OMSB Nurse Exam cheat sheet

Normal adult vital signs: temperature 36.1-37.2 C oral, pulse 60-100/min, respirations 12-20/min, blood pressure under 120/80 mmHg, SpO2 95-100% on room air.

Hypoglycemia is blood glucose below 70 mg/dL; treat conscious patient with 15 g fast carbohydrate, recheck in 15 minutes, repeat up to three times.

Digoxin therapeutic range 0.5-2.0 ng/mL; hold dose and notify prescriber if apical pulse is below 60/min in an adult.

Insulin onset: rapid-acting (lispro, aspart) 10-15 min, short-acting regular 30-60 min, NPH 1-2 h, glargine 1-2 h with no peak.

Heart failure daily weight gain of more than 1 kg (2 lb) in a day or 2.3 kg (5 lb) in a week signals fluid retention.

Postoperative deep vein thrombosis prevention: early ambulation, sequential compression devices, and anticoagulant prophylaxis per order; calf pain, unilateral swelling, and warmth are warning signs.

Cirrhosis complications to monitor: ascites, esophageal varices, hepatic encephalopathy (asterixis, confusion), and spontaneous bacterial peritonitis.

Chronic obstructive pulmonary disease: teach pursed-lip breathing and tripod position; target oxygen saturation 88-92% in patients at risk of CO2 retention.

Estimated date of delivery by Naegele rule: first day of last menstrual period minus 3 months plus 7 days plus 1 year.

Normal fetal heart rate 110-160 beats/min; baseline below 110 is bradycardia, above 160 is tachycardia, and either requires repositioning and reassessment.

Stages of labor: first stage from onset to full 10 cm dilation, second stage from full dilation to birth, third stage from birth to placental delivery, fourth stage the first 1-2 hours postpartum.

Postpartum hemorrhage is blood loss over 500 mL after vaginal birth or over 1000 mL after cesarean; uterine atony is the most common cause, so fundal massage and uterotonics come first.

Preeclampsia: blood pressure 140/90 mmHg or higher after 20 weeks plus proteinuria or end-organ signs; magnesium sulfate is given for seizure prophylaxis with monitoring of reflexes, respirations, and urine output.

Newborn Apgar scored at 1 and 5 minutes on five components: appearance, pulse, grimace, activity, respiration, each 0-2 points.

Exclusive breastfeeding is recommended for the first 6 months; colostrum is produced in the first 2-3 days and is rich in immunoglobulin A.

Infant weight doubles by about 5 months and triples by 12 months; birth weight is regained by 10-14 days of age.

Adult chain of survival: recognize and activate emergency response, early high-quality CPR, early defibrillation, advanced life support, and post-cardiac-arrest care.

High-quality adult CPR: compression rate 100-120/min, depth at least 5 cm but not more than 6 cm, full chest recoil, minimize interruptions to under 10 seconds.

Defibrillation for shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) as early as possible; a single shock then resume compressions immediately.

Sepsis bundle: measure lactate, obtain blood cultures before antibiotics, give broad-spectrum antibiotics and 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or higher.

Anaphylaxis first-line treatment is intramuscular epinephrine 0.3-0.5 mg of 1:1000 solution into the anterolateral thigh, repeated every 5-15 minutes as needed.

Acute coronary syndrome: aspirin 160-325 mg chewed, obtain 12-lead ECG within 10 minutes of arrival, and target door-to-balloon time of 90 minutes or less for primary PCI.

Glasgow Coma Scale range 3-15; score of 8 or less indicates severe injury and need to assess airway protection.

Mechanical ventilation alarms: high-pressure alarm suggests secretions, biting, coughing, or tubing kink; low-pressure alarm suggests disconnection or cuff leak.

Levels of prevention: primary prevents disease before it occurs (immunization), secondary detects early disease (screening), tertiary limits disability (rehabilitation).

Incidence counts new cases in a period; prevalence counts all existing cases at a point in time.

Attack rate equals number of new cases divided by population at risk, multiplied by 100, used in outbreak investigations.

Herd immunity threshold depends on basic reproduction number; high immunization coverage protects those who cannot be vaccinated.

Reportable disease surveillance is mandated by national public health authorities; nurses must notify suspected cases per local list and timelines.

Sensitivity is the proportion of true cases correctly identified; specificity is the proportion of non-cases correctly identified.

Community assessment uses windshields survey, key informant interviews, and secondary data such as census and health authority statistics.

Screening programs follow Wilson and Jungner criteria, including an important health problem, accepted treatment, and a suitable test.

World Health Organization five moments for hand hygiene: before touching a patient, before clean/aseptic procedure, after body fluid exposure risk, after touching a patient, after touching patient surroundings.

Standard precautions apply to all patients regardless of diagnosis; transmission-based precautions (contact, droplet, airborne) are added for specific pathogens.

Airborne precautions require a negative-pressure room, N95 or equivalent respirator, and door kept closed; examples are tuberculosis, measles, and varicella.

Droplet precautions require a surgical mask within about 1-2 meters; examples are influenza, pertussis, and meningococcal disease.

Six rights of medication administration: right patient, drug, dose, route, time, and documentation; many settings add reason and response.

Pressure injury staging: stage 1 intact skin with non-blanchable erythema, stage 2 partial-thickness loss, stage 3 full-thickness loss, stage 4 full-thickness with exposed bone, tendon, or muscle.

Normal adult urine output is about 0.5-1 mL/kg/hour; output below 30 mL/hour for an adult suggests hypovolemia or renal impairment.

Needlestick injury: wash with soap and water, do not squeeze or scrub, report immediately, and start post-exposure prophylaxis evaluation within hours.

Informed consent requires capacity, disclosure of risks and benefits and alternatives, understanding, and voluntariness; the physician obtains consent and the nurse witnesses or clarifies.

Four ethical principles: autonomy (respect patient choice), beneficence (do good), non-maleficence (avoid harm), justice (fair distribution).

Nursing code of conduct requires accountability, competence, confidentiality, and reporting of unsafe practice or impaired colleagues.

Confidentiality exceptions include patient consent, legal requirement, serious risk to others, and mandatory reporting of certain conditions or abuse.

Advance directives include living wills and durable power of attorney for healthcare; they apply when the patient loses decision-making capacity.

Mandatory reporting duties commonly cover suspected child abuse, elder abuse, and specified communicable diseases; follow local law and institutional policy.

Documentation is a legal record: record objectively, contemporaneously, in ink, without alterations or blank lines; late entries are labeled as such.

Negligence requires duty, breach of duty, causation, and damages; professional scope of practice is defined by licensing law and employer policy.