MNB/LJM Nursing Examination flashcards

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

Normal adult respiratory rate

12 to 20 breaths per minute at rest. Rates below 12 indicate bradypnea; above 20 indicate tachypnea and may signal hypoxia, pain, fever, or metabolic acidosis.

Braden Scale interpretation

Scores range from 6 to 23 across six subscales. Lower scores mean higher pressure injury risk; a score of 9 or below indicates very high risk requiring aggressive prevention.

Pulse deficit measurement

Auscultate the apical pulse and palpate the radial pulse simultaneously for a full minute. The difference between the two rates is the pulse deficit, seen in atrial fibrillation.

Left versus right heart failure

Left-sided failure causes pulmonary congestion with crackles, orthopnea, and dyspnea. Right-sided failure causes systemic congestion with jugular venous distension, hepatomegaly, and peripheral edema.

Hyperkalemia emergency treatment

Give IV calcium gluconate first to stabilize the myocardium, then shift potassium intracellularly with insulin plus glucose or albuterol, and remove potassium with diuretics or dialysis.

Cushing triad

A late sign of increased intracranial pressure consisting of hypertension with widened pulse pressure, bradycardia, and irregular respirations. It requires urgent escalation.

Naegele rule

Estimate the delivery date by taking the first day of the last menstrual period, subtracting three months, adding seven days, and adding one year.

Late decelerations

Fetal heart rate drops that begin after the contraction peak and return slowly. They reflect uteroplacental insufficiency and require repositioning, oxygen, and stopping oxytocin.

Magnesium sulfate toxicity antidote

Calcium gluconate reverses magnesium toxicity. Monitor deep tendon reflexes, respiratory rate, and urine output; loss of reflexes and respiratory depression below 12 per minute are warning signs.

APGAR scoring

Assessed at one and five minutes after birth for Appearance, Pulse, Grimace, Activity, and Respiration, each scored 0 to 2. A total of 7 or higher is normal.

Holliday-Segar maintenance fluids

Pediatric daily fluid requirement: 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram above 20.

Epiglottitis nursing priority

Never inspect the throat or use a tongue blade because laryngospasm may cause complete airway obstruction. Keep the child calm, upright, and prepare for emergent airway management.

Kawasaki disease criteria

Fever for at least five days plus four of five findings: conjunctivitis, oral changes, rash, extremity changes, and cervical lymphadenopathy. Treat with IV immunoglobulin and aspirin.

Serotonin syndrome triad

Mental status changes, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia. Caused by serotonergic drug combinations; stop the offending agents and give supportive care.

Lithium therapeutic range

0.6 to 1.2 mEq/L for maintenance therapy. Toxicity presents with tremor, vomiting, ataxia, and confusion; sodium and fluid balance must be maintained.

Delirium tremens timing

Alcohol withdrawal delirium typically occurs 48 to 96 hours after the last drink, with hallucinations, agitation, and autonomic instability. Treat with benzodiazepines and thiamine.

Levels of prevention

Primary prevents disease before onset through immunization and education. Secondary detects disease early through screening. Tertiary limits disability through rehabilitation and chronic disease management.

Incidence versus prevalence

Incidence counts new cases during a defined period divided by the population at risk. Prevalence counts all existing cases at a point in time divided by the total population.

Herd immunity threshold

The proportion needing immunity equals 1 minus 1 divided by the basic reproduction number. For a disease with R0 of 5, the threshold is 80 percent.

Digoxin administration rule

Hold digoxin and notify the provider when the adult apical pulse is below 60 beats per minute. Hypokalemia increases toxicity risk; therapeutic range is 0.5 to 2 ng/mL.

Warfarin and heparin antidotes

Vitamin K reverses warfarin; protamine sulfate reverses heparin. Warfarin is monitored with INR, targeting 2 to 3 for most indications.

Vancomycin infusion precautions

Infuse over at least 60 minutes to prevent red man syndrome, which causes flushing and hypotension from rapid infusion. Monitor trough levels and renal function.

Cardiac output formula

Cardiac output equals heart rate multiplied by stroke volume. Normal adult cardiac output is 4 to 8 liters per minute.

Normal arterial blood gas values

pH 7.35 to 7.45, PaCO2 35 to 45 mmHg, bicarbonate 22 to 26 mEq/L, and PaO2 80 to 100 mmHg. These values anchor acid-base interpretation.

Airborne precautions requirements

Use a negative-pressure room with at least 12 air changes per hour and an N95 or higher respirator. Applies to tuberculosis, measles, and varicella.

C. difficile hand hygiene

Wash hands with soap and water because alcohol-based rub does not kill C. difficile spores. Use contact precautions and dedicated equipment.

Two patient identifiers

Verify identity using two identifiers, such as full name and date of birth or medical record number, before medication administration, transfusion, and procedures. Room number is not acceptable.

RCA versus FMEA

Root cause analysis reviews a sentinel event after it occurs. Failure mode and effects analysis prospectively identifies where a process could fail and prioritizes prevention.

SBAR handoff

Situation, Background, Assessment, and Recommendation. This structured format standardizes handoffs and escalation of patient concerns.

Informed consent elements

Requires patient competence, voluntariness, and disclosure of risks, benefits, and alternatives. The provider performing the procedure obtains consent; the nurse witnesses and verifies understanding.

Negligence elements

Four elements must be proven: duty owed to the patient, breach of that duty, causation linking the breach to harm, and actual damages.

Five rights of delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. The delegating nurse retains accountability for outcomes.