Iran Nursing Competency Exam key terms

A five-step clinical reasoning cycle of assessment, diagnosis, planning, implementation, and evaluation that structures every nursing encounter. Each step depends on documented data from the previous one, and evaluation loops back to reassessment when goals are not met.

A clinical judgment about a patient's actual or potential response to health problems, stated in a standardized format of problem, etiology, and defining characteristics. It describes responses nurses are licensed to treat independently, unlike a medical diagnosis.

Systematic reading of temperature, pulse, respiration, blood pressure, and oxygen saturation against age-specific normal ranges. Trends and combinations matter more than single readings; for example, rising pulse with falling blood pressure suggests early shock.

Practices that keep a sterile field and sterile items free from microorganisms during invasive procedures such as catheter insertion or wound care. It includes hand hygiene, sterile gloves, sterile drapes, and avoiding contact with non-sterile surfaces.

Infection control measures applied to every patient regardless of diagnosis: hand hygiene, gloves, gown, mask and eye protection based on anticipated exposure, safe sharps handling, and safe waste disposal. They replace the older category of universal precautions.

Additional isolation measures used with standard precautions for contact, droplet, or airborne spread. Choice depends on the pathogen's route; for example, pulmonary tuberculosis requires airborne precautions with a fit-tested N95 respirator and negative-pressure room.

The immediate sequence after a sharps exposure: wash the site with soap and water without squeezing, report at once, and obtain source and exposed-person testing for HIV, hepatitis B, and hepatitis C. Post-exposure prophylaxis and follow-up timing depend on the source status.

Short-course medication or immunization given after occupational or other exposure to prevent infection from taking hold, such as antiretroviral therapy after HIV exposure or hepatitis B immunoglobulin and vaccine. Timing is urgent and usually starts within hours.

The checks performed before every dose: right patient, drug, dose, route, time, and documentation, with some settings adding reason and refusal. Two independent identifiers and accurate calculation prevent most administration errors.

A drug that carries a heightened risk of serious harm when used incorrectly, such as insulin, heparin, opioids, concentrated electrolytes, and chemotherapy. These require independent double checks, standardized concentrations, and clear labeling.

A formal comparison of a patient's complete current medication list with new orders at admission, transfer, and discharge to find omissions, duplications, and interactions. It is a core patient-safety practice during care transitions.

A numerical score combining vital signs and level of consciousness that flags clinical deterioration before cardiac arrest. Escalation thresholds trigger a defined response, often a rapid response team review.

A multidisciplinary team that arrives at the bedside when a ward patient meets deterioration criteria, bringing critical care expertise to prevent cardiac arrest and unplanned intensive care admission. Activation is encouraged without fear of reprimand.

The sequence of actions that improves survival after cardiac arrest: early recognition and call for help, early high-quality cardiopulmonary resuscitation, early defibrillation, advanced life support, and post-resuscitation care. Each link must be strong for the next to help.

Chest compressions at 100 to 120 per minute, at least 5 cm deep in adults, with full recoil, minimal interruptions, and a compression-to-ventilation ratio of 30:2 for one rescuer. Rescuer rotation every two minutes limits fatigue.

Delivery of an unsynchronized electrical shock to terminate ventricular fibrillation or pulseless ventricular tachycardia. It is most effective when applied early, and compressions resume immediately afterward for two minutes before rhythm recheck.

Heart rate divided by systolic blood pressure, normally about 0.5 to 0.7. A value of 0.9 or higher suggests occult hypoperfusion and can rise before blood pressure falls in bleeding or sepsis.

Sorting patients by urgency so that limited resources reach those who need them first. Categories range from immediate resuscitation to non-urgent, and reassessment is required because a patient's condition can change while waiting.

An event in which patient numbers or injury severity overwhelm usual resources, requiring a shift from individual care to greatest good for the greatest number. Field triage tags guide transport priority rather than first-come order.

Rapid identification of suspected infection plus new organ dysfunction using tools such as the sequential organ failure assessment score. Early recognition, cultures, antibiotics, and fluid resuscitation within the first hour improve survival.

Regulation of body water and solutes so that intake and output match, assessed through daily weights, intake and output records, laboratory values, and signs such as edema or thirst. Imbalances can cause arrhythmias, confusion, and seizures.

Care across the preoperative, intraoperative, and postoperative phases, including consent verification, site marking, positioning, temperature management, and postoperative airway and wound monitoring. The surgical safety checklist coordinates the team at each phase.

A structured verbal confirmation by the surgical team at three points: before induction, before incision, and before the patient leaves the operating room. It verifies identity, procedure, site, allergies, antibiotics, and instrument and sponge counts.

Infection occurring within 30 days of surgery, or up to a year if an implant is placed, at or near the incision. Prevention includes appropriate antibiotic timing, glucose control, normothermia, and sterile technique.

New hypertension after 20 weeks of gestation with proteinuria or other organ dysfunction such as renal, hepatic, neurological, or hematological involvement. It can progress to eclampsia, so blood pressure, reflexes, and headache or visual symptoms are monitored closely.

Drug given to prevent or treat seizures in preeclampsia and eclampsia. Nurses monitor deep tendon reflexes, respiratory rate, and urine output, and keep calcium gluconate ready as the antidote for toxicity.

A severe variant of preeclampsia marked by hemolysis, elevated liver enzymes, and low platelets. Symptoms include right upper quadrant pain, nausea, and malaise, and it can appear with only mildly elevated blood pressure.

Blood loss of 500 mL or more after vaginal birth or 1000 mL or more after cesarean birth, or any loss causing hemodynamic instability. Uterine atony is the most common cause, so uterine massage and uterotonics are first-line actions.

Continuous or intermittent assessment of fetal heart rate and uterine contractions to detect hypoxia. Interpretation uses baseline rate, variability, accelerations, and decelerations, and category classification guides whether to continue, intervene, or expedite birth.

A stepwise response at birth: warm, dry, stimulate, and clear the airway if needed, then assess breathing and heart rate. Positive pressure ventilation begins if the baby is apneic or the heart rate is low, and compressions follow if it stays very low.

A rapid assessment at one and five minutes after birth scoring appearance, pulse, grimace, activity, and respiration from 0 to 2 each. It summarizes newborn condition and response to resuscitation but does not predict long-term outcome alone.

Calculation of drug doses and fluid volumes per kilogram of body weight because children's pharmacokinetics differ from adults. Doses are checked against maximum adult limits, and weight is measured in kilograms to avoid conversion errors.

Estimation of fluid deficit from weight change, mucous membranes, tears, skin turgor, capillary refill, and mental status. Oral rehydration is preferred in mild to moderate cases, while severe dehydration requires intravenous fluids and close monitoring.

Purposeful use of verbal and nonverbal techniques such as open questions, reflection, silence, and clarification to build trust and help patients express concerns. It avoids false reassurance, advice-giving, and changing the subject.

Structured inquiry about thoughts, plans, means, intent, prior attempts, and protective factors to estimate immediate danger and guide level of observation. Direct questions do not increase risk, and means restriction is a key intervention.

Detention for psychiatric assessment or treatment without the patient's consent, permitted only when criteria such as danger to self or others or grave disability are met and legally reviewed. The patient retains rights to information, representation, and appeal.

A patient's voluntary agreement to a procedure after receiving and understanding information about its nature, risks, benefits, and alternatives, given by a person with capacity. The nurse verifies and witnesses consent but does not obtain it in place of the provider.

The legal and ethical duty to protect health information from unauthorized disclosure, sharing it only with those involved in care or as permitted by law. Breaches may be justified for mandatory reporting or serious public health risk.

A legal obligation to notify authorities of defined events such as suspected child or elder abuse, certain communicable diseases, or serious incidents. Nurses report in good faith and are protected when following statutory requirements.

Negligence is failure to meet a reasonable standard of care, and malpractice is professional negligence in a care relationship. Proof usually requires duty, breach, causation, and damages, judged against what a prudent nurse would do.

Rules for a legally sound record: accurate, timely, objective, complete, and attributable entries, with corrections made by dated addendum rather than alteration. The record is the main evidence of the care actually given.

A structured progress note recording subjective data, objective findings, assessment, and plan. It supports continuity between clinicians and makes clinical reasoning visible in the record.

Documentation of an adverse event or near miss through a designated system separate from the clinical record. The purpose is system learning and prevention, not punishment, and reporting is generally protected.

A structured team review after a serious safety event that traces contributing factors in systems, processes, and environment rather than blaming an individual. Findings lead to action plans with owners and deadlines.

A small-scale improvement method in which a change is planned, tested, studied for results, and then adopted, adapted, or abandoned. Repeated cycles build evidence before wide implementation.

A measurable marker of care structure, process, or outcome used to compare performance over time or between units, such as catheter-related infection rate or fall rate per 1000 patient days. Indicators guide improvement priorities.

A bundle of measures for patients at risk: risk screening on admission, bed in low position with brakes locked, call light within reach, non-slip footwear, adequate lighting, and assisted toileting. Sedation review reduces risk further.

Physical or chemical limitation of movement used only when less restrictive measures fail and there is imminent danger. It requires a provider order, time limits, monitoring of circulation, breathing, and hydration, and frequent reassessment.

Repositioning, support surfaces, skin inspection, moisture management, and nutrition to avoid localized tissue damage from pressure and shear. Staging describes depth of tissue loss and guides treatment.

Transferring authority to perform a specific task to a competent person while the nurse retains accountability for the decision and outcome. The five rights of delegation are task, circumstance, person, direction, and supervision.

The legally defined activities a nurse may perform at a given license level, set by law, regulation, and employer policy. Acting outside it creates risk even when the nurse feels competent.

The defined line of authority a nurse follows to escalate a concern when a patient is at risk or a decision cannot be resolved at the bedside. Clear escalation protects patients and staff.

Acting to protect a patient's rights, preferences, and safety, including speaking up when care seems wrong and supporting informed choices. It may require escalation within or beyond the organization.

First-contact, continuous, comprehensive, and community-based care that addresses most health needs and coordinates referral to specialist services. It emphasizes prevention, health promotion, and equity.

Actions that enable people to increase control over and improve their health, going beyond disease prevention to address living and working conditions. Approaches include education, policy, and supportive environments.

Ongoing systematic collection, analysis, and interpretation of health data, with timely dissemination for action. It detects outbreaks, tracks trends, and evaluates control programs.

A structured response to a disease cluster: confirm the diagnosis and existence of an outbreak, define and find cases, describe time, place, and person, form and test hypotheses, then implement control measures and communicate findings.

A written, individualized plan of nursing diagnoses, goals, interventions, and evaluation criteria that guides and communicates care across shifts. It is updated as the patient's condition changes.

Judging care by comparing observed patient status with measurable, time-bound goals set during planning. When goals are unmet, the plan is revised rather than simply restated.