OBA NCLEX-RN (Part 1) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Five rights of delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. The RN retains accountability for client outcomes after delegating.

Airborne precautions

Used for tuberculosis, measles, and varicella. Requires an N95 or higher respirator, a negative-pressure room with the door closed, and client masking during transport.

Droplet precautions

Used for influenza, pertussis, and meningococcal disease. A surgical mask is worn within three feet of the client, and the client wears a mask when leaving the room.

C. difficile hand hygiene

C. difficile spores resist alcohol. Wash hands with soap and water, wear gown and gloves, and use dedicated equipment for clients with this infection.

RACE fire response

Rescue anyone in danger, Alarm by activating the fire system, Contain the fire by closing doors, and Extinguish or Evacuate. Class C extinguishers are used for electrical fires.

SBAR handoff

A structured communication tool: Situation, Background, Assessment, and Recommendation. State the current problem first, then supporting data, then what you want done.

Standard precautions

Infection control applied to every client regardless of diagnosis. Includes hand hygiene and gloves for blood or body fluids, with gowns, masks, and eye protection as splashing risk dictates.

High-alert medication double-check

Insulin, heparin, and opioids require an independent second nurse verification of dose and pump settings before administration, because errors carry severe harm potential.

Infant feeding rules

Breast milk or iron-fortified formula is the only source of nutrition until about six months. Whole cow's milk is not given before twelve months of age.

Infant weight milestones

Birth weight doubles by five to six months and triples by twelve months. Head circumference equals chest circumference around one to two years of age.

Folic acid in pregnancy

Four hundred micrograms of folic acid daily, started before conception, reduces the risk of neural tube defects such as spina bifida in the developing fetus.

Colorectal screening start

Average-risk adults begin colorectal cancer screening at age forty-five, using stool-based tests, colonoscopy, or other approved methods at guideline-specified intervals.

HPV vaccination schedule

Routine HPV vaccination is recommended at eleven to twelve years, with catch-up through age twenty-six. Two doses are given if started before age fifteen.

Five A's for cessation

Ask about tobacco use, Advise quitting, Assess willingness, Assist with a quit plan, and Arrange follow-up. This framework structures brief cessation counseling at every visit.

Bone density screening

Women aged sixty-five and older should have bone mineral density testing to detect osteoporosis, with earlier screening for those who have major risk factors.

Prenatal first visit labs

The initial prenatal panel includes blood type, Rh factor, antibody screen, rubella titer, hemoglobin, and screening for infections such as HIV and hepatitis B.

Therapeutic communication

Use open-ended questions, reflection, restatement, and silence. Avoid false reassurance, advice-giving, and asking why, because these block client expression and invite defensiveness.

Panic-level anxiety

Perception is narrowed and rational thought is lost. The nurse uses short, simple directions, stays with the client, and reduces environmental stimulation until the episode subsides.

Delirium versus dementia

Delirium has acute onset, fluctuating consciousness, and reversible causes such as infection or medication. Dementia is chronic, progressive, and occurs with clear consciousness.

Alcohol withdrawal

Manifestations include tremor, tachycardia, hypertension, and diaphoresis. Severe withdrawal causes seizures and delirium tremens, treated with benzodiazepines and thiamine replacement.

Suicide risk assessment

Ask directly about suicidal thoughts, plan, means, and intent. Direct questions do not increase risk. High-risk clients need line-of-sight observation and removal of harmful objects.

Refeeding syndrome

Rapid nutrition in a malnourished client can cause hypophosphatemia, hypokalemia, and cardiac dysrhythmia. Monitor electrolytes and advance calories slowly during rehabilitation.

Kubler-Ross grief stages

Denial, anger, bargaining, depression, and acceptance. The stages are not linear, may overlap, and a client may return to an earlier stage at any point.

Mandatory abuse reporting

Suspected abuse of children, older adults, or dependent adults must be reported to designated authorities per state law. The nurse documents objective findings and does not investigate.

Respiratory alkalosis

pH rises above 7.45 and PaCO2 falls below 35 mmHg, caused by hyperventilation. The kidneys compensate by excreting bicarbonate, lowering HCO3.

Metabolic acidosis

pH falls below 7.35 and HCO3 falls below 22 mEq/L, as in diabetic ketoacidosis or diarrhea. Rapid deep respirations (Kussmaul) develop as respiratory compensation.

Hyperkalemia treatment

Give IV calcium to protect the myocardium, insulin with glucose to shift potassium intracellularly, and kayexalate or dialysis to remove potassium. Monitor peaked T waves.

Hyponatremia correction rate

Sodium is corrected no faster than eight to ten mEq/L in twenty-four hours. Faster correction risks osmotic demyelination, causing confusion, seizures, and permanent neurologic damage.

Insulin onset times

Rapid-acting insulin (lispro) starts in about fifteen minutes, regular insulin in thirty minutes, and NPH in one to two hours. Mealtime insulin is timed to the onset.

Digoxin hold parameters

For an adult, hold digoxin and notify the provider when the apical pulse is below sixty beats per minute. Monitor for toxicity signs such as visual halos and nausea.

Postoperative atelectasis prevention

Encourage incentive spirometry every one to two hours, coughing, deep breathing, and early ambulation. These measures also reduce the risk of venous thromboembolism and pneumonia.

Alteplase window in stroke

IV alteplase may be given within three to four and one-half hours of symptom onset after ruling out hemorrhage. Monitor neurologic status and signs of bleeding afterward.