NCNZ IQN Theoretical Exam cheat sheet

NCNZ scope of practice: a nurse may perform only activities they are educated and competent for, or that are appropriately delegated and supervised.

HPCA Act 2003 requires an annual practising certificate; practising without one is unlawful except for limited statutory exceptions.

Valid informed consent requires decision-making capacity, adequate information about benefits and risks, and a voluntary choice; written consent is not always required.

Health Information Privacy Code 2020: health information may be disclosed only with consent or a specific legal exception; document the basis for disclosure.

Professional boundaries: sexual relationships with current patients are prohibited; declare conflicts of interest and avoid exploitative dual relationships.

Delegation rule: the delegator retains accountability; the delegate must be competent, work within scope, and have adequate supervision and resources.

Cultural safety requires the nurse to reflect on their own power and bias and to deliver care that the recipient experiences as culturally safe.

Documentation standard: contemporaneous, objective, signed, and dated entries; correct errors with a single line, initials, and date, not by obliteration.

Serious-risk reporting: if a colleague's impairment or conduct poses serious risk to patients, notify the employer and Registrar under local policy and HPCA requirements.

ABCDE priority sequence: Airway, Breathing, Circulation, Disability, Exposure; treat immediately life-threatening problems before history or secondary assessment.

Early warning score: calculated from respiratory rate, oxygen saturation, oxygen use, blood pressure, heart rate, consciousness, and temperature; higher scores trigger escalating review.

Medication administration rights: right person, drug, dose, route, time, reason, and documentation; check allergies before administration.

High-risk medicines require an independent second check according to local policy, including calculation, dose, and route.

Pressure injury prevention: use validated risk assessment, inspect skin, reposition according to risk, manage moisture and nutrition, and use pressure-redistributing surfaces when indicated.

Falls management: screen risk on admission and after any change; apply multifactorial interventions such as orientation, mobility aids, toileting rounds, and bed brakes.

Five moments of hand hygiene: before touching a patient, before clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings.

Deterioration escalation: use a structured communication tool and the local early warning protocol to request urgent review; do not delay escalation while completing a full assessment.

Restraint decision rule: use only as a last resort, with legal authority, the least restrictive option, monitoring of physical and psychological safety, documentation, and review.

ISBAR structure: Identify, Situation, Background, Assessment, Recommendation; include risks and an explicit request or plan.

Handover content: current condition, recent observations, medications, allergies, risks, goals of care, and escalation plan; read back critical information.

Teach-back: ask the patient to explain information in their own words; this tests understanding better than asking whether they understand.

Interpreter rule: use a trained interpreter for consent, complex explanations, and confidential discussions; avoid using children or untrained family members except in urgent safety situations.

Open disclosure: acknowledge the harm event, explain known facts, offer support, outline investigation, and give an apology; an apology is not an admission of liability.

Health literacy communication: use plain language, limit key points, chunk information, use visual aids, and confirm understanding.

Conflict escalation: address disagreement respectfully, focus on patient safety and shared goals, use clear facts, and escalate through the agreed chain of command when resolution fails.

Clinical documentation: record contemporaneous, factual, objective entries with date, time, signature, and relevant patient statements; avoid judgmental language and unauthorized abbreviations.

Whānau involvement rule: with the patient's consent, involve family or whānau in care planning and communication while respecting cultural roles and privacy boundaries.

Clinical governance: a system through which healthcare organisations are accountable for quality and safety, including leadership, risk management, incident review, and continuous improvement.

PDSA cycle: Plan, Do, Study, Act; test a small change, measure the result, review the data, then adapt, adopt, or abandon the change.

Incident reporting: report adverse events and near misses through organisational systems so system failures can be identified and learning shared, usually without individual blame.

Root cause analysis: a structured review after a serious adverse event that examines contributing system factors such as communication, equipment, staffing, and policy rather than blaming one person.

Clinical audit: measure practice against an agreed standard, identify gaps, implement changes, and re-audit to confirm improvement.

Evidence-based practice: integrate the best available research evidence, the clinician's expertise, and the patient's values, preferences, and circumstances.

Closed-loop communication: the sender gives a clear message, the receiver repeats it back, and the sender confirms accuracy; this reduces misunderstandings in interprofessional teams.

Health equity: fair access to healthcare and fair outcomes for all groups; improvement work should identify and reduce avoidable inequities, including Māori health inequities in New Zealand.

Discharge planning: start early, use multidisciplinary input, reconcile medicines, confirm follow-up, and give the patient written information about warning signs and who to contact.