Taiwan Registered Nurse Licensing Examination cheat sheet

Normal adult vital signs: oral temperature 36.5-37.5 C, pulse 60-100/min, respirations 12-20/min, blood pressure below 120/80 mmHg.

Cardiac output equals heart rate multiplied by stroke volume; mean arterial pressure approximates diastolic pressure plus one-third of pulse pressure.

Body fluid compartments: intracellular fluid is about two-thirds and extracellular fluid about one-third of total body water; plasma is roughly one-quarter of extracellular fluid.

Inflammation cardinal signs are redness, heat, swelling, pain, and loss of function; these arise from vasodilation and increased capillary permeability.

Gram-positive bacteria retain crystal violet due to a thick peptidoglycan layer; gram-negative cells have a thin layer plus an outer membrane containing endotoxin.

Autonomic opposites: sympathetic stimulation raises heart rate and dilates bronchioles and pupils; parasympathetic stimulation slows heart rate and promotes digestion.

Wound healing by primary intention occurs in clean approximated edges; secondary intention applies to open wounds healing by granulation.

Isotonic solutions (0.9% saline, lactated Ringer) expand extracellular volume; hypotonic solutions shift water into cells and can cause swelling.

Left-sided heart failure produces pulmonary congestion (dyspnea, crackles, orthopnea); right-sided failure produces systemic congestion (edema, jugular venous distention, hepatomegaly).

Myocardial infarction triage: ST-elevation myocardial infarction requires reperfusion, and aspirin is chewed early unless contraindicated.

Hypoglycemia signs (sweating, tremor, confusion) are treated with 15 g fast-acting oral carbohydrate if conscious; unconscious patients need IV glucose or glucagon.

Diabetic ketoacidosis presents with hyperglycemia, ketonemia, metabolic acidosis, and Kussmaul respirations; total body potassium is depleted even if serum potassium is normal.

Chronic obstructive pulmonary disease: use low-flow controlled oxygen, pursed-lip breathing, and assess for CO2 retention; barrel chest and prolonged expiration are typical.

Acute kidney injury oliguric phase shows rising creatinine and potassium; hyperkalemia is the most immediately life-threatening electrolyte disturbance.

Stroke: thrombolysis window is generally within 4.5 hours of symptom onset; sudden facial droop, arm weakness, and speech difficulty are warning signs.

Postoperative care priorities: airway patency, vital signs, pain control, early ambulation, and monitoring for deep vein thrombosis and atelectasis.

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

First stage of labor extends from onset of regular contractions to full cervical dilation (10 cm); second stage runs from full dilation to delivery of the baby.

Fetal heart rate normal range is 110-160 beats/min; late decelerations suggest uteroplacental insufficiency and require repositioning and oxygen.

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

Preeclampsia is hypertension after 20 weeks with proteinuria or end-organ dysfunction; magnesium sulfate prevents seizures and requires monitoring of reflexes and respirations.

Lochia progresses from rubra (days 1-3), to serosa (days 4-10), to alba (after about day 10).

Human chorionic gonadotropin rises early in pregnancy and is the target of urine and serum pregnancy tests.

Ovulation generally occurs about 14 days before the next menstrual period, making the fertile window the mid-cycle days.

Pediatric vital signs fall with age: newborns have heart rates near 120-160/min and respirations near 30-60/min; school-age children approach adult values.

Infant weight typically doubles by 4-5 months and triples by 12 months; birth weight is regained by about 2 weeks.

Developmental milestones: head control by about 3 months, sitting with support by 6 months, sitting alone by 8 months, walking by 12-15 months.

Dehydration in children is assessed by fontanel status, mucous membranes, tears, urine output, and capillary refill; infants dehydrate faster due to higher body water.

Pediatric drug dosing is weight-based (mg/kg); always verify weight and use the prescribed maximum dose before administration.

Croup causes barking cough and inspiratory stridor; epiglottitis causes drooling, tripod positioning, and muffled voice and requires airway protection without throat examination.

Kawasaki disease diagnostic features include fever over 5 days, conjunctivitis, rash, cervical lymphadenopathy, and mucosal and extremity changes; coronary artery monitoring is essential.

Fever in an infant under 3 months warrants urgent evaluation because of immature immune response and risk of serious bacterial infection.

Therapeutic communication uses open-ended questions, reflection, and clarification; avoid false reassurance, giving advice, and changing the subject.

Priority in psychiatric emergencies: ensure safety, remove harmful objects, and assess suicide risk directly and calmly.

Serotonin syndrome presents with agitation, hyperreflexia, tremor, and fever after serotonergic drugs; neuroleptic malignant syndrome presents with rigidity, hyperthermia, and autonomic instability.

Extrapyramidal side effects of antipsychotics include acute dystonia, akathisia, parkinsonism, and tardive dyskinesia; anticholinergic drugs treat the first three.

Lithium therapeutic serum level is roughly 0.6-1.2 mEq/L; toxicity shows tremor, vomiting, ataxia, and confusion and is worsened by dehydration.

Alcohol withdrawal can progress to delirium tremens with tremor, hallucinations, and seizures; benzodiazepines are the mainstay of treatment.

Delirium has acute onset with fluctuating attention; dementia has gradual, progressive cognitive decline with stable consciousness.

Stages of grief described by Kubler-Ross are denial, anger, bargaining, depression, and acceptance; they are not strictly sequential.

Levels of prevention: primary prevents disease before onset (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 or over a period.

Epidemiologic triad is host, agent, and environment; breaking any link interrupts disease transmission.

Herd immunity threshold depends on pathogen transmissibility; higher basic reproduction number requires higher vaccination coverage.

Reportable communicable diseases must be reported to public health authorities within mandated timeframes for outbreak control.

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

Home visit sequence: establish rapport, assess the family and environment, identify needs, plan with the family, and evaluate outcomes.

Occupational and environmental exposure assessment includes identifying the hazard, route of exposure, duration, and susceptible populations.