SNB RN Licensure Exam cheat sheet

Normal adult vital signs: temperature 36.5-37.5 C, pulse 60-100/min, respirations 12-20/min, BP <120/80 mmHg, SpO2 95-100% on room air.

Maslow hierarchy orders intervention priority: physiologic needs (airway, breathing, circulation) before safety, then love/belonging, esteem, self-actualization.

Stages of pressure injury: 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.

Intake-output balance: 1 kg body weight change equals approximately 1 liter of fluid; normal adult urine output is at least 0.5 mL/kg/hour.

Six rights of medication administration: right patient, drug, dose, route, time, and documentation; verify with two identifiers.

Isotonic solutions (0.9% NaCl, LR) expand extracellular volume; hypotonic (0.45% NaCl) shifts fluid into cells; hypertonic (3% NaCl) pulls fluid out of cells.

Wound healing phases in order: hemostasis, inflammatory, proliferative, maturation (remodeling); the inflammatory phase lasts about 3-5 days.

Falls prevention bundle: bed in lowest position, brakes locked, call light within reach, non-skid footwear, hourly rounding, and bed alarm for high-risk patients.

Metabolic acidosis: pH <7.35 with HCO3 <22 mEq/L; respiratory compensation is hyperventilation producing decreased PaCO2.

Metabolic alkalosis: pH >7.45 with HCO3 >26 mEq/L; compensation is hypoventilation producing increased PaCO2.

Respiratory acidosis: pH <7.35 with PaCO2 >45 mmHg; causes include hypoventilation, COPD, and opioid overdose.

Respiratory alkalosis: pH >7.45 with PaCO2 <35 mmHg; causes include hyperventilation, pain, anxiety, and early salicylate toxicity.

Myocardial infarction markers rise in sequence: myoglobin first (1-4 h), then troponin (3-12 h, remains 7-14 days), then CK-MB (4-6 h).

Signs of digoxin toxicity: nausea, anorexia, visual changes (yellow-green halos), bradycardia; therapeutic range 0.5-2.0 ng/mL.

Hypoglycemia is blood glucose <70 mg/dL; treat conscious patient with 15 g fast-acting carbohydrate and recheck in 15 minutes.

Postoperative priority assessments follow ABC: airway patency, breathing/oxygenation, then circulation (pulse, BP, bleeding) before pain and wound checks.

Naegele rule for estimated due date: first day of last menstrual period minus 3 months plus 7 days plus 1 year.

Normal fetal heart rate is 110-160 beats/min; late decelerations indicate uteroplacental insufficiency and require repositioning and oxygen.

Variable decelerations indicate umbilical cord compression; respond with maternal position change and continued monitoring.

Stages of labor: first (latent and active cervical dilation), second (full dilation to birth), third (birth to placental delivery), fourth (first 1-2 hours postpartum).

Postpartum hemorrhage is blood loss >1000 mL after cesarean or >500 mL after vaginal birth; uterine atony is the most common cause; massage the fundus.

APGAR scores are assigned at 1 and 5 minutes for appearance, pulse, grimace, activity, and respiration; each 0-2, total 10.

Breast milk is the sole recommended nutrition for the first 6 months; iron-fortified foods begin around 6 months with continued breastfeeding.

Expected infant weight: doubles birth weight by 5-6 months and triples by 12 months; birth weight is regained by 2 weeks of age.

Serotonin syndrome triad: mental status changes, autonomic instability, and neuromuscular hyperactivity; onset usually within 24 hours of serotonergic agents.

Neuroleptic malignant syndrome: rigidity, high fever, altered consciousness, autonomic instability; associated with dopamine antagonists such as haloperidol.

Lithium therapeutic range is 0.6-1.2 mEq/L; toxicity signs include tremor, vomiting, and ataxia; maintain adequate sodium and hydration.

Alcohol withdrawal timeline: tremor and anxiety at 6-12 hours, hallucinations at 12-24 hours, withdrawal seizures at 24-48 hours, delirium tremens at 48-96 hours.

Clozapine requires regular absolute neutrophil count monitoring because of agranulocytosis risk.

Suicide risk assessment: ask directly about ideation, plan, intent, and access to means; highest risk is often shortly after discharge or during acute crisis.

Therapeutic communication techniques include open-ended questions, reflection, and silence; avoid false reassurance, advice-giving, and why questions.

Anorexia nervosa medical risks: bradycardia, hypotension, hypothermia, electrolyte imbalance (hypokalemia), and refeeding syndrome during early treatment.

Levels of prevention: primary (immunization, health education), secondary (screening, early detection), tertiary (rehabilitation, chronic disease management).

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

Attack rate equals number of new cases divided by population at risk, expressed as a percentage.

Herd immunity threshold depends on basic reproduction number: for measles roughly 92-95% of the population must be immune.

Epidemiologic triad: agent, host, and environment; disease occurs when these factors interact to favor transmission.

Notifiable disease reporting is mandated by law to local or state health authorities; examples include tuberculosis, measles, and foodborne illness clusters.

Sensitivity is the proportion of true positives correctly identified; specificity is the proportion of true negatives correctly identified.

Community assessment frameworks: windshield survey for visual observation, key informant interviews, and secondary data review of vital statistics.

Informed consent elements: patient competence, voluntary decision, disclosure of risks and benefits, and understanding of alternatives.

Nurse practice acts define scope of practice and licensure; each state board of nursing enforces them.

Mandatory reporting includes suspected child abuse, elder abuse, communicable diseases, and impaired colleagues; reporting is a legal duty.

Confidentiality exceptions: patient consent, legal subpoena, duty to warn of imminent harm, and mandatory reporting requirements.

Ethical principles: autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), veracity (truthfulness), fidelity (loyalty).

Advance directives include living wills and durable power of attorney for health care; a do-not-resuscitate order requires a physician order.

Negligence elements: duty, breach of duty, causation, and damages; all four must be established in a malpractice claim.

Delegation follows the five rights: right task, circumstance, person, direction/communication, and supervision; the RN retains accountability.

Normal adult vital signs: temperature 36.5-37.5 C, pulse 60-100/min, respirations 12-20/min, BP <120/80 mmHg, SpO2 95-100% on room air.

Maslow hierarchy orders intervention priority: physiologic needs (airway, breathing, circulation) before safety, then love/belonging, esteem, self-actualization.

Stages of pressure injury: 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.

Intake-output balance: 1 kg body weight change equals approximately 1 liter of fluid; normal adult urine output is at least 0.5 mL/kg/hour.

Six rights of medication administration: right patient, drug, dose, route, time, and documentation; verify with two identifiers.

Isotonic solutions (0.9% NaCl, LR) expand extracellular volume; hypotonic (0.45% NaCl) shifts fluid into cells; hypertonic (3% NaCl) pulls fluid out of cells.

Wound healing phases in order: hemostasis, inflammatory, proliferative, maturation (remodeling); the inflammatory phase lasts about 3-5 days.

Falls prevention bundle: bed in lowest position, brakes locked, call light within reach, non-skid footwear, hourly rounding, and bed alarm for high-risk patients.

Metabolic acidosis: pH <7.35 with HCO3 <22 mEq/L; respiratory compensation is hyperventilation producing decreased PaCO2.

Metabolic alkalosis: pH >7.45 with HCO3 >26 mEq/L; compensation is hypoventilation producing increased PaCO2.

Respiratory acidosis: pH <7.35 with PaCO2 >45 mmHg; causes include hypoventilation, COPD, and opioid overdose.

Respiratory alkalosis: pH >7.45 with PaCO2 <35 mmHg; causes include hyperventilation, pain, anxiety, and early salicylate toxicity.

Myocardial infarction markers rise in sequence: myoglobin first (1-4 h), then troponin (3-12 h, remains 7-14 days), then CK-MB (4-6 h).

Signs of digoxin toxicity: nausea, anorexia, visual changes (yellow-green halos), bradycardia; therapeutic range 0.5-2.0 ng/mL.

Hypoglycemia is blood glucose <70 mg/dL; treat conscious patient with 15 g fast-acting carbohydrate and recheck in 15 minutes.

Postoperative priority assessments follow ABC: airway patency, breathing/oxygenation, then circulation (pulse, BP, bleeding) before pain and wound checks.

Naegele rule for estimated due date: first day of last menstrual period minus 3 months plus 7 days plus 1 year.

Normal fetal heart rate is 110-160 beats/min; late decelerations indicate uteroplacental insufficiency and require repositioning and oxygen.

Variable decelerations indicate umbilical cord compression; respond with maternal position change and continued monitoring.

Stages of labor: first (latent and active cervical dilation), second (full dilation to birth), third (birth to placental delivery), fourth (first 1-2 hours postpartum).

Postpartum hemorrhage is blood loss >1000 mL after cesarean or >500 mL after vaginal birth; uterine atony is the most common cause; massage the fundus.

APGAR scores are assigned at 1 and 5 minutes for appearance, pulse, grimace, activity, and respiration; each 0-2, total 10.

Breast milk is the sole recommended nutrition for the first 6 months; iron-fortified foods begin around 6 months with continued breastfeeding.

Expected infant weight: doubles birth weight by 5-6 months and triples by 12 months; birth weight is regained by 2 weeks of age.

Serotonin syndrome triad: mental status changes, autonomic instability, and neuromuscular hyperactivity; onset usually within 24 hours of serotonergic agents.

Neuroleptic malignant syndrome: rigidity, high fever, altered consciousness, autonomic instability; associated with dopamine antagonists such as haloperidol.

Lithium therapeutic range is 0.6-1.2 mEq/L; toxicity signs include tremor, vomiting, and ataxia; maintain adequate sodium and hydration.

Alcohol withdrawal timeline: tremor and anxiety at 6-12 hours, hallucinations at 12-24 hours, withdrawal seizures at 24-48 hours, delirium tremens at 48-96 hours.

Clozapine requires regular absolute neutrophil count monitoring because of agranulocytosis risk.

Suicide risk assessment: ask directly about ideation, plan, intent, and access to means; highest risk is often shortly after discharge or during acute crisis.

Therapeutic communication techniques include open-ended questions, reflection, and silence; avoid false reassurance, advice-giving, and why questions.

Anorexia nervosa medical risks: bradycardia, hypotension, hypothermia, electrolyte imbalance (hypokalemia), and refeeding syndrome during early treatment.

Levels of prevention: primary (immunization, health education), secondary (screening, early detection), tertiary (rehabilitation, chronic disease management).

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

Attack rate equals number of new cases divided by population at risk, expressed as a percentage.

Herd immunity threshold depends on basic reproduction number: for measles roughly 92-95% of the population must be immune.

Epidemiologic triad: agent, host, and environment; disease occurs when these factors interact to favor transmission.

Notifiable disease reporting is mandated by law to local or state health authorities; examples include tuberculosis, measles, and foodborne illness clusters.

Sensitivity is the proportion of true positives correctly identified; specificity is the proportion of true negatives correctly identified.

Community assessment frameworks: windshield survey for visual observation, key informant interviews, and secondary data review of vital statistics.

Informed consent elements: patient competence, voluntary decision, disclosure of risks and benefits, and understanding of alternatives.

Nurse practice acts define scope of practice and licensure; each state board of nursing enforces them.

Mandatory reporting includes suspected child abuse, elder abuse, communicable diseases, and impaired colleagues; reporting is a legal duty.

Confidentiality exceptions: patient consent, legal subpoena, duty to warn of imminent harm, and mandatory reporting requirements.

Ethical principles: autonomy (self-determination), beneficence (do good), nonmaleficence (do no harm), justice (fairness), veracity (truthfulness), fidelity (loyalty).

Advance directives include living wills and durable power of attorney for health care; a do-not-resuscitate order requires a physician order.

Negligence elements: duty, breach of duty, causation, and damages; all four must be established in a malpractice claim.

Delegation follows the five rights: right task, circumstance, person, direction/communication, and supervision; the RN retains accountability.