NCLEX-RN key terms

Transferring responsibility for a specific task to another staff member while the delegating nurse keeps accountability for the outcome; only tasks allowed by the delegatee's legal scope and training may be assigned.

The legally defined duties and limits of each licensed role, set by state nurse practice acts; working outside those limits can harm clients and bring professional discipline.

A client's voluntary agreement to a procedure after receiving accurate information about its purpose, risks, benefits, and alternatives; the nurse verifies understanding and witnesses the signature, while the provider obtains consent.

Written instructions made while a client is competent that guide future care, such as a living will or durable power of attorney for health care; nurses confirm the document exists and follow its directions.

The formal line of authority for reporting concerns and escalating unsafe situations; the nurse notifies the immediate supervisor first and moves upward until the problem is addressed.

A structured handoff format - Situation, Background, Assessment, Recommendation - that helps nurses report a client's condition concisely and reduces omissions during transitions of care.

Infection-control practices used for every client regardless of diagnosis: hand hygiene plus gloves, gown, mask, and eye protection based on expected contact with blood, body fluids, secretions, or nonintact skin.

Extra precautions for clients with known or suspected contagious organisms: airborne (negative-pressure room, N95 respirator), droplet (mask, private room), and contact (gown, gloves, dedicated equipment).

Techniques that keep objects and areas free of all microorganisms, used for invasive procedures such as catheter insertion and dressing changes; a break in technique requires replacing the contaminated item.

A work area treated as free of microorganisms, maintained by keeping sterile items above waist level, avoiding contact with nonsterile objects, and never turning away from it.

Cleaning hands with soap and water or alcohol-based rub at key moments, such as before client contact and after body-fluid exposure; it is the single most effective way to prevent healthcare-associated infection.

Any device or method that limits a client's movement, used only for safety after less restrictive measures fail, with a provider order, time limits, frequent assessment, and periodic release of the limb.

Actions taken before disease occurs to reduce risk, such as immunizations, seatbelt use, and nutrition education; the goal is to keep healthy people healthy.

Finding disease early through screening while it is most treatable, such as mammography, colonoscopy, and blood pressure checks; also called health screening.

Expected physical, cognitive, and social abilities at a given age, used to judge whether a child is progressing normally and to choose age-appropriate teaching and safety measures.

A client's ability to obtain and understand basic health information needed to make decisions; low literacy calls for plain language, pictures, and teach-back rather than written instructions alone.

Purposeful conversation that helps clients express feelings, using open questions, reflection, and silence while avoiding advice, false reassurance, and judgment.

Unconscious mental strategies that reduce anxiety, such as denial, projection, and rationalization; the nurse notices the pattern and responds calmly rather than arguing with it.

Short-term, goal-directed help for a person whose usual coping fails during an acute event; the focus is safety, immediate problem solving, and linking to ongoing support.

Close observation and environmental safety measures for a client at risk of self-harm, including removing ligature points and sharps, checking at prescribed intervals, and documenting findings.

Calm verbal and environmental techniques that reduce agitation before violence occurs, such as speaking softly, giving space, offering choices, and avoiding confrontation.

Systematically measuring pain with the client's self-report and an appropriate scale, plus location, quality, timing, and effect on function; reassess after every intervention.

Localized damage to skin and underlying tissue from sustained pressure, often over bony prominences; prevention includes repositioning, moisture control, and support surfaces.

Measures that reduce the risk of food or fluid entering the airway, such as upright positioning, chin tuck, small bites, and checking swallow safety before oral intake.

Effects of prolonged bed rest, including pressure injury, atelectasis, constipation, venous stasis, and muscle loss; prevented by turning, early ambulation, breathing exercises, and hydration.

How the body handles a drug over time - absorption, distribution, metabolism, and excretion - which determines onset, peak, duration, and dosing intervals.

The gap between a drug's effective dose and its toxic dose; drugs with a narrow index, such as digoxin and warfarin, need close monitoring and often blood level checks.

Blood levels drawn to check whether a drug is in its effective range: a peak soon after a dose and a trough just before the next; timing errors make the results unreliable.

Leakage of a vesicant drug, such as some chemotherapy agents or vasopressors, out of a vein into surrounding tissue, causing pain and tissue damage; stop the infusion and follow protocol.

A drug with a heightened risk of serious harm when used incorrectly, including insulin, heparin, and opioids; it requires independent double-checks, standardized concentrations, and clear labeling.

An immune or other response to transfused blood marked by fever, chills, rash, dyspnea, or back pain; stop the transfusion at once, keep the line open with saline, and notify the provider.

Subtle changes such as rising respiratory rate, new confusion, or falling urine output that precede serious deterioration; they prompt rapid assessment and escalation before a crisis develops.

Measures to prevent deep vein thrombosis and pulmonary embolism in at-risk clients, including early ambulation, compression devices, and anticoagulants as prescribed.

Steps that reduce injury risk for clients with balance or strength problems, such as bed brakes, low bed position, call light within reach, nonskid footwear, and assisted toileting.

Life-threatening organ dysfunction caused by a dysregulated response to infection; signs include fever or low temperature, fast heart rate, low blood pressure, and altered mentation, requiring rapid fluids and antibiotics.

A shift in blood pH from the normal 7.35 to 7.45 caused by breathing or metabolic problems; interpretation uses pH, PaCO2, and bicarbonate to identify respiratory or metabolic acidosis or alkalosis.

Blood glucose low enough to cause symptoms such as sweating, tremor, confusion, and seizures; conscious clients receive fast-acting carbohydrate, while unconscious clients receive IV dextrose or glucagon.

A state of decreased body water marked by thirst, low urine output, fast heart rate, and low blood pressure; treatment replaces fluid and corrects the cause.