MNB/LJM Nursing Examination key terms

A five-step clinical reasoning framework (assessment, diagnosis, planning, implementation, evaluation) that guides individualized nursing care and is documented and revised as the patient's condition changes.

A clinical judgment about a patient's response to health conditions or life processes that nurses are licensed and able to treat independently, distinct from a medical diagnosis.

The nursing process phase in which actual outcomes are compared with expected outcomes to judge whether interventions worked and whether the care plan needs revision.

Transferring authority to perform a specific task to a competent assistive person while the delegating nurse retains accountability for the decision, supervision, and outcome.

The criteria a nurse applies before assigning a task: right task, right circumstance, right person, right direction and communication, and right supervision and evaluation.

A worker trained to perform delegated, routine, and predictable patient care tasks under nursing supervision; the worker cannot assess, teach, or make clinical judgments.

The legally defined set of activities a nurse may perform at a given licensure level, set by state statute and board of nursing rules rather than by employer preference.

State legislation that establishes the board of nursing, defines licensure requirements, and sets the legal boundaries of nursing practice within that jurisdiction.

The state regulatory body that licenses nurses, interprets the Nurse Practice Act, investigates complaints, and imposes discipline for unsafe or unlawful practice.

A patient's voluntary agreement to a procedure after receiving and understanding its nature, risks, benefits, and alternatives; the provider obtains it, and the nurse witnesses and verifies understanding.

Acting to protect and promote a patient's rights, preferences, and safety, including speaking up when care or decisions conflict with the patient's stated wishes.

The ethical and legal principle that competent patients have the right to make their own health care decisions, including refusing recommended treatment.

The ethical duty to act in ways that promote the patient's good and to weigh potential benefits against risks when choosing interventions.

The ethical obligation to avoid causing harm, including preventing foreseeable injury from treatment, medication errors, falls, or unsafe practice.

A situation in which two or more morally defensible options conflict and no choice satisfies every obligation, often resolved through ethics consultation and shared decision-making.

The six-link sequence required for transmission: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

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

Additional contact, droplet, or airborne precautions used with standard precautions for specific pathogens, based on how the organism spreads.

The single most effective infection prevention measure: alcohol-based rub for routine care and soap and water when hands are visibly soiled or after caring for patients with C. difficile.

Practices that keep objects and areas free of all microorganisms, used for invasive procedures such as catheter insertion, dressing changes, and surgery.

Verification standards including right patient, drug, dose, route, time, documentation, reason, and the patient's right to refuse; two identifiers are used for patient matching.

A drug that carries elevated risk of serious harm when misused, such as insulin, heparin, and opioids, requiring independent double-checks and standardized storage and labeling.

A formal process of comparing a patient's full medication list across transitions of care to identify omissions, duplications, and interactions before new orders are written.

The ratio between a drug's toxic dose and its effective dose; a narrow index means small dose changes can cause toxicity, so serum levels are monitored.

An unintended, harmful response to a medication given at a normal dose, ranging from rash and nausea to organ injury and anaphylaxis.

Metabolism of an oral drug by the liver before it reaches systemic circulation, which reduces bioavailability and explains why oral doses often exceed intravenous doses.

The concentration of dissolved particles per kilogram of fluid; serum values guide fluid replacement and are compared with urine osmolality to interpret hydration and kidney function.

Shift of fluid into a space where it is not functionally available, such as the peritoneal cavity in ascites or burned tissue, causing edema with intravascular volume depletion.

A state of decreased intravascular or total body water producing thirst, tachycardia, hypotension, poor skin turgor, and concentrated urine; corrected with isotonic fluids and cause-specific treatment.

The average arterial pressure during one cardiac cycle, estimated as diastolic pressure plus one-third of the pulse pressure; values below about 65 mmHg threaten organ perfusion.

Inadequate tissue perfusion that impairs cellular oxygenation, producing altered mentation, tachycardia, hypotension, oliguria, and cool or warm skin depending on the type.

Noninvasive estimation of arterial oxygen saturation using light absorption; readings are unreliable with poor perfusion, nail polish, motion, or abnormal hemoglobin.

A structured screening, such as the Morse Fall Scale, that identifies patients likely to fall and triggers interventions like bed alarms, low beds, and frequent rounding.

Any device or method that limits a patient's movement and is used only for safety after less restrictive measures fail, with a provider order, time limits, and frequent monitoring.

Verification of identity using two patient-specific identifiers before any procedure, medication, or specimen collection, rather than room or bed number.

A structured handoff format covering situation, background, assessment, and recommendation, used to communicate changes in condition clearly and reduce omissions.

A 3-to-15 score combining eye opening, verbal response, and motor response used to quantify level of consciousness and detect neurologic deterioration.

Blood loss after birth exceeding about 1,000 mL with cesarean or 500 mL with vaginal delivery, most often caused by uterine atony and managed with uterine massage and oxytocin.

Pregnancy disorder marked by new hypertension after 20 weeks with proteinuria or organ dysfunction, requiring close monitoring for seizures and placental abruption.

A 0-to-10 assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and color performed at one and five minutes after birth.

A composite scoring tool using vital signs and behavior to identify hospitalized children at risk of clinical deterioration and prompt escalation of care.

Purposeful use of active listening, open questions, reflection, and silence to help patients express feelings and clarify concerns without judgment or false reassurance.

Structured inquiry about ideation, plan, intent, means, and protective factors that determines observation level, safety measures, and referral for a patient at risk.

Legal detention of a person for psychiatric evaluation or treatment without consent when they pose a danger to self or others or are gravely disabled, following statutory criteria.

Use of the treatment environment and daily group routines as therapeutic tools to build safety, social skills, and responsibility in inpatient psychiatric settings.

Conditions of birth, growth, living, working, and aging that shape health outcomes, such as income, housing, food access, education, and neighborhood safety.

A person's ability to obtain, understand, and use health information to make decisions; low literacy calls for plain language, teach-back, and visually simple materials.

Action taken before disease occurs to reduce risk, such as immunization, seat belt use, exercise promotion, and smoking prevention education.

A diagnosis that must be reported to public health authorities under state law so that surveillance, contact tracing, and outbreak control can occur.

An unexpected occurrence involving death or serious physical or psychological harm, or the risk of it, that triggers immediate investigation and root cause analysis.

A structured, nonpunitive review that traces an adverse event back to underlying system failures and produces corrective actions rather than blaming individuals.

Continuous, data-driven effort to improve care processes and outcomes using methods such as PDSA cycles, measurement, and staff engagement.