Free NCLEX Quick Reference Cheat Sheet

Save this page — it covers the highest-yield NCLEX topics in one place.

1

ABCs of Nursing Priority (Airway → Breathing → Circulation)

  • Always prioritize airway first — it is non-negotiable
  • Actual airway obstruction > risk of airway obstruction
  • Circulation issues in order: hemorrhage → shock → cardiac arrest
  • After ABC, apply Maslow's Hierarchy: physiologic > safety > love/belonging > esteem > self-actualization
2

Critical Lab Values (memorize these)

LabNormalCritical LowCritical High
Sodium (Na+)135–145 mEq/L< 120> 160
Potassium (K+)3.5–5.0 mEq/L< 2.5> 6.5
Glucose70–100 mg/dL< 40> 500
HemoglobinM: 14–18 / F: 12–16 g/dL< 7> 20
Platelets150,000–400,000/μL< 20,000> 1,000,000
INR0.8–1.2 (therapeutic: 2–3)> 4
PTT25–35 sec> 70 sec
pH7.35–7.45< 7.2> 7.6
PaO₂80–100 mmHg< 60
PaCO₂35–45 mmHg< 20> 70
HCO₃⁻22–26 mEq/L< 10> 40
3

ABG Interpretation (ROME Method)

ROME Mnemonic

Respiratory Opposite — Metabolic Equal

Respiratory (Opposite)

pH↑ + PaCO₂↓ = Resp. Alkalosis

pH↓ + PaCO₂↑ = Resp. Acidosis

Metabolic (Equal)

pH↑ + HCO₃↑ = Met. Alkalosis

pH↓ + HCO₃↓ = Met. Acidosis

Compensation Guide:

  • Compensated — pH normal, HCO₃ and PaCO₂ both abnormal
  • Partially compensated — pH still abnormal, HCO₃ and PaCO₂ both off
  • Uncompensated — pH abnormal, only one value (HCO₃ or PaCO₂) is off
4

5 Rights of Delegation

1
Right TaskCan it be delegated per scope of practice?
2
Right CircumstanceIs the patient stable with a predictable outcome?
3
Right PersonDoes the delegate have the training and competency?
4
Right DirectionWere clear, specific instructions given?
5
Right SupervisionIs follow-up and evaluation planned?

⚠ RN CANNOT Delegate:

Assessment · Nursing Diagnosis · Care Planning · Evaluation · Patient/Family Teaching · Unstable patients

5

Isolation Precautions Quick Reference

TypeDisease ExamplesPPE Required
AirborneTB, measles, chickenpox, COVIDN95 + gown + gloves + eye protection; negative pressure room
DropletInfluenza, mumps, pertussis, meningitisSurgical mask + gown + gloves
ContactC. diff, MRSA, VRE, scabies, norovirusGown + gloves
Protective (Reverse)Neutropenic patientsPositive pressure room, mask, sterile technique
6

Medication Safety — High-Alert Drugs

InsulinAlways double-check dose + type with two nurses; never mix NPH with other insulins unless prescribed.
HeparinUse weight-based protocol; monitor PTT; antidote = protamine sulfate.
WarfarinMonitor INR; antidote = Vitamin K (phytonadione).
DigoxinTherapeutic 0.5–2 ng/mL; hold if HR < 60; toxicity signs: nausea, yellow-green vision, bradycardia.
LithiumTherapeutic 0.6–1.2 mEq/L; toxic > 1.5; maintain adequate Na+ and fluid intake.
Magnesium Sulfate (OB)Therapeutic 4–7 mEq/L; antidote = calcium gluconate; monitor RR (≥ 12), urine output (≥ 30 mL/hr), deep tendon reflexes.
7

NCLEX Priority Framework — When to Act NOW

🚨New onset chest pain or shortness of breath
🚨O₂ saturation < 90%
🚨BP < 90/60 or > 180/120
🚨HR < 50 or > 130
🚨Temp > 103°F / 39.4°C
🚨Sudden altered level of consciousness
🚨Bleeding that won't stop
🚨Blood glucose < 60 or > 400
8

Therapeutic Communication — Do vs. Don't

✓ Use This✗ Avoid This
Open-ended questions ("Tell me more about…")Closed questions ("Are you feeling better?")
Reflection / restatementFalse reassurance ("Everything will be fine")
Clarification ("What do you mean by…")Giving advice ("You should…")
Silence with presenceChanging the subject
Empathy statements ("That sounds difficult")Judgmental statements
9

Maternity Quick Reference

FHR Normal Range:110–160 bpm

Variable Decelerations

Cause: Cord compression

Reposition mother, administer O₂, notify provider

🚨 Late Decelerations

Cause: Uteroplacental insufficiency

EMERGENCY — notify immediately, O₂, left lateral position, stop Pitocin

Early Decelerations

Cause: Head compression

Normal finding — no intervention needed

Postpartum Hemorrhage

Uterine atony is the #1 cause — massage uterus, assess bladder, administer Pitocin

10

NCLEX NGN — Clinical Judgment Measurement Model (CJMM)

6 Cognitive Skills (in order):

1. Recognize Cues2. Analyze Cues3. Prioritize Hypotheses4. Generate Solutions5. Take Action6. Evaluate Outcomes

NGN Item Types:

Extended drag-and-dropMatrix gridsBow-tieHighlightDrop-down cloze

Strategy:

Read the scenario → identify what changed → ask “what's the most urgent concern?”

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