Latino Americans —May view illness as a sign of weakness, punishment for evil doing; may consult with a curandero or voodoo priest; family members are typically involved in all aspects of decision making such as terminal illness; may see no reason to submit to mammograms or vaccinations. ● Native Americans —May turn to a medicine man to determine the true cause of an illness; may value the ability to endure pain or grief with silent stoicism; diet may be deficient in vitamin D and calcium because many suffer from lactose intolerance or don’t drink milk; obesity and diabetes are major health concerns; may divert eyes to the floor when they are praying or paying attention. ● Western Culture —May value technology almost exclusively in the struggle to conquer diseases; health is understood to be the absence, minimization, or control of disease process; eating utensils usually consists of knife, fork, and spoon; three daily meals is typical. ● Acute Renal Disease —protein-restricted, high-calorie, fluid-controlled, sodium and potassium controlled. ● Addison’s disease —increased sodium, low potassium diet. ● ADHD and Bipolar —high-calorie and provide finger foods. ● Burns —high protein, high caloric, increase in Vitamin C. ● Cancer —high-calorie, high-protein. ● Celiac Disease —gluten-free diet (no BROW: barley, rye, oat, and wheat). ● Chronic Renal Disease —protein- restricted, low-sodium, fluid-restricted, potassium-restricted, phosphorus- restricted. Cirrhosis (stable) —normal protein Cirrhosis with hepatic insufficiency — restrict protein, fluids, and sodium. Constipation —high-fiber, increased fluids COPD —soft, high-calorie, low- carbohydrate, high-fat, small frequent feedings Cystic Fibrosis —increase in fluids. Diarrhea — liquid, low- fiber, regular, fluid and electrolyte replacement Gallbladder diseases —low-fat, calorie- restricted, regular Gastritis —low-fiber, bland diet Hepatitis —regular, high-calorie, high- protein Hyperlipidemias —fat-controlled, calorie- restricted Hypertension, heart failure, CAD —low- sodium, calorie-restricted, fat-controlled Kidney Stones —increased fluid intake, calcium-controlled, low-oxalate Nephrotic Syndrome —sodium-restricted, high-calorie, high-protein, potassium- restricted. Obesity, overweight —calorie-restricted, high-fiver Pancreatitis —low-fat, regular, small frequent feedings; tube feeding or total parenteral nutrition. Peptic ulcer —bland diet Pernicious Anemia —increase Vitamin B12 (Cobalamin), found in high amounts on shellfish, beef liver, and fish. ● ● ●
20. Common Diets
● Air/Pulmonary embolism —turn patient to left side and lower HOB. ● Postural Drainage —Lung segment to be drained should be in the uppermost position to allow gravity to work. ● Post Lumbar puncture —patient should lieflat in supine to prevent headache and leaking of CSF. ● Continuous Bladder Irrigation (CBI) — catheter should be taped to thigh so legs should be kept straight. ● After myringotomy —position on the side of affected ear after surgery (allows drainage of secretion). ● Post cataract surgery —patient will sleep on unaffected side with a night shield for 1-4 weeks. ● Detached retina —area of detachment should be in the dependent position. ● Post thyroidectomy —low or semi- Fowlers, support head, neck and shoulders. ● Thoracentesis —sitting on the side of the bed and leaning over the table (during procedure); affected side up (after procedure). ● Spina Bifida — position infant on prone so that sac does not rupture. ● Buck’s Traction —elevate foot of bed for counter-traction. ● Post Total Hip Replacement —don’t sleep on operated side, don’tflex hip more than 45-60 degrees, don’t elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows. ● Prolapsed cord —knee-chest position or Trendelenburg. ● Cleft-lip —position on back or in infant seat to prevent trauma to the suture line. While feeding, hold in upright position. ● Cleft-palate —prone. ● Hemorrhoidectomy —assist to lateral position. ● Hiatal Hernia —upright position. ● Preventing Dumping Syndrome —eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low fiber diet, and small frequent meals). ● Enema Administration —position patient in left-side lying (Sim’s position) with knees flexed. ● Post supratentorial surgery (incision behind hairline) —elevate HOB 30-45 degrees. ● Post infratentorial surgery (incision at nape of neck) — position patient flat and lateral on either side. ● Increased ICP —high Fowler’s. ● Laminectomy —back as straight as possible; log roll to move and sandbag on sides. ● Spinal Cord Injury —immobilize on spine board, with head in neutral position. Immobilize head with padded C-collar, maintain traction and alignment of head ● Asthma — orthopneic position where patient is sitting up and bent forward with arms supported on a table or chair arms. ● Post Bronchoscopy —flat on bed with head hyperextended. ● Cerebral Aneurysm —high Fowler’s. ● Hemorrhagic Stroke : HOV elevated 30 degrees to reduce ICP and facilitate venous drainage. ● Ischemic Stroke : HOB flat. ● Cardiac Catheterization —keep site extended. ● Epistaxis —lean forward. ● Above Knee Amputation —elevate for first 24 hours on pillow, position on prone daily for hip extension. ● Below Knee Amputation —foot of bed elevated for first 24 hours, position prone daily for hip extension. ● Tube feeding for patients with decreased LOC —position patient on right side to promote emptying of the stomach with HOB elevated to prevent aspiration. ● Sickle Cell Anemia —increase fluids to maintain hydration since sickling increases when patients become dehydrated. ● Stroke —mechanical soft, regular, or tube-feeding. ● Underweight —high-calorie, high protein ● Vomiting —fluid and electrolyte replacement
21. Positioning Clients
● Deep vein thrombosis (DVT) —Homan’s Sign. ● Angina —crushing, stabbing pain relieved by NTG. ● Myocardial Infarction (MI) —crushing, stabbing pain radiating to left shoulder, neck, and arms. Unrelieved by NTG. ● Parkinson’s disease —pill-rolling tremors. ● Cytomegalovirus (CMV) infection —Owl’s eye appearance of cells (huge nucleus in cells). ● Glaucoma —tunnel vision. ● Retinal Detachment —flashes of light, shadow with curtain across vision. ● Basilar Skull Fracture —Raccoon eyes (periorbital ecchymosis) and Battle’s sign (mastoid ecchymosis). ● Buerger’s Disease —intermittent claudication (pain at buttocks or legs from poor circulation resulting in impaired walking). ● Diabetic Ketoacidosis —acetone breathe. ● Pregnancy Induced Hypertension (PIH) —proteinuria, hypertension, edema. ● Diabetes Mellitus — polydipsia, polyphagia, polyuria. ● Gastroesophageal Reflux Disease (GERD) —heart burn. ● Hirschsprung’s Disease (Toxic Megacolon)— ribbon- like stool. ● Sexual Transmitted Infections: ● Herpes Simplex Type II — painful vesicles on genitalia ● Genital Warts —warts 1-2 mm in diameter. ● Syphilis —painless chancres ● Chancroid —painful chancres. ● Gonorrhea —green, creamy discharges and painful urination. ● Chlamydia —milky discharge and painful urination. ● Candidiasis —white cheesy odorless vaginal discharges. ● Trichomoniasis —yellow, itchy, frothy, and foul-smelling vaginal discharges. ● Delegate sterile skills (e.g., dressing change) to the RN or LPN. ● Where non-skilled care is required, delegate the stable client to the nursing assistant. ● Assign the most critical client to the RN. ● Clients who are being discharged should have final assessments done by the RN. ● The Licensed Practical Nurse (LPN) can monitor clients with IV therapy, insert urinary catheters, feeding tubes, and apply restraints. ● Assessment, teaching, medication administration, evaluation, unstable patients cannot be delegated to an unlicensed assistive personnel. ● Weight is the best indicator of dehydration. ● When patient is in distress, administration of medication is rarely the best choice. ● Always check for allergies before administering antibiotics. ● Neutropenic patients should not receive vaccines, fresh fruits, or flowers. ● Nitroglycerine patch is administered up to three times with intervals of five minutes. ● Morphine is contraindicated in pancreatitis because it causes spasms of the Sphincter of Oddi. Demerol should be given. ● Never give potassium (K+) in IV push. ● Infants born to an HIV-positive mother should receive all immunizations of schedule. ● Gravida is the number of pregnancies a woman has had, regardless of outcome. ● Para is the number of pregnancies that reached viability, regardless of whether the fetus was delivered alive or stillborn. A fetus is considered viable at 20 weeks’ gestation. ● Lochia rubra is the vaginal discharge of almost pure blood that occurs during the first few days after childbirth. ● Lochia serosa is the serous vaginal discharge that occurs 4 to 7 days after childbirth. ● Lochia alba is the vaginal discharge of decreased blood and increased leukocytes that’s the final stage of lochia. It occurs 7 to 10 days after childbirth. ● In the event of fire, the acronym most often used is RACE. (R) Remove the patient. (A) Activate the alarm. (C) Attempt to contain the fire by closing
23. Miscellaneous Tips
bologna, Chianti wine, and beer may ● NCLEX-RN Practice Questions —Over cause severe hypertension in a patient 2,100 free sample questions who takes a monoamine oxidase (http://nurseslabs.com/nclex- practice- inhibitor. q u e s t i o n s / ) ● Projection is the unconscious assigning ● 20 NCLEX Tips and Strategies Every of a thought,feeling, or action to Nursing Students Should Know someone or something else. (http://nurseslabs.com/20-nclex-tips- ● Sublimation is the channeling of strategies-every-nursing-students- unacceptable impulses into socially k n o w / ) acceptable behavior. ● 12 Tips to Answer NCLEX Select All That ● Repression is an unconscious defense Apply (SATA) Questions mechanism whereby unacceptable or (http://nurseslabs.com/tips-answer- painful thoughts, impulses, memories, or select-apply-questions-nclex/) feelings are pushed from the ● 5 Principles in Answering Therapeutic consciousness or forgotten. Communication Questions —great tips ● People with obsessive-compulsive on how to answer TheraCom questions disorder realize that their behavior is (http://nurseslabs.com/5- principles- unreasonable, but are powerless to answering-therapeutic- communication- control it. q u e s t i o n s / ) ● A significant toxic risk associated with ● 11 Test Taking Tips & Strategies For clozapine (Clozaril) administration is Nurses (http://nurseslabs.com/11- test- blood dyscrasia. t a k i n g - t i p s - s t r a t e g i e s / ) ● Adverse effects of haloperidol (Haldol) ● Nursing Bullets —collection of bite- sized administration include drowsiness; nursing information, great for reviews! insomnia; weakness; headache; and (http://nurseslabs.com/tag/nursing- extrapyramidal symptoms, such as b u l l e t s - 2 / ) akathisia, tardivedyskinesia, and ● Kevin’s Ultimate Guide: 28 Free NCLEX dystonia. Resources (http://www.kevinsreview.com/nclexblo g / u l t i m a t e - g u i d e - 2 8 - f r e e - n c l e x - r e v i e w s - questions-and-resources/) ● NCLEX Daily —Facebook page that posts daily questions for NCLEX (https://www.facebook.com/nclexdaily) the door. (E) Extinguish the fire if it can be done safely. ● Before signing an informed consent form, the patient should know whether other treatment options are available and should understand what will occur during the preoperative, intraoperative, and postoperative phases; the risks involved; and the possible complications. The patient should also have a general idea of the time required from surgery to recovery. In addition, he should have an opportunity to ask questions. ● The first nursing intervention in a quadriplegic client who is experiencing autonomic dysreflexia is to elevate his head as high as possible. ● Usually, patients who have the same infection and are in strict isolation can share a room. ● Veracity is truth and is an essential component of a therapeutic relationship between a health care provider and his patient. ● Beneficence is the duty to do no harm and the duty to do good. There’s an obligation in patient care to do no harm and an equal obligation to assist the patient. ● Nonmaleficence is the duty to do no harm. ● Tyramine-rich food, such as aged cheese, chicken liver, avocados, bananas, meat tenderizer, salami, ● Hypervigilance and déjà vu are signs of posttraumatic stress disorder (PTSD).
24. NCLEX Online Resources ● NCLEX-RN Official Website (https://www.ncsbn.org/nclex.htm) ● Registration for the NCLEX (https://portal.ncsbn.org/)
