NCK Licensure Exam key terms

A rapid, ordered first assessment of an unstable or trauma patient: Airway, Breathing, Circulation, Disability (neurologic status), and Exposure with temperature control. Life-threatening problems found in an earlier step are corrected before moving to the next.

The process of sorting patients by urgency so that limited staff and resources go first to those who will benefit most. Categories range from immediate resuscitation to non-urgent, and the system used must be applied consistently.

A mass-casualty sorting method that assigns color tags by survivability rather than by severity alone. In the common scheme, red means immediate, yellow delayed, green minor or walking, and black expectant or deceased.

A 3-to-15 score summing eye opening, verbal response, and best motor response. A score of 8 or below generally signals severe impairment and the need to protect the airway; the motor component is the strongest predictor.

Shining light into one eye and observing constriction in that eye (direct) and the other (consensual). Document size, shape, equality, and reactivity; a fixed, dilated pupil can signal herniation or drug effect and requires urgent reporting.

Blood pressure and pulse measured with the patient lying, then sitting, then standing. A drop of about 20 mmHg systolic or 10 mmHg diastolic, or a pulse rise of about 20 beats per minute, suggests volume depletion or autonomic impairment.

0.9% sodium chloride, an isotonic crystalloid used for volume replacement. It contains no potassium or calcium and in large volumes can cause hyperchloremic metabolic acidosis, so it is not a universal default fluid.

The three timing values that determine when a dose starts lowering glucose, when hypoglycemia risk is greatest, and how long the effect lasts. Rapid-acting analogs peak in roughly 1 to 2 hours; long-acting basal insulins are nearly peakless.

Blood glucose low enough to cause symptoms such as sweating, tremor, confusion, or seizure. A conscious patient receives about 15 g of fast-acting carbohydrate and recheck in 15 minutes; an unconscious patient needs IV glucose or glucagon.

A prewritten order set that sets the insulin dose according to the measured blood glucose at that moment. It treats hyperglycemia reactively and does not replace scheduled basal or prandial coverage for most hospitalized patients.

Practices that prevent wrong insulin, wrong dose, and needle-stick injury: never share pens even with a new needle, label opened vials with date, inspect for cloudiness, and verify the insulin type against the order before drawing up.

A drug that carries a heightened risk of significant patient harm when used in error, such as insulin, heparin, opioids, and concentrated electrolytes. These require independent double-checks and standardized storage and labeling.

The core checks before giving a drug: right patient, right drug, right dose, right route, and right time. Many facilities add right documentation and right reason; the rights are a minimum, not a substitute for clinical judgment.

Two qualified clinicians separately verify a high-risk calculation or product without one simply confirming the other's reading. Each performs the check alone, then they compare results before administration.

The margin between a drug's effective and toxic doses, with a narrow index meaning little margin. For such drugs, blood levels are measured to keep concentrations inside the therapeutic range, for example vancomycin, digoxin, and lithium.

Drawing a blood level shortly before the next scheduled dose to confirm the drug is clearing adequately. Timing matters: a level drawn too early falsely reads high, so the exact draw time must be documented and reported.

A coordinated program to use antibiotics only when indicated, at the right dose, route, and duration. It reduces resistance and harms such as Clostridioides difficile infection, and nurses contribute by timely cultures and prompt de-escalation.

Infection-prevention practices applied to every patient regardless of diagnosis: hand hygiene, gloves for contact with body fluids, and eye or face protection when splash is likely. They are the baseline layer beneath transmission-based precautions.

Extra measures added to standard precautions for a known or suspected pathogen: contact for organisms such as MRSA or C. difficile, droplet for influenza or pertussis, and airborne for tuberculosis, measles, and varicella.

The correct order for putting on and removing protective gear. Donning generally goes gown, mask or respirator, goggles, then gloves; doffing removes the most contaminated items first, with hand hygiene immediately after.

The World Health Organization points at which hand hygiene is required: before touching a patient, before a clean procedure, after body-fluid exposure risk, after touching a patient, and after touching patient surroundings.

A microbe resistant to several classes of antibiotics, such as MRSA, VRE, and carbapenem-resistant Enterobacterales. Spread is limited by hand hygiene, dedicated equipment, and, when indicated, contact precautions and screening cultures.

Practices that keep an object or field free of all microorganisms, used for invasive procedures such as catheter insertion and dressing changes. Sterile touches sterile; anything that contacts a non-sterile surface is contaminated.

A bundle of practices for central venous catheters: hand hygiene, maximal sterile barrier at insertion, chlorhexidine skin antisepsis, optimal site selection, and daily review of whether the line is still needed.

Targeted measures for a patient assessed as likely to fall: bed low and locked, call light in reach, non-skid footwear, frequent rounding, and bed or chair alarms when appropriate. Restraints are a last resort, not a routine fall measure.

Physical or chemical restriction of movement used only for immediate safety after less restrictive options fail, and only on a time-limited order. Patients need frequent assessment, circulation checks, repositioning, and documentation of continued need.

A patient's voluntary agreement to a procedure after receiving the diagnosis, purpose, risks, benefits, and alternatives. The provider discloses and obtains consent; the nurse verifies understanding, voluntariness, and that the correct form is signed.

The right to accept or refuse treatment, expressed in advance through documents such as a living will or durable power of attorney for health care. These guide care when the patient can no longer decide.

An unexpected occurrence involving death or serious physical or psychological harm, or the risk of it, such as wrong-site surgery or a retained foreign object. It triggers immediate investigation and a root-cause analysis.

A structured communication format: Situation, Background, Assessment, and Recommendation. It reduces omissions when transferring care by forcing a clear statement of what the receiver should do next.

The defined sequence for raising a concern when a patient's condition worsens or an order seems unsafe. The nurse notifies the responsible provider, then proceeds up the hierarchy without waiting indefinitely for a response.

Transferring a task to an assistive person while the nurse keeps accountability. The rights are task, circumstance, person, direction and communication, and supervision and evaluation; assessment and teaching stay with the nurse.

Purposeful use of open questions, reflection, silence, and clarification to help a patient express feelings and make decisions. It avoids false reassurance, advice-giving, and changing the subject.

A structured inquiry into thoughts, plans, intent, means access, and protective factors, asked directly and documented. High risk with a specific plan and available means requires immediate safety measures and escalation.

A deliberately structured inpatient environment that uses safety, routine, group activities, and consistent staff behavior as treatment. It aims to build trust and reality-testing while limiting self-harm and elopement risk.

A rare, life-threatening reaction to antipsychotics marked by high fever, severe muscle rigidity, altered mental status, and autonomic instability. The drug is stopped at once and urgent medical treatment is required.

Excessive blood loss after birth, commonly defined as more than 1000 mL or any loss causing hemodynamic instability. Uterine atony is the leading cause; management includes uterine massage, uterotonics, and volume replacement.

Palpating the uterine fundus for firmness and position after birth. A boggy uterus that is displaced upward and to the right may signal a full bladder or atony and is massaged while the bladder is emptied.

Observation for signs of excess magnesium when it is given for preeclampsia or preterm labor: loss of deep tendon reflexes, respiratory depression, oliguria, and flushing. Calcium gluconate is the antidote.

New hypertension after 20 weeks with proteinuria or organ dysfunction. Report severe headache, visual changes, epigastric or right upper quadrant pain, and sudden swelling, which can precede seizures or HELLP syndrome.

Tapping a tendon, such as the patellar, to elicit a graded contraction (0 absent to 4+ hyperactive). It is used in neurologic checks and to monitor for magnesium toxicity, where reflexes diminish before breathing fails.

A 0-to-10 rating of a newborn at 1 and 5 minutes after birth: heart rate, respiratory effort, muscle tone, reflex irritability, and color. It describes response to resuscitation, not long-term prognosis.

The newborn's limited ability to conserve heat, which makes hypothermia and cold stress common. Nurses use skin-to-skin contact, warm blankets, hats, and delayed bathing, and watch for signs of respiratory distress from cold stress.

Calculating a child's dose from milligrams per kilogram and confirming the result against a safe maximum. Weight must be in kilograms, and the dose is rechecked when it looks unusually high or low for the child.

Subtle cues that a child is deteriorating: grunting, nasal flaring, retractions, lethargy, poor feeding, and decreased urine output. Children compensate well and then decompensate quickly, so trends matter more than single values.

A framework explaining health behavior by perceived susceptibility, severity, benefits, barriers, and cues to action. It helps nurses design education that addresses a specific barrier, such as cost or inconvenience, rather than assuming ignorance.

Primary prevention stops disease before it starts, such as immunization; secondary finds it early, such as screening; tertiary limits disability after it exists, such as cardiac rehabilitation. Matching a program to the right level is a common exam task.

The conditions where people live, work, and age that shape health, including income, housing, food access, education, and transportation. Community health assessment looks for these rather than treating health as individual choice alone.

A diagnosis that law requires clinicians to report to public health authorities, enabling case investigation, contact tracing, and outbreak detection. Examples vary by jurisdiction but often include tuberculosis, measles, and certain sexually transmitted infections.

Classification of localized skin and tissue damage from pressure and shear, from stage 1 erythema through full-thickness loss to unstageable and deep-tissue injury. Staging guides repositioning, support surfaces, and nutrition planning.

A scored risk assessment for pressure injury using sensory perception, moisture, activity, mobility, nutrition, and friction and shear. Lower scores mean higher risk and trigger a prevention plan such as scheduled turning.