Nursing Exam Cram Sheet for the NCLEX Nursing Exam Cram Sheet for the NCLEX-RN
The final mountain that nursing students must summit before becoming a
... [Show More] registered nurse is the NCLEX. Preparing for the NCLEX can be stressful as taking in colossal amounts of information has never been easy. This is where this cram sheet can help-- it contains condensed facts about the licensure exam and key nursing information. When exam time comes, you can write and transfer these vital information from your head to a blank sheet of paper provided by the testing center.
1. Test Information Six hours—the maximum time allotted for the NCLEX is 6 hours. Take breaks if you need a time out or need to move around.
75/265—the minimum number of questions you can answer is 75 and a maximum of 265.
Read the question and answers carefully—do not jump into conclusions or make wild guesses.
Look for keywords—Avoid answers with absolutes like always, never, all, every, only, must, except, none, or no.
Don’t read into the question—Never assume anything that has not been specifically mentioned and don’t add extra meaning to the question.
Eliminate answers that are clearly wrong or incorrect—to increase your probability of selecting the correct answer!
Watch for grammatical inconsistencies—Subjects and verbs should agree. If the question is an incomplete sentence, the correct answer should complete the question in a grammatically correct manner.
Rephrase the question—putting the question into your own words can pluck the unneeded info and reveal the core of the stem.
Make an educated guess—if you can’t make the best answer for a question after carefully reading it, choose the answer with the most information.
2. Vital Signs Heart rate: 80—100 bpm Respiratory rate: 12-20 rpm Blood pressure: 110-120/60 mmHg Temperature: 37 °C (98.6 °F)
3. Hematology values RBCs: 4.5—5.0 million WBCs: 5,000—10,000 Platelets: 200,000—400,000 Hemoglobin (Hgb): 12—16 gm (female); 14—18 gm (male).
Hematocrit (Hct): 37—47 (female); 40— 54 (male)
4. Serum electrolytes Sodium: 135—145 mEq/L Potassium: 3.5—5.5 mEq/L Calcium: 8.5—10.9 mEq/L Chloride: 95—105 mEq/L Magnesium: 1.5—2.5 mEq/L Phosphorus: 2.5—4.5 mEq/L
Via: http://nurseslabs.com/nclex-cram-sheet/
5. ABG Values pH: 7.36—7.45 HCO3: 24—26 mEq/L CO2: 35—45 mEq/L PaO2: 80%—100% SaO2: >95%
6. Acid-Base Balance Remember ROME (respiratory opposite/metabolic equal) to remember that in respiratory acid/base disorders the pH is opposite to the other components.
Use the Tic-Tac-Toe Method for interpreting ABGs. Read more about it here (http://bit.ly/abgtictactoe).
7. Chemistry Values Glucose: 70—110 mg/dL Specific Gravity: 1.010—1.030 BUN: 7-22 mg/dL Serum creatinine: 0.6—1.35 mg/dL LDH: 100-190 U/L Protein: 6.2—8.1 g/dL Albumin: 3.4—5.0 g/dL Bilirubin: <1.0 mg/dL Total Cholesterol: 130—200 mg/dL Triglyceride: 40—50 mg/dL Uric acid: 3.5—7.5 mg/dL CPK: 21-232 U/L8. Therapeutic Drug Levels
Carbamazepine (Tegretol): 4—10
mcg/ml
Digoxin (Lanoxin): 0.8—2.0 ng/ml
Gentamycin (Garamycin): 5—10 mcg/ml
(peak), <2.0 mcg/ml (valley)
Lithium (Eskalith): 0.8—1.5 mEq/L
Phenobarbital (Solfoton): 15—40
mcg/mL
Phenytoin (Dilantin): 10—20 mcg/dL
Theophylline (Aminophylline): 10—20
mcg/dL
Tobramycin (Tobrex): 5—10 mcg/mL
(peak), 0.5—2.0 mcg/mL (valley)
Valproic Acid (Depakene): 50—100
mcg/ml
Vancomycin (Vancocin): 20—40 mcg/ml
(peak), 5 to 15 mcg/ml (trough)
9. Anticoagulant therapy
Sodium warfarin (Coumadin) PT: 10—12
seconds (control). The antidote is
Vitamin K.
INR (Coumadin): 0.9—1.2
Heparin PTT: 30—45 seconds (control).
The antidote is protamine sulfate.
APTT: 23.3—31.9 seconds
Fibrinogen level: 203—377 mg/dL
10. Conversions
1 teaspoon (t) = 5 ml
1 tablespoon (T) = 3 t = 15 ml
1 oz = 30 ml
1 cup = 8 oz
1 quart = 2 pints
1 pint = 2 cups
1 grain (gr) = 60 mg
Via: http://nurseslabs.com/nclex-cram-sheet/
1 gram (g) = 1,000 mg
1 kilogram (kg) = 2.2 lbs
1 lb = 16 oz
Convert C to F: C+40 multiply by 9/5 and
subtract 40
Convert F to C: F+40 multiply by 5/9 and
subtract 40
11. Maternity Normal Values
Fetal Heart Rate: 120—160 bpm
Variability: 6—10 bpm
Amniotic fluid: 500—1200 ml
Contractions: 2—5 minutes apart with
duration of < 90 seconds and intensity
of <100 mmHg.
APGAR Scoring: Appearance, Pulses,
Grimace, Activity, Reflex Irritability. Done
at 1 and 5 minutes with a score of 0 for
absent, 1 for decreased, and 2 for
strongly positive. Scores 7 and above
are generally normal, 4 to 6 fairly low,
and 3 and below are generally regarded
as critically low.
AVA: The umbilical cord has two arteries
and one vein.
12. STOP—Treatment for maternal hypotension
after an epidural anesthesia:
Stop infusion of Pitocin.
Turn the client on her left side.
Administer oxygen.
If hypovolemia is present, push IV fluids.
13. Pregnancy Category of Drugs
Category A—No risk in controlled human
studies
Category B—No risk in other studies.
Examples: Amoxicillin, Cefotaxime.
Category C—Risk not ruled out.
Examples: Rifampicin (Rifampin),
Theophylline (Theolair).
Category D—Positive evidence of risk.
Examples: Phenytoin, Tetracycline.
Category X—Contraindicated in
Pregnancy. Examples: Isotretinoin
(Accutane), Thalidomide (Immunoprin),
etc.
Pregnancy Category N—Not yet
classified
14. Drug Schedules
Schedule I—no currently accepted
medical use and for research use only
(e.g., heroin, LSD, MDMA).
Schedule II—drugs with high potential
for abuse and requires written
prescription (e.g., Ritalin,
hydromorphone (Dilaudid), meperidine
(Demerol), and fentanyl).
Schedule III—requires new prescription
after six months or five refills (e.g.,
codeine, testosterone, ketamine).
Schedule IV—requires new prescription
after six months (e.g., Darvon, Xanax,
Soma, and Valium).
Schedule V—dispensed as any other
prescription or without prescription
(e.g., cough preparations, Lomotil,
Motofen).
15. Medication Classifications
Antacids—reduces hydrochloric acid in
the stomach.
Antianemics—increases blood cell
production. Anticholinergics—decreases oral
secretions.
dose. Check digitalis and potassium
levels.
Anticoagulants—prevents clot
formation,
Anticonvulsants—used for management
of seizures and/or bipolar disorders.
Antidiarrheals—decreases gastric
motility and reduce water in bowel.
Antihistamines—block the release of
histamine.
Antihypertensives—lower blood
pressure and increases blood flow.
Anti-infectives—used for the treatment
of infections,
Bronchodilators—dilates large air
passages in asthma or lung diseases
(e.g., COPD).
Diuretics—decreases water/sodium
from the Loop of Henle.
Laxatives—promotes the passage of
stool.
Miotics—constricts the pupils.
Mydriatics—dilates the pupils.
Narcotics/analgesics—relieves
moderate to severe pain.
16. Rules of nines for calculating Total Body
Surface Area (TBSA) for burns
Head: 9%
Arms: 18% (9% each)
Back: 18%
Legs: 36% (18% each)
Genitalia: 1%
17. Medications
Digoxin (Lanoxin)—Assess pulses for a
full minute, if less than 60 bpm hold
Via: http://nurseslabs.com/nclex-cram-sheet/
Aluminum Hydroxide (Amphojel)—
Treatment of GERD and kidney stones.
WOF constipation.
Hydroxyzine (Vistaril)—Treatment of
anxiety and itching. WOF dry mouth.
Midazolam (Versed)—given for
conscious sedation. WOF respiratory
depression and hypotension.
Amiodarone (Cordarone)—WOF
diaphoresis, dyspnea, lethargy. Take
missed dose any time in the day or to
skip it entirely. Do not take double dose.
Warfarin (Coumadin)—WOF for signs of
bleeding, diarrhea, fever, or rash. Stress
importance of complying with
prescribed dosage and follow-up
appointments.
Methylphenidate (Ritalin)—Treatment of
ADHD. Assess for heart related side-
effects and reported immediately. Child
may need a drug holiday because the
drug stunts growth.
Dopamine—Treatment of hypotension,
shock, and low cardiac output. Monitor
ECG for arrhythmias and blood pressure.
Rifampicin—causes red-orange tears
and urine.
Ethambutol—causes problems with
vision, liver problem.
Isoniazid—can cause peripheral neuritis,
take vitamin B6 to counter.
18. Developmental Milestones
2—3 months: able to turn head up, and
can turn side to side. Makes cooing or
gurgling noises and can turn head to
sound.
4—5 months: grasps, switch and roll
over tummy to back. Can babble and
can mimic sounds.
6—7 months: sits at 6 and waves bye-
bye. Can recognize familiar faces and
knows if someone is a stranger. Passes
things back and forth between hands.
8—9 months: stands straight at eight,
has favorite toy, plays peek-a-boo.
10—11 months: belly to butt.
12—13 months: twelve and up, drinks
from a cup. Cries when parents leave,
uses furniture to cruise.
19. Cultural Considerations
African Americans—May believe that
illness is caused by supernatural causes
and seek advice and remedies form faith
healers; they are family oriented; have
higher incidence of high blood pressure
and obesity; high incidence of lactose
intolerance with difficulty digesting milk
and milk products.
Arab Americans—May remain silent
about health problems such as STIs,
substance abuse, and mental illness; a
devout Muslim may interpret illness as
the will of Allah, a test of faith; may rely
on ritual cures or alternative therapies
before seeking help from health care
provider; after death, the family maywant to prepare the body by washing
and wrapping the body in unsewn white
cloth; postmortem examinations are
discouraged unless required by law.
May avoid pork and alcohol if Muslim.
Islamic patients observe month long
fast of Ramadan (begins approximately
mid-October); people suffering from
chronic illnesses, pregnant women,
breast-feeding, or menstruating don’t
fast. Females avoid eye contact with
males; use same-sex family members as
interpreters.
Asian Americans—May value ability to
endure pain and grief with silent
stoicism; typically family oriented;
extended family should be involved in
care of dying patient; believes in “hot-
cold” yin/yang often involved; sodium
intake is generally high because of
salted and dried foods; may believe
prolonged eye contact is rude and an
invasion of privacy; may not without
necessarily understanding; may prefer
to maintain a comfortable physical
distance between the patient and the
health care provider.
Latino Americans—May view illness as a
sign of weakness, punishment for evil
doing; may consult with a curandero or
voodoo priest; family members are
typically involved in all aspects of
decision making such as terminal
illness; may see no reason to submit to
mammograms or vaccinations.
Via: http://nurseslabs.com/nclex-cram-sheet/
Native Americans—May turn to a
medicine man to determine the true
cause of an illness; may value the ability
to endure pain or grief with silent
stoicism; diet may be deficient in
vitamin D and calcium because many
suffer from lactose intolerance or don’t
drink milk; obesity and diabetes are
major health concerns; may divert eyes
to the floor when they are praying or
paying attention.
Western Culture—May value technology
almost exclusively in the struggle to
conquer diseases; health is understood
to be the absence, minimization, or
control of disease process; eating
utensils usually consists of knife, fork,
and spoon; three daily meals is typical.
20. Common Diets
Acute Renal Disease—protein-restricted,
high-calorie, fluid-controlled, sodium and
potassium controlled.
Addison’s disease—increased sodium,
low potassium diet.
ADHD and Bipolar—high-calorie and
provide finger foods.
Burns—high protein, high caloric,
increase in Vitamin C.
Cancer—high-calorie, high-protein.
Celiac Disease—gluten-free diet (no
BROW: barley, rye, oat, and wheat).
Chronic Renal Disease—protein-
restricted, low-sodium, fluid-restricted,
potassium-restricted, phosphorus-
restricted.
Cirrhosis (stable)—normal protein
Cirrhosis with hepatic insufficiency—
restrict protein, fluids, and sodium.
Constipation—high-fiber, increased
fluids
COPD—soft, high-calorie, low-
carbohydrate, high-fat, small frequent
feedings
Cystic Fibrosis—increase in fluids.
Diarrhea—liquid, low-fiber, regular, fluid
and electrolyte replacement
Gallbladder diseases—low-fat, calorie-
restricted, regular
Gastritis—low-fiber, bland diet
Hepatitis—regular, high-calorie, high-
protein
Hyperlipidemias—fat-controlled, calorie-
restricted
Hypertension, heart failure, CAD—low-
sodium, calorie-restricted, fat-controlled
Kidney Stones—increased fluid intake,
calcium-controlled, low-oxalate
Nephrotic Syndrome—sodium-restricted,
high-calorie, high-protein, potassium-
restricted.
Obesity, overweight—calorie-restricted,
high-fiver
Pancreatitis—low-fat, regular, small
frequent feedings; tube feeding or total
parenteral nutrition.
Peptic ulcer—bland diet
Pernicious Anemia—increase Vitamin
B12 (Cobalamin), found in high amounts
on shellfish, beef liver, and fish. Sickle Cell Anemia—increase fluids to
maintain hydration since sickling
increases when patients become
dehydrated.
Air/Pulmonary embolism—turn patient
to left side and lower HOB.
Stroke—mechanical soft, regular, or
tube-feeding.
Underweight—high-calorie, high protein
Vomiting—fluid and electrolyte
replacement
21. Positioning Clients
Asthma—orthopneic position where
patient is sitting up and bent forward
with arms supported on a table or chair
arms.
Post Bronchoscopy—flat on bed with
head hyperextended.
Cerebral Aneurysm—high Fowler’s.
Hemorrhagic Stroke: HOV elevated 30
degrees to reduce ICP and facilitate
venous drainage.
Ischemic Stroke: HOB flat.
Cardiac Catheterization—keep site
extended.
Epistaxis—lean forward.
Above Knee Amputation—elevate for
first 24 hours on pillow, position on
prone daily for hip extension.
Below Knee Amputation—foot of bed
elevated for first 24 hours, position
prone daily for hip extension.
Tube feeding for patients with
decreased LOC—position patient on
right side to promote emptying of the
stomach with HOB elevated to prevent
aspiration.
Via: http://nurseslabs.com/nclex-cram-sheet/
Postural Drainage—Lung segment to be
drained should be in the uppermost
position to allow gravity to work.
Post Lumbar puncture—patient should
lie flat in supine to prevent headache
and leaking of CSF.
Continuous Bladder Irrigation (CBI)—
catheter should be taped to thigh so
legs should be kept straight.
After myringotomy—position on the side
of affected ear after surgery (allows
drainage of secretion).
Post cataract surgery—patient will sleep
on unaffected side with a night shield
for 1-4 weeks.
Detached retina—area of detachment
should be in the dependent position.
Post thyroidectomy—low or semi-
Fowlers, support head, neck and
shoulders.
Thoracentesis—sitting on the side of the
bed and leaning over the table (during
procedure); affected side up (after
procedure).
Spina Bifida— position infant on prone
so that sac does not rupture.
Buck’s Traction—elevate foot of bed for
counter-traction.
Post Total Hip Replacement—don’t
sleep on operated side, don’t flex hip
more than 45-60 degrees, don’t elevate
HOB more than 45 degrees. Maintain hip
abduction by separating thighs with
pillows.
Prolapsed cord—knee-chest position or
Trendelenburg.
Cleft-lip—position on back or in infant
seat to prevent trauma to the suture
line. While feeding, hold in upright
position.
Cleft-palate—prone.
Hemorrhoidectomy—assist to lateral
position.
Hiatal Hernia—upright position.
Preventing Dumping Syndrome—eat in
reclining position, lie down after meals
for 20-30 minutes (also restrict fluids
during meals, low fiber diet, and small
frequent meals).
Enema Administration—position patient
in left-side lying (Sim’s position) with
knees flexed.
Post supratentorial surgery (incision
behind hairline)—elevate HOB 30-45
degrees.
Post infratentorial surgery (incision at
nape of neck)—position patient flat and
lateral on either side.
Increased ICP—high Fowler’s.
Laminectomy—back as straight as
possible; log roll to move and sand bag
on sides.
Spinal Cord Injury—immobilize on spine
board, with head in neutral position.
Immobilize head with padded C-collar,
maintain traction and alignment of headmanually. Log roll client and do not
allow client to twist or bend.
Liver Biopsy—right side lying with pillow
or small towel under puncture site for at
least 3 hours.
Paracentesis—flat on bed or sitting.
Intestinal Tubes—place patient on right
side to facilitate passage into
duodenum.
Nasogastric Tubes—elevate HOB 30
degrees to prevent aspiration. Maintain
elevation for continuous feeding or
1hour after intermittent feedings.
Pelvic Exam—lithotomy position.
Rectal Exam—knee-chest position,
Sim’s, or dorsal recumbent.
During internal radiation—patient should
be on bed rest while implant is in place.
Autonomic Dysreflexia—place client in
sitting position (elevate HOB) first
before any other implementation.
Shock—bed rest with extremities
elevated 20 degrees, knees straight,
head slightly elevated (modified
Trendelenburg).
Head Injury—elevate HOB 30 degrees to
decrease intracranial pressure.
Peritoneal Dialysis when outflow is
inadequate—turn patient side to side
before checking for kinks in the tubing.
Myelogram
Water-based dye—semi Fowler’s
for at least 8 hours.
Oil-based dye—flat on bed for at
least 6-8 hours to prevent leakage
of CSF.
Air dye—Trendelenburg.
22. Common Signs and Symptoms
Pulmonary Tuberculosis (PTB)—low-
grade afternoon fever.
Pneumonia—rust-colored sputum.
Asthma—wheezing on expiration.
Emphysema—barrel chest.
Kawasaki Syndrome—strawberry
tongue.
Pernicious Anemia—red beefy tongue.
Down syndrome—protruding tongue.
Cholera—rice-watery stool and washer
woman’s hands (wrinkled hands from
dehydration).
Malaria—stepladder like fever with
chills.
Typhoid—rose spots in the abdomen.
Dengue—fever, rash, and headache.
Positive Herman’s sign.
Diphtheria—pseudo membrane
formation.
Measles—Koplik’s spots (clustered
white lesions on buccal mucosa).
Systemic Lupus Erythematosus—
butterfly rash.
Leprosy—leonine facies (thickened
folded facial skin).
Bulimia—chipmunk facies (parotid gland
swelling).
Appendicitis—rebound tenderness at
McBurney’s point. Rovsing’s sign
(palpation of LLQ elicits pain in RLQ).
Via: http://nurseslabs.com/nclex-cram-sheet/
Psoas sign (pain from flexing the thigh
to the hip).
Meningitis—Kernig’s sign (stiffness of
hamstrings causing inability to
straighten the leg when the hip is flexed
to 90 degrees), Brudzinski’s sign (forced
flexion of the neck elicits a reflex flexion
of the hips).
Tetany—hypocalcemia, [+] Trousseau’s
sign; Chvostek sign.
Tetanus— Risus sardonicus or rictus
grin.
Pancreatitis—Cullen’s sign (ecchymosis
of the umbilicus), Grey Turner’s sign
(bruising of the flank).
Pyloric Stenosis—olive like mass.
Patent Ductus Arteriosus—washing
machine-like murmur.
Addison’s disease—bronzelike skin
pigmentation.
Cushing’s syndrome—moon face
appearance and buffalo hump.
Grave’s Disease (Hyperthyroidism)—
Exophthalmos (bulging of the eye out of
the orbit).
Intussusception—Sausage-shaped
mass.
Multiple Sclerosis—Charcot’s Triad:
nystagmus, intention tremor, and
dysarthria.
Myasthenia Gravis—descending muscle
weakness, ptosis (drooping of eyelids).
Guillain-Barre Syndrome—ascending
muscles weakness. Deep vein thrombosis (DVT)—Homan’s Sign.
Angina—crushing, stabbing pain relieved by NTG.
Myocardial Infarction (MI)—crushing, stabbing pain radiating to left shoulder, neck, and arms. Unrelieved by NTG.
Parkinson’s disease—pill-rolling tremors. Cytomegalovirus (CMV) infection—Owl’s eye appearance of cells (huge nucleus in cells).
Glaucoma—tunnel vision. Retinal Detachment—flashes of light, shadow with curtain across vision.
Basilar Skull Fracture—Raccoon eyes (periorbital ecchymosis) and Battle’s sign (mastoid ecchymosis).
Buerger’s Disease—intermittent claudication (pain at buttocks or legs from poor circulation resulting in impaired walking).
Diabetic Ketoacidosis—acetone breathe. Pregnancy Induced Hypertension (PIH)—proteinuria, hypertension, edema.
Diabetes Mellitus—polydipsia, polyphagia, polyuria.
Gastroesophageal Reflux Disease (GERD)—heart burn.
Hirschsprung’s Disease (Toxic Megacolon)—ribbon-like stool.
Sexual Transmitted Infections: Herpes Simplex Type II—painful vesicles on genitalia
Genital Warts—warts 1-2 mm in diameter.
Via: http://nurseslabs.com/nclex-cram-sheet/
Syphilis—painless chancres Chancroid—painful chancres. Gonorrhea—green, creamy discharges and painful urination.
Chlamydia—milky discharge and painful urination.
Candidiasis—white cheesy odorless vaginal discharges.
Trichomoniasis—yellow, itchy, frothy, and foul-smelling vaginal discharges.
23. Miscellaneous Tips Delegate sterile skills (e.g., dressing change) to the RN or LPN.
Where non-skilled care is required, delegate the stable client to the nursing assistant.
Assign the most critical client to the RN. Clients who are being discharged should have final assessments done by the RN.
The Licensed Practical Nurse (LPN) can monitor clients with IV therapy, insert urinary catheters, feeding tubes, and apply restraints.
Assessment, teaching, medication administration, evaluation, unstable patients cannot be delegated to an unlicensed assistive personnel.
Weight is the best indicator of dehydration.
When patient is in distress, administration of medication is rarely the best choice.
Always check for allergies before administering antibiotics.
Neutropenic patients should not receive vaccines, fresh fruits, or flowers.
Nitroglycerine patch is administered up to three times with intervals of five minutes.
Morphine is contraindicated in pancreatitis because it causes spasms of the Sphincter of Oddi. Demerol should be given.
Never give potassium (K+) in IV push. Infants born to an HIV-positive mother should receive all immunizations of schedule.
Gravida is the number of pregnancies a woman has had, regardless of outcome.
Para is the number of pregnancies [Show Less]