BNMC Licensing Exam flashcards

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

Primary prevention

Interventions that prevent disease before it occurs, such as immunization, health education, and safe water. It targets susceptible populations and reduces incidence rather than detecting existing disease.

Incidence versus prevalence

Incidence is the number of new cases in a population over a period. Prevalence is all existing cases at a point in time. Prevalence depends on both incidence and duration of disease.

Naegele rule

Method to estimate delivery date by adding seven days to the first day of the last menstrual period, subtracting three months, and adding one year. Assumes a 28-day cycle.

Late decelerations

Fetal heart rate drops that begin after the uterine contraction peak and return after it ends. They suggest uteroplacental insufficiency and require repositioning, oxygen, and stopping oxytocin.

APGAR score

Assessment at one and five minutes after birth scoring appearance, pulse, grimace, activity, and respiration from zero to two each. Total of seven to ten is generally reassuring.

Postpartum hemorrhage definition

Blood loss greater than 500 mL after vaginal birth or 1000 mL after cesarean birth, or any loss causing hemodynamic instability. Uterine atony is the most common cause.

Magnesium sulfate toxicity signs

Loss of deep tendon reflexes, respiratory depression, and oliguria indicate magnesium toxicity. Calcium gluconate is the antidote. Monitor reflexes, respirations, and urine output during infusion.

Pressure injury staging

Stage one is non-blanchable erythema of intact skin. Stage two is partial-thickness skin loss. Stage three exposes subcutaneous fat. Stage four exposes fascia, muscle, or bone.

Maslow priority framework

Prioritization model placing physiologic needs first, then safety, belonging, esteem, and self-actualization. Airway, breathing, and circulation always take precedence in nursing care decisions.

Airborne precautions

Isolation used for tuberculosis, measles, and varicella. Requires a negative-pressure room and an N95 respirator. Standard precautions continue alongside transmission-based precautions.

Stages of wound healing

Hemostasis occurs within minutes to hours. Inflammation lasts one to five days. Proliferation lasts five days to three weeks. Maturation and remodeling continue for up to a year or more.

ST-elevation myocardial infarction

Acute coronary occlusion causing ST elevation. Requires reperfusion within ninety minutes of first medical contact. Give chewed aspirin unless contraindicated and monitor for arrhythmias.

Diabetic ketoacidosis management

Give isotonic saline first, then insulin infusion. Monitor potassium closely because insulin shifts potassium into cells, causing hypokalemia. Follow glucose, anion gap, and mental status.

Stroke thrombolytic window

Alteplase may be given up to four and a half hours after symptom onset. Blood pressure must be below 185/110 mmHg before administration. Assess for bleeding contraindications first.

Hepatic encephalopathy

Complication of cirrhosis causing confusion, asterixis, and altered consciousness from elevated ammonia. Treat with lactulose to promote ammonia excretion and restrict dietary protein only if indicated.

COPD oxygen target

Target oxygen saturation of 88 to 92 percent in patients at risk of carbon dioxide retention. Use controlled low-flow delivery such as a Venturi mask and monitor respiratory status.

Pediatric dehydration signs

Assess sunken fontanelle, dry mucous membranes, absent tears, poor skin turgor, and decreased urine output. Mild to moderate dehydration is treated with oral rehydration solution.

Kawasaki disease treatment

Give intravenous immunoglobulin and aspirin to reduce inflammation and prevent coronary artery aneurysms. Monitor cardiac status and watch for persistent fever requiring retreatment.

Epiglottitis warning signs

Drooling, tripod positioning, muffled voice, and high fever suggest epiglottitis. Do not inspect the throat without airway readiness because spasm can cause complete obstruction.

Infant fever red flag

Fever in an infant younger than three months requires immediate medical evaluation and full sepsis workup. Young infants have immature immunity and may show nonspecific signs of serious infection.

Therapeutic communication

Use open-ended questions, reflection, silence, and clarification to encourage expression. Avoid false reassurance, giving advice, and asking why questions that imply judgment.

Serotonin syndrome

Caused by excess serotonergic activity, producing mental status changes, autonomic instability, and neuromuscular hyperactivity. Stop the offending drugs and provide supportive care.

Neuroleptic malignant syndrome

Life-threatening reaction to antipsychotics causing rigidity, high fever, altered consciousness, and autonomic instability. Stop the drug and give dantrolene or bromocriptine.

Lithium toxicity

Signs include tremor, vomiting, ataxia, and confusion when levels exceed the therapeutic range of 0.6 to 1.2 mEq/L. Maintain sodium and fluid intake and monitor serum levels.

Six rights of medication

Verify right patient, drug, dose, route, time, and documentation. Use two patient identifiers. Follow facility policy for high-alert medications requiring independent double checks.

Warfarin and heparin antidotes

Vitamin K reverses warfarin, monitored by INR with a usual target of 2 to 3. Protamine sulfate reverses heparin, monitored by activated partial thromboplastin time.

Digoxin administration rule

Count the apical pulse for one full minute before giving digoxin. Hold the dose and notify the prescriber if the adult heart rate is below 60 beats per minute.

Insulin onset categories

Rapid-acting lispro and aspart begin in 10 to 15 minutes. Short-acting regular begins in 30 to 60 minutes. Intermediate NPH begins in one to two hours. Long-acting glargine has no peak.

Informed consent elements

Requires patient capacity, voluntariness, disclosure of risks and benefits, and alternatives. The physician obtains consent; the nurse witnesses and advocates for the patient.

Negligence four elements

To prove negligence, the plaintiff must show duty owed, breach of that duty, causation linking breach to injury, and actual damages. All four elements are required.

Delegation criteria

Delegate only stable patients with predictable outcomes to unlicensed assistive personnel. The nurse retains accountability for assessment, teaching, evaluation, and the overall nursing process.

Evidence hierarchy

Ranked from strongest to weakest: systematic reviews and meta-analyses, randomized controlled trials, cohort studies, case-control studies, case reports, and expert opinion.

Sensitivity and specificity

Sensitivity is true positives divided by true positives plus false negatives. Specificity is true negatives divided by true negatives plus false positives. Both describe test accuracy.

Validity versus reliability

Validity is whether an instrument measures what it claims to measure. Reliability is consistency of repeated measurement. A test can be reliable without being valid.