Nursing Cram Sheet for the NCLEX-RN

The final mountain that nursing students must summit before becoming a 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 this vital information from your head to a blank sheet of paper provided by the testing center.

1 . T E S T IN F O R M A T IO N 3. HEMATOLOGYVALUES 7. C H E M IS T R Y V A L U E S

Six hours the maximum time allotted for the RBCs: 4.5 5.0 million Glucose: 70 110 mg/dL
NCLEX is 6 hours. Take breaks if you need a time WBCs: 5,000 10,000 Specific Gravity: 1.010 1.030
out or need to move around. Platelets: 200,000 400,000 BUN: 7-22 mg/dL
75/265 the minimum number of question you can Hemoglobin (Hgb): 12 16 gm (F); 14 18 gm Serum creatinine: 0.6 1.35 mg/dL
answer is 75 and a maximum of 265. (M). LDH: 100-190 U/L
Read the question and answers carefully do Hematocrit (Hct): 37 47 (F); 40 54 (M) Protein: 6.2 8.1 g/dL
not jump into conclusions or make wild guesses. Albumin: 3.4 5.0 g/dL
Look for keywords avoid answers with 4. SERUMELECTROLYTES Bilirubin: <1.0 mg/dL
absolutes like always, never, all, every, only, must, Total Cholesterol: 130 200 mg/dL
except, none, or no. Triglyceride: 40 50 mg/dL
Sodium: 135 145 mEq/L
Dont read into the question Never assume
Potassium: 3.5 5.5 mEq/L Uric acid: 3.5 7.5 mg/dL
anything that has not been specifically mentioned
Calcium: 8.5 10.9 mEq/L CPK: 21-232 U/L
and dont add extra meaning to the question.
Eliminate answers that are clearly wrong or Chloride: 95 105 mEq/L
Magnesium: 1.5 2.5 mEq/L 8. T H E R A P E U T IC D R U G L E V E L S
incorrect to increase your probability of
selecting the correct answer! Phosphorus: 2.5 4.5 mEq/L
Watch for grammatical inconsistencies Carbamazepine (Tegretol): 4 10 mcg/ml
Subjects and verbs should agree. If the question is 5. ABGVALUES Digoxin (Lanoxin): 0.8 2.0 ng/ml
an incomplete sentence, the correct answer Gentamycin (Garamycin): 5 10 mcg/ml
should complete the question in a grammatically pH: 7.36 7.45 (peak), <2.0 mcg/ml (valley)
correct manner. HCO3: 24 26 mEq/L Lithium (Eskalith): 8 1.5 mEq/L
Rephrase the question putting the question into
2
CO : 35 45 mEq/L Phenobarbital (Solfoton): 15 40 mcg/mL
your own words can pluck the unneeded info and PaO2: 80% 100% Phenytoin (Dilantin): 10 20 mcg/dL
reveal the core of the stem. Theophylline (Aminophylline): 10 20 mcg/dL
SaO2: >95
Make an educated guess if you cant make the Tobramycin (Tobrex): 5 10 mcg/mL (peak), 0.5
best answer for a question after carefully reading 2.0 mcg/mL (valley)
6. A C ID - B A S E B A L A N C E
it, choose the answer with the most information. Valproic Acid (Depakene): 50 100 mcg/ml
Remember ROME (respiratory opposite/metabolic Vancomycin (Vancocin): 20 40 mcg/ml (peak), 5
2 . V IT A L S IG N S to 15 mcg/ml (trough)
equal) to remember that in respiratory acid/base
disorders the pH is opposite to the other
Heart rate: 80 100 bpm
components.
Respiratory rate: 12-20 rpm Use the Tic-Tac-Toe Method for interpreting ABGs.
Blood pressure: 110-120/60 mmHg Read more about it here
Temperature: 37 C (98.6 F) (http://bit.ly/abgtictactoe).
9. A N T IC O A G U L A N T T H E R A P Y 1 2 . A P G A R S C O R IN G 15.DRUGSCHEDULES

Sodium warfarin (Coumadin) PT: 10 12 Appearance, Pulses, Grimace, Activity, Reflex Schedule I no currently accepted medical use
seconds (control). The antidote is Vitamin K. Irritability. and for research use only (e.g., heroin, LSD,
INR (Coumadin): 0.9 1.2 Done at 1 and 5 minutes with a score of 0 for MDMA).
Heparin PTT: 30 45 seconds (control). The absent, 1 for decreased, and 2 for strongly positive. Schedule II drugs with high potential for abuse
antidote is protamine sulfate. Scores 7 and above are generally normal, 4 to 6 and requires written prescription (e.g., Ritalin,
APTT: 3 31.9 seconds fairly low, and 3 and below are generally regarded hydromorphone (Dilaudid), meperidine (Demerol),
Fibrinogen level: 203 377 mg/dL as critically low. and fentanyl).
Schedule III requires new prescription after six
1 0 . U N IT C O N V E R S IO N S 1 3 . E P ID U R A L A N E S T H E S IA : S T O P months or five refills (e.g., codeine, testosterone,
ketamine).
STOP is a treatment for maternal hypotension after Schedule IV requires new prescription after six
1 teaspoon (t) = 5 ml
an epidural anesthesia. months (e.g., Darvon, Xanax, Soma, and Valium).
1 tablespoon (T) = 3 t = 15 ml
Stop infusion of Pitocin. Schedule V dispensed as any other prescription
1 oz = 30 ml or without prescription (e.g., cough preparations,
1 cup = 8 oz Turn the client on her left side.
Lomotil, Motofen).
1 quart = 2 pints Oxygen therapy.
1 pint = 2 cups Push IV fluids, if hypovolemia is present.
1 6 . M E D IC A T IO N C L A S S IF IC A T IO N S
1 grain (gr) = 60 mg
1 gram (g) = 1,000 mg 14.PREGNANCYCATEGORYOFDRUGS
Antacids reduces hydrochloric acid in the
1 kilogram (kg) = 2.2 lbs stomach.
1 lb = 16 oz Category A No risk in controlled human studies
Antianemics increases blood cell production.
Convert C to F: C+40 multiply by 9/5 and subtract Category B No risk in other studies. Examples: Anticholinergics decreases oral secretions.
40 Amoxicillin, Cefotaxime.
Anticoagulants prevents clot formation,
Convert F to C: F+40 multiply by 5/9 and subtract Category C Risk not ruled out. Examples:
Anticonvulsants used for management of
40 Rifampicin (Rifampin), Theophylline (Theolair).
seizures and/or bipolar disorders.
Category D Positive evidence of risk. Examples:
Antidiarrheals decreases gastric motility
1 1 . M A T E R N IT Y N O R M A L V A LU E S Phenytoin, Tetracycline.
and reduce water in bowel.
Category X Contraindicated in Pregnancy.
Antihistamines block the release of histamine.
Fetal Heart Rate: 120 160 bpm Examples: Isotretinoin (Accutane), Thalidomide
Antihypertensives lower blood pressure and
Variability: 6 10 bpm (Immunoprin), etc.
increases blood flow.
Category N Not yet classified
Amniotic fluid: 500 1200 ml Anti-infectives used for the treatment of
Contractions: 2 5 minutes apart with duration infections,
of < 90 seconds and intensity of <100 mmHg. Bronchodilators dilates large air passages
AVA: The umbilical cord has two arteries and one in asthma or lung diseases (e.g., COPD).
vein. Diuretics decreases water/sodium from the
Loop of Henle.
Laxatives promotes the passage of stool.
Miotics constricts the pupils.
Mydriatics dilates the pupils. 2
Narcotics/analgesics relieves moderate
to severe pain.
1 7 . R U L E O F N IN E S Ethambutol causes problems with vision,
Midazolam (Versed) given for conscious liver problem.
sedation. Watch out for (WOF) respiratory Isoniazid can cause peripheral neuritis, take
For calculating Total Body Surface Area (TBSA) for
depression and hypotension. vitamin B6 to counter.
burns:
Amiodarone (Cordarone) WOF diaphoresis,
Head and neck: 9%
dyspnea, lethargy. Take missed dose any time in 1 9 . D E V E L O P M E N T A L M IL E S T O N E S
Upper limbs: 18% (9% each)
the day or to skip it entirely. Do not take double
Anterior torso: 18%
dose. 2 3 months: able to turn head up, and can turn
Posterior torso: 18% Warfarin (Coumadin) WOF for signs of bleeding, side to side. Makes cooing or gurgling noises and
Legs: 36% (18% each) diarrhea, fever, or rash. Stress importance of
Genitalia: 1% can turn head to sound.
complying with prescribed dosage and follow-up
4 5 months: grasps, switch and roll over tummy
appointments.
1 8 . M E D IC A T IO N S to back. Can babble and can mimic sounds.
Methylphenidate (Ritalin) Treatment of ADHD.
6 7 months: sits at 6 and waves bye-bye. Can
Assess for heart related side-effects and reported
recognize familiar faces and knows if someone is
Digoxin (Lanoxin) Assess pulses for a full immediately. Child may need a drug holiday
a stranger. Passes things back and forth between
minute, if less than 60 bpm hold dose. Check because the drug stunts growth.
hands.
digitalis and potassium levels. Dopamine Treatment of hypotension, shock, and
8 9 months: stands straight at eight, has
Aluminum Hydroxide (Amphojel) Treatment of low cardiac output. Monitor ECG for arrhythmias
favorite toy, plays peek-a-boo.
GERD and kidney stones. WOF constipation. and blood pressure.
10 11 months: belly to butt.
Hydroxyzine (Vistaril) Treatment of anxiety and Rifampicin causes red-orange tears and urine.
12 13 months: twelve and up, drinks from a cup.
itching. WOF dry mouth. Cries when parents leave, uses furniture to cruise.

2 0 . C U L T U R A L C O N S ID E R A T IO N S

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 may want 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 dont 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.
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 dont 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 typica
3
2 1 . C O M M O N D IE T S

Acute Renal Disease protein-restricted, Cirrhosis with hepatic insufficiency restrict Nephrotic Syndrome sodium-restricted, high-
high-calorie, fluid-controlled, sodium and protein, fluids, and sodium. calorie, high-protein, potassium-restricted.
potassium controlled. Constipation high-fiber, increased fluids Obesity, overweight calorie-restricted, high-fiver
Addisons disease increased sodium, low COPD soft, high-calorie, low-carbohydrate, Pancreatitis low-fat, regular, small frequent
potassium diet. high-fat, small frequent feedings feedings; tube feeding or total parenteral nutrition.
ADHD and Bipolar high-calorie and Cystic Fibrosis increase in fluids. Peptic ulcer bland diet
provide finger foods. Diarrhea liquid, low-fiber, regular, fluid and Pernicious Anemia increase Vitamin B12
Burns high protein, high caloric, increase electrolyte replacement (Cobalamin), found in high amounts on shellfish,
in Vitamin C. Gallbladder diseases low-fat, calorie- beef liver, and fish.
Cancer high-calorie, high-protein. restricted, regular Sickle Cell Anemia increase fluids to maintain
Celiac Disease gluten-free diet (no BROW: Gastritis low-fiber, bland diet hydration since sickling increases when patients
barley, rye, oat, and wheat). Hepatitis regular, high-calorie, high-protein become dehydrated.
Chronic Renal Disease protein-restricted, low- Hyperlipidemias fat-controlled, calorie-restricted Stroke mechanical soft, regular, or tube-feeding.
sodium, fluid-restricted, potassium-restricted, Hypertension, heart failure, CAD low- Underweight high-calorie, high protein
phosphorus-restricted. sodium, calorie-restricted, fat-controlled Vomiting fluid and electrolyte replacement
Cirrhosis (stable) normal protein Kidney Stones increased fluid intake, calcium-
controlled, low-oxalate

2 2 . P O S IT IO N IN G C L IE N T S

Asthma Orthopneic position where patient is the stomach with HOB elevated to prevent Post thyroidectomy low or semi-Fowlers,
sitting up and bent forward with arms supported aspiration. support head, neck and shoulders.
on a table or chair arms. Air/Pulmonary embolism turn patient to left side Thoracentesis sitting on the side of the bed and
Post Bronchoscopy flat on bed with and lower HOB. leaning over the table (during procedure); affected
head hyperextended. Postural Drainage Lung segment to be drained side up (after procedure).
Cerebral Aneurysm high Fowlers. should be in the uppermost position to allow Spina Bifida position infant on prone so that sac
Hemorrhagic Stroke HOV elevated 30 degrees gravity to work. does not rupture.
to reduce ICP and facilitate venous drainage. Post Lumbar puncture patient should lie flat in Bucks Traction elevate foot of bed for counter-
Ischemic Stroke HOB flat. supine to prevent headache and leaking of CSF. traction.
Cardiac Catheterization keep site extended. Continuous Bladder Irrigation (CBI) Post Total Hip Replacement dont sleep on
Epistaxis lean forward. catheter should be taped to thigh so legs should operated side, dont flex hip more than 45-60
Above Knee Amputation elevate for first 24 be kept straight. degrees, dont elevate HOB more than 45 degrees.
hours on pillow, position on prone daily for hip After myringotomy position on the side of Maintain hip abduction by separating thighs with
extension. affected ear after surgery (allows drainage of pillows.
Below Knee Amputation foot of bed elevated for secretion). Prolapsed cord knee-chest position or
first 24 hours, position prone daily for hip extension. Post cataract surgery patient will sleep on Trendelenburg.
Tube feeding for patients with decreased LOC unaffected side with a night shield for 1-4 weeks. Cleft-lip position on back or in infant seat to
position patient on right side to promote emptying of Detached retina area of detachment should be prevent trauma to the suture line. While feeding, 4
in the dependent position. hold in upright position.
Cleft-palate prone.
 Hemorrhoidectomy assist to lateral position. padded C-collar, maintain traction and alignment of Autonomic Dysreflexia place client in
Hiatal Hernia upright position. head manually. Log roll client and do not allow sitting position (elevate HOB) first before any
Preventing Dumping Syndrome eat in reclining client to twist or bend. other implementation.
position, lie down after meals for 20-30 minutes Liver Biopsy right side lying with pillow or small Shock bed rest with extremities elevated 20
(also restrict fluids during meals, low fiber diet, and towel under puncture site for at least 3 hours. degrees, knees straight, head slightly
small frequent meals). Paracentesis flat on bed or sitting. elevated (modified Trendelenburg).
Enema Administration position patient in left- Intestinal Tubes place patient on right side to Head Injury elevate HOB 30 degrees to
side lying (Sims position) with knees flexed. facilitate passage into duodenum. decrease intracranial pressure.
Post supratentorial surgery (incision behind Nasogastric Tubes elevate HOB 30 degrees to Peritoneal Dialysis when outflow is inadequate
hairline) elevate HOB 30-45 degrees. prevent aspiration. Maintain elevation for turn patient side to side before checking for kinks
Post infratentorial surgery (incision at nape continuous feeding or 1hour after intermittent in the tubing.
of neck) position patient flat and lateral on feedings. Myelogram Water-based dye semi Fowlers for
either side. Rectal Exam knee-chest position, Sims, or at least 8 hours.
Increased ICP high Fowlers. dorsal recumbent. Myelogram Oil-based dye flat on bed for at least
Laminectomy back as straight as possible; log During internal radiation patient should be on 6-8 hours to prevent leakage of CSF.
roll to move and sand bag on sides. bed rest while implant is in place. Myelogram Air dye Trendelenburg
Spinal Cord Injury immobilize on spine board,
with head in neutral position. Immobilize head with
2 3 . C O M M O N S IG N S A N D S Y M P T O M S

Pulmonary Tuberculosis (PTB) low-grade Appendicitis rebound tenderness at McBurneys Graves Disease (Hyperthyroidism)
afternoon fever. point. Rovsings sign (palpation of LLQ elicits pain Exophthalmos (bulging of the eye out of the orbit).
Pneumonia rust-colored sputum. in RLQ). Psoas sign (pain from flexing the thigh to Intussusception Sausage-shaped mass.
Asthma wheezing on expiration. the hip). Multiple Sclerosis Charcots Triad: nystagmus,
Emphysema barrel chest. Meningitis Kernigs sign (stiffness of hamstrings intention tremor, and dysarthria.
Kawasaki Syndrome strawberry tongue. causing inability to straighten the leg when the hip Myasthenia Gravis descending muscle
Pernicious Anemia red beefy tongue. is flexed to 90 degrees), Brudzinskis sign (forced weakness, ptosis (drooping of eyelids).
Down syndrome protruding tongue. flexion of the neck elicits a reflex flexion of the Guillain-Barre Syndrome ascending muscles
Cholera rice-watery stool and washer womans hips). weakness.
hands (wrinkled hands from dehydration).
Tetany hypocalcemia, [+] Trousseaus sign; Deep vein thrombosis (DVT) Homans Sign.
Chvostek sign. Angina crushing, stabbing pain relieved by NTG.
Malaria stepladder like fever with chills.
Tetanus Risus sardonicus or rictus grin. Myocardial Infarction (MI) crushing,
Typhoid rose spots in the abdomen.
Pancreatitis Cullens sign (ecchymosis of the stabbing pain radiating to left shoulder, neck,
Dengue fever, rash, and headache. Positive
umbilicus), Grey Turners sign (bruising of the and arms. Unrelieved by NTG.
Hermans sign.
flank). Parkinsons disease pill-rolling tremors.
Diphtheria pseudomembrane formation.
Pyloric Stenosis olive like mass. Cytomegalovirus (CMV) infection Owls eye
Measles Kopliks spots (clustered white lesions
Patent Ductus Arteriosus washing machine-like appearance of cells (huge nucleus in cells).
on buccal mucosa).
murmur. Glaucoma tunnel vision.
Systemic Lupus Erythematosus butterfly rash.
Addisons disease bronze-like skin Retinal Detachment flashes of light, shadow
Leprosy leonine facies (thickened folded facial
pigmentation. with curtain across vision.
skin).
Cushings syndrome moon face appearance 5
Bulimia chipmunk facies (parotid gland swelling).
and buffalo hump.
 Basilar Skull Fracture Raccoon eyes (periorbital Diabetes Mellitus polydipsia, polyphagia, Syphilis painless chancres.
ecchymosis) and Battles sign (mastoid polyuria. Chancroid painful chancres.
ecchymosis). Gastroesophageal Reflux Disease (GERD) Gonorrhea green, creamy discharges and painful
Buergers Disease intermittent claudication (pain heartburn. urination.
at buttocks or legs from poor circulation resulting in Hirschsprungs Disease (Toxic Megacolon) Chlamydia milky discharge and painful urination.
impaired walking). ribbon-like stool. Candidiasis white cheesy odorless vaginal
Diabetic Ketoacidosis acetone breathe. Herpes Simplex Type II painful vesicles on discharges.
Pregnancy Induced Hypertension (PIH) genitalia Trichomoniasis yellow, itchy, frothy, and foul-
proteinuria, hypertension, edema. Genital Warts warts 1-2 mm in diameter. smelling vaginal discharges

2 4 . M IS C E L L A N E O U S T IP S

Delegate sterile skills (e.g., dressing change) to the Para is the number of pregnancies that Veracity is truth and is an essential component of a
RN or LPN. reached viability, regardless of whether the therapeutic relationship between a health care
Where non-skilled care is required, delegate fetus was delivered alive or stillborn. A fetus is provider and his patient.
the stable client to the nursing assistant. considered viable at 20 weeks gestation. Beneficence is the duty to do no harm and the duty
Assign the most critical client to the RN. Lochia rubra is the vaginal discharge of almost to do good. Theres an obligation in patient care to
Clients who are being discharged should have pure blood that occurs during the first few days do no harm and an equal obligation to assist the
final assessments done by the RN. after childbirth. patient.
The Licensed Practical Nurse (LPN) can Lochia serosa is the serous vaginal discharge Nonmaleficence is the duty to do no harm.
monitor clients with IV therapy, insert urinary that occurs 4 to 7 days after childbirth. Tyramine-rich food, such as aged cheese, chicken
catheters, feeding tubes, and apply restraints. Lochia alba is the vaginal discharge of decreased liver, avocados, bananas, meat tenderizer, salami,
Assessment, teaching, medication administration, blood and increased leukocytes thats the final bologna, Chianti wine, and beer may cause severe
evaluation, unstable patients cannot be stage of lochia. It occurs 7 to 10 days after hypertension in a patient who takes a monoamine
delegated to an unlicensed assistive personnel. childbirth. oxidase inhibitor.
Weight is the best indicator of dehydration. In the event of fire, the acronym most often used is Projection is the unconscious assigning of a
When patient is in distress, administration RACE. (R) Remove the patient. (A) Activate the thought, feeling, or action to someone or
of medication is rarely the best choice. alarm. (C) Attempt to contain the fire by closing the something else.
Always check for allergies before administering door. (E) Extinguish the fire if it can be done safely. Sublimation is the channeling of unacceptable
antibiotics. Before signing an informed consent form, the impulses into socially acceptable behavior.
Neutropenic patients should not receive patient should know whether other treatment Repression is an unconscious defense mechanism
vaccines, fresh fruits, or flowers. options are available and should understand what whereby unacceptable or painful thoughts,
Nitroglycerine patch is administered up to will occur during the preoperative, intraoperative, impulses, memories, or feelings are pushed from
three times with intervals of five minutes. and postoperative phases; the risks involved; and the consciousness or forgotten.
Morphine is contraindicated in pancreatitis because the possible complications. The patient should People with obsessive-compulsive disorder
it causes spasms of the Sphincter of Oddi. also have a general idea of the time required from realize that their behavior is unreasonable, but
Demerol should be given. surgery to recovery. In addition, he should have an are powerless to control it.
Never give potassium (K+) in IV push. opportunity to ask questions. A significant toxic risk associated with clozapine
Infants born to an HIV-positive mother should The first nursing intervention in a quadriplegic (Clozaril) administration is blood dyscrasia.
receive all immunizations of schedule. client who is experiencing autonomic dysreflexia Adverse effects of haloperidol (Haldol)
Gravida is the number of pregnancies a woman is to elevate his head as high as possible. administration include drowsiness; insomnia;
has had, regardless of outcome. Usually, patients who have the same infection and weakness; headache; and extrapyramidal 6
are in strict isolation can share a room.
symptoms, such as akathisia, tardive dyskinesia, Hypervigilance and dj vu are signs of
and dystonia. posttraumatic stress disorder (PTSD