MNMC Nurses' Competency Exam flashcards
MNMC Nurses' Competency Exam · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Sentinel Event
- An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof, that requires immediate investigation and a root cause analysis.
- Root Cause Analysis
- A structured retrospective review that identifies underlying system failures contributing to an adverse event and recommends changes to prevent recurrence rather than blaming individuals.
- Two Patient Identifiers
- The requirement to confirm identity with two independent identifiers, such as full name and date of birth or medical record number, before care or medication.
- Pressure Injury Stage 3
- Full-thickness loss of skin with subcutaneous fat visible but no exposed fascia, muscle, tendon, cartilage, or bone; slough or eschar may be present.
- Restraint Order Requirement
- A time-limited provider order with a face-to-face evaluation within one hour for violent restraints and frequent monitoring of circulation, skin, and range of motion.
- Chain of Infection
- A six-link sequence: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host; breaking any link prevents transmission.
- Standard Precautions
- Infection control measures applied to all patients regardless of diagnosis, including hand hygiene, gloves, gown, mask, eye protection, and safe sharps handling.
- Airborne Precautions
- Measures for tuberculosis, measles, varicella, and disseminated zoster using an N95 or higher respirator and a negative-pressure room with the door closed.
- C. difficile Hand Hygiene
- Soap-and-water handwashing is required because alcohol-based rubs do not kill Clostridioides difficile spores; contact precautions with gown and gloves are also used.
- Six Rights of Medication
- Right patient, right drug, right dose, right route, right time, and right documentation; many facilities also add right reason and right to refuse.
- Heparin Antidote
- Protamine sulfate reverses unfractionated heparin; aPTT is monitored for unfractionated heparin and anti-Xa levels for low-molecular-weight heparin.
- Warfarin Antidote
- Vitamin K (phytonadione) reverses warfarin effect, with fresh frozen plasma or prothrombin complex concentrate used for active bleeding; INR target is typically 2 to 3.
- Naloxone Use
- An opioid antagonist titrated to restore adequate respiratory rate rather than full arousal, avoiding acute withdrawal and uncontrolled pain in opioid-tolerant patients.
- High-Alert Medications
- Drugs with heightened risk of harm, such as insulin, heparin, opioids, and concentrated electrolytes, requiring independent double-checks and standardized concentrations.
- Glasgow Coma Scale
- A score summing eye (1–4), verbal (1–5), and motor (1–6) responses; 15 is fully alert and 8 or less indicates severe injury with airway concern.
- Mean Arterial Pressure
- Calculated as (systolic + 2 × diastolic) divided by 3; a value below 65 mmHg suggests inadequate organ perfusion and requires intervention.
- Orthostatic Hypotension
- A fall of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing, often causing dizziness and increased fall risk.
- ABCDE Assessment
- A prioritized evaluation sequence of Airway, Breathing, Circulation, Disability, and Exposure, repeated after every intervention in deteriorating patients.
- Nasogastric Tube Verification
- Confirmation by measuring aspirate pH of 5.5 or less and chest X-ray as the definitive check; auscultating an air bolus is not reliable.
- Tracheostomy Suction Limit
- Each suction pass should last 10 to 15 seconds with suction applied only during withdrawal, pre-oxygenation, and recovery time between passes.
- Blood Transfusion First 15 Minutes
- The period of closest monitoring for a hemolytic reaction; start slowly, verify with a second nurse, and use 0.9% sodium chloride as the only compatible fluid.
- Informed Consent Elements
- Requires patient capacity, voluntary choice, disclosure of risks and benefits, and understanding; the provider obtains consent and the nurse witnesses it.
- Five Rights of Delegation
- Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation when assigning care to assistive personnel.
- Mandatory Reporting
- A legal duty to report suspected child, older adult, or dependent adult abuse and certain communicable diseases, regardless of patient or family objection.
- Negligence Elements
- The four elements are duty, breach of duty, causation, and damages; nursing duty is measured against a reasonably prudent nurse in similar circumstances.
- SBAR Handoff
- A structured communication format of Situation, Background, Assessment, and Recommendation used to report changes and escalate concerns to providers.
- Closed-Loop Communication
- The sender transmits a message, the receiver repeats it back for confirmation, and the sender verifies accuracy, reducing errors in high-risk settings.
- Teach-Back Method
- Asking the patient to restate teaching in their own words to confirm understanding, rather than asking whether they understand.
- Adult CPR Parameters
- Compressions at 100 to 120 per minute, 5 to 6 cm deep, with full recoil, interruptions under 10 seconds, and a 30:2 compression-to-ventilation ratio.
- Shockable Rhythms
- Ventricular fibrillation and pulseless ventricular tachycardia are treated with immediate defibrillation; asystole and pulseless electrical activity are not shockable.
- Anaphylaxis First-Line Drug
- Intramuscular epinephrine 0.3 to 0.5 mg of 1:1000 concentration into the anterolateral thigh, followed by airway support, oxygen, and IV fluids.
- Sepsis Bundle
- Measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics and 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or higher.