MNMC Nurses' Competency Exam key terms

The six-link sequence by which pathogens spread: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Breaking any single link prevents transmission.

Infection control practices applied to every patient regardless of diagnosis, including hand hygiene, gloves, gowns, masks, eye protection, safe sharps handling, and safe injection practices.

Additional isolation measures beyond standard precautions, chosen according to pathogen route: contact for organisms such as MRSA or C. difficile, droplet for influenza or pertussis, and airborne for tuberculosis or measles.

Barrier items worn to prevent exposure to bloodborne pathogens and other hazards, including gloves, gown, mask, respirator, and eye protection. It must be removed in the correct sequence to avoid self-contamination.

Practices that keep objects and areas free of all microorganisms, used for invasive procedures such as catheter insertion, dressing changes, and surgery. Sterile technique requires sterile supplies and strict field monitoring.

A primary bloodstream infection occurring within a defined window after central venous catheter placement and not related to another site. Prevention bundles emphasize hand hygiene, maximal sterile barrier, chlorhexidine skin antisepsis, and daily review of line necessity.

A urinary tract infection associated with an indwelling urinary catheter. Prevention focuses on appropriate indications, aseptic insertion, closed drainage, dependent drainage bag position, and prompt removal.

Cleaning hands with soap and water or alcohol-based rub at the World Health Organization's five moments: before patient contact, before aseptic tasks, after body fluid exposure, after patient contact, and after touching patient surroundings.

A structured process of obtaining and comparing a patient's complete medication list across transitions of care to identify omissions, duplications, dosing errors, and interactions before new orders are written.

A drug that carries a heightened risk of significant patient harm when used in error, such as insulin, heparin, opioids, and concentrated electrolytes. Independent double checks and standardized labeling are typical safeguards.

Drug names that appear or sound similar but have different active ingredients or strengths, creating selection errors. Tall-man lettering, read-back verification, and separated storage reduce confusion.

A property of drugs whose effective and toxic blood concentrations lie close together, such as digoxin, warfarin, and lithium. Such drugs require careful dosing and often therapeutic drug monitoring.

Any injury resulting from medication use, whether or not the drug was prescribed correctly. It includes adverse drug reactions, dosing errors, and administration mistakes, and should be reported through incident systems.

A communication safety practice in which the receiver repeats a verbal or telephone order back to the prescriber, who confirms it. It prevents errors from misheard drug names, doses, and routes.

A structured handoff format covering Situation, Background, Assessment, and Recommendation. It organizes clinical information so the receiving clinician can act quickly and safely.

A team communication pattern in which a sender directs a message, the receiver repeats it back, and the sender confirms accuracy. It is used in emergencies to confirm orders and prevent task duplication.

A brief pause before an invasive procedure in which the team verbally confirms patient identity, procedure, site, and consent. It is a core element of surgical safety checklists.

An unexpected occurrence involving death or serious physical or psychological injury, or the risk of such outcomes. Such events trigger immediate investigation and root cause analysis.

A systematic retrospective method for identifying the underlying system failures that contributed to an adverse event, with the goal of designing preventive changes rather than assigning individual blame.

A framework that distinguishes human error, at-risk behavior, and reckless conduct when responding to safety events. It encourages reporting and learning while holding individuals accountable for conscious disregard of risk.

A patient's voluntary agreement to a treatment or procedure after receiving information about its nature, risks, benefits, and alternatives. The patient must have decision-making capacity and the discussion must be documented.

The legal and ethical principle that competent patients have the right to make their own healthcare decisions, including refusing treatment, based on complete and understandable information.

A legal document, such as a living will or durable power of attorney for healthcare, that records a patient's treatment preferences or names a surrogate decision-maker for use when the patient cannot speak.

A physician order, authorized by the patient or surrogate, directing that cardiopulmonary resuscitation not be attempted if the patient suffers cardiac or respiratory arrest. It does not limit other comfort-focused care.

United States federal law that protects the privacy and security of identifiable health information and sets rules for permitted disclosure. Nurses must share only the minimum necessary information with authorized parties.

A nurse's legal obligation to notify designated authorities of specified events, such as suspected abuse, communicable diseases, impaired colleagues, or certain injuries. Reporting is required even when it breaches usual confidentiality.

Statutorily required disclosure of defined incidents to a regulatory or public health agency, such as suspected child or elder abuse, gunshot wounds, or reportable infectious diseases.

Failure to provide the care a reasonably prudent nurse would provide in similar circumstances, resulting in harm. Proof requires a duty, a breach, causation, and actual damages.

The activities, responsibilities, and limits of a nurse's role as defined by state law, licensure, and institutional policy. Nurses must not perform tasks beyond their authorized scope or competence.

Transferring performance of a selected nursing task to an assistive personnel while retaining accountability for the outcome. The nurse must assess patient stability, task complexity, and the delegate's competence.

A group of clinicians who can be summoned to the bedside when a patient shows early signs of deterioration, outside of a cardiac arrest. Early activation aims to prevent arrest and unplanned intensive care transfer.

A numeric score calculated from routine vital signs such as respiratory rate, oxygen saturation, blood pressure, pulse, temperature, and consciousness. Rising scores prompt escalation of care.

Death or serious deterioration from a complication that could have been prevented by timely recognition and intervention. It is a widely used indicator of hospital safety and monitoring quality.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. Recognition relies on signs such as altered mentation, elevated respiratory rate, low blood pressure, and rising lactate.

Sepsis with persistent hypotension requiring vasopressors to maintain adequate mean arterial pressure and with elevated lactate despite adequate fluid resuscitation. It carries high mortality and demands immediate treatment.

A spectrum of myocardial ischemia including unstable angina and myocardial infarction. Key nursing actions are rapid electrocardiogram acquisition, aspirin administration per protocol, and continuous cardiac monitoring.

Purposeful use of verbal and nonverbal techniques, such as open-ended questions, reflection, and silence, to build trust and help patients express concerns. It avoids false reassurance and judgmental responses.

A confirmation technique in which the patient explains information back in their own words. It verifies understanding of instructions and reveals gaps that need re-teaching.

Verification of a patient's identity using at least two approved identifiers, such as name and date of birth, before any medication, procedure, or specimen collection. Room numbers are never acceptable identifiers.