NCK Licensure Exam flashcards

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

Pulse deficit

The difference between the apical and radial pulse rates, counted simultaneously for one full minute. A deficit suggests some heartbeats do not generate a palpable peripheral pulse, as in atrial fibrillation.

Braden Scale threshold

A pressure injury risk tool scoring 6 to 23, where lower scores indicate higher risk. A score of 18 or below prompts preventive interventions such as repositioning and pressure-redistribution surfaces.

Naegele rule

Method estimating the delivery date from the first day of the last menstrual period: add 7 days, subtract 3 months, and add 1 year. It assumes a 28-day cycle and ovulation near day 14.

Apgar score components

Five components scored 0 to 2 each at 1 and 5 minutes: heart rate, respiratory effort, muscle tone, reflex irritability, and color. A total of 7 to 10 is generally reassuring.

Magnesium sulfate toxicity antidote

Calcium gluconate. Toxicity signs include loss of deep tendon reflexes, respiratory rate below 12 per minute, and oliguria; the drug is used for preeclampsia seizure prophylaxis and fetal neuroprotection.

Holliday-Segar maintenance fluids

Pediatric hourly fluid calculation: 100 mL/kg per day for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram above 20. Divide the total by 24 for hourly rate.

FLACC pain scale

Behavioral pain scale for infants and young children scoring face, legs, activity, cry, and consolability from 0 to 2 each. A total of 4 or more suggests moderate to severe pain.

Kawasaki disease treatment

High-dose intravenous immunoglobulin plus aspirin prevents coronary artery aneurysm, the major complication. Diagnostic criteria include fever over 5 days with conjunctivitis, mucosal, rash, extremity, and lymph node changes.

Serotonin syndrome

A toxic reaction to serotonergic drugs marked by mental status change, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia. Stop the offending agents and give supportive care.

Neuroleptic malignant syndrome

A life-threatening reaction to antipsychotics with rigidity, hyperthermia, altered mental status, and elevated creatine kinase. Stop the drug and treat with dantrolene or bromocriptine plus supportive cooling.

Lithium therapeutic range

Serum lithium levels of 0.6 to 1.2 mEq/L for maintenance therapy. Toxicity causes tremor, vomiting, ataxia, and confusion; dehydration and NSAIDs raise levels by reducing renal clearance.

Delirium tremens timing

Alcohol withdrawal delirium typically appears 48 to 96 hours after the last drink, with tremor, seizures earlier at 12 to 24 hours. Benzodiazepines and thiamine are first-line treatment.

Incidence versus prevalence

Incidence counts new cases during a period divided by the population at risk. Prevalence counts all existing cases at a point or over a period, so it rises with longer disease duration.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission, calculated as 1 minus 1 divided by the basic reproduction number. Measles requires roughly 92 to 95 percent coverage.

Sensitivity and specificity

Sensitivity is the proportion of true cases correctly identified as positive. Specificity is the proportion of non-cases correctly identified as negative. Positive predictive value also depends on disease prevalence.

Five rights of delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. Nursing judgment and initial patient assessment cannot be delegated to unlicensed assistive personnel.

Just culture

A safety framework that consoles human error, coaches at-risk behavior, and sanctions reckless behavior. It encourages nonpunitive reporting of errors and near misses to improve system safety.

Informed consent elements

Capacity, disclosure of risks, benefits, and alternatives, voluntariness, and comprehension. The provider performing the procedure obtains consent; the nurse witnesses and clarifies but does not obtain it.

Digoxin therapeutic level

Serum digoxin levels of 0.5 to 2 ng/mL. Hold the dose for an adult apical pulse below 60 per minute, and watch for nausea, anorexia, visual halos, and bradycardia indicating toxicity.

Warfarin reversal agent

Vitamin K reverses warfarin anticoagulation, with fresh frozen plasma or prothrombin complex concentrate for severe bleeding. Therapy is monitored by INR, targeting 2 to 3 for most indications.

Heparin monitoring and antidote

Heparin is monitored by activated partial thromboplastin time, usually kept at 1.5 to 2.5 times control. Protamine sulfate is the antidote and also partially reverses low-molecular-weight heparin.

Opioid overdose triad

Pinpoint pupils, respiratory depression, and unconsciousness. Naloxone reverses opioid effects but has a shorter half-life than many opioids, so repeat dosing and monitoring may be required.

Insulin onset times

Lispro and aspart act in 10 to 15 minutes, regular insulin in 30 to 60 minutes, NPH in 1 to 2 hours, and glargine in 1 to 2 hours with no peak. Timing prevents hypoglycemia.

Airborne precautions requirements

A negative-pressure room with at least 6 to 12 air exchanges per hour and an N95 or higher respirator for staff. Used for tuberculosis, measles, and varicella, not for droplet-spread diseases.

Five moments of hand hygiene

Before patient contact, before an aseptic procedure, after body fluid exposure risk, after patient contact, and after touching patient surroundings. Alcohol rub is preferred except for C. difficile and norovirus.

Needlestick postexposure steps

Wash the site with soap and water, report immediately, and begin HIV postexposure prophylaxis within hours; it is most effective within 2 hours. Baseline testing includes HIV, hepatitis B, and hepatitis C.

ST-elevation MI reperfusion target

Reperfusion within 90 minutes of first medical contact when percutaneous coronary intervention is available. Aspirin, nitroglycerin, oxygen only if hypoxic, and anticoagulation are given concurrently.

Diabetic ketoacidosis potassium rule

Add potassium replacement once the serum level is below 5.2 mEq/L and urine output is adequate. Insulin drives potassium into cells, so untreated hypokalemia can cause fatal arrhythmia.

Stroke fibrinolytic window

Intravenous fibrinolytic therapy is given up to 4.5 hours from symptom onset after head CT excludes hemorrhage and glucose is checked. Blood pressure must be controlled below 185/110 mmHg.

Postpartum hemorrhage definition

Blood loss over 500 mL after vaginal birth or over 1000 mL after cesarean, or any loss causing hemodynamic instability. Uterine atony is the most common cause, treated with fundal massage and uterotonics.

Fetal heart rate baseline

A normal baseline is 110 to 160 beats per minute. Late decelerations suggest uteroplacental insufficiency and require left lateral positioning, oxygen, and stopping oxytocin if running.

Epiglottitis airway priority

Suspect with drooling, tripod positioning, muffled voice, and high fever. Avoid inspecting the throat, which can trigger complete airway obstruction, and keep the child calm until the airway is secured.