NUR 224study guid HESi &NCLEX
Here is a study guide composed by 3 students to help us pass the HESI exit and
NCLEX exams.
All three of us passed the first time with 75 questions.
If you know everything on this guide you will do well.
Kind of long but worth studying.
HESI Hints & NCLEX Gems
• Answering NCLEX Questions
o Maslow’s Hierarchy of
Needs
• Physiologic
• Safety
• Love and Belonging
• Esteem
• Self-actualization
o Nursing Process
• Assessment
• Diagnosis (Analysis)
• Planning
• Implementation (treatment)
• Evaluation
o ABCs
• Airway
• Breathing
• Circulation
• Normal
Values o Hgb
• Males 14-18
• Females 12-
16 o Hct
• Males 42-52
• Females 37-
47 o RBCs
• Males 4.7-6.1 million
• Females 4.2-5.4 million
o WBCs
• 4.5-11k
o Platelets
• 150-400k
o PT (Coumadin/Warfarin)
• 11-12.5 sec (INR and PT TR = 1.5-2 times normal)
o APTT (Heparin)
• 60-70 sec (APTT and PTT TR = 1.5-2.5 times normal)
,NUR 224study guid HESi &NCLEX
o BUN 10-20
o Creatinine 0.5-1.2
o Glucose 70-110
o Cholesterol < 200
o Bilirubin Newborn 1-12
o Phenylalanine Newborn < 2, Adult < 6
o Na+ 136-145
o K+ 3.5-5
• HypoK+ . . . Prominent U waves, Depressed ST segment, Flat T waves
• HyperK+ . . . Tall T-Waves, Prolonged PR interval, wide QRS
o Ca++ 9-10.5
• Hypocalcemia … muscle spasms, convulsions, cramps/tetany, + Trousseau’s, +
Chvostek’s, prolonged ST interval, prolonged QT segment
o Mg+ 1.5-2.5
o Cl- 96-106
o Phos 3-4.5
o Albumin 3.5-5
o Spec Gravity 1.005-1.030
o Glycosylated Hemoglobin (Hgb A1c): 4-6% ideal, < 7.5% = OK (120 days)
o Dilantin TR = 10-20
o Lithium TR = 0.5-1.5
o Arterial Blood Gases … Used for Acidosis vs. Alkalosis
• PH 7.35-7.45
• CO2 35-45 (Respiratory driver) … High = Acidosis
• HCO3 21-28 (Metabolic driver) … High = Alkalosis
• O2 80-100
• O2 Sat 95-100%
• Antidotes
o Digoxin … Digiband
o Coumadin … Vitamin K (Keep PT and INR @ 1-1.5 X normal)
o Benzodiazapines … Flumzaemil (Tomazicon)
o Magnesium Sulfate … Calcium Gluconate?
o Heparin … Protamine Sulfate (Keep APTT and PTT @ 1.5-2.5 X normal)
o Tylenol … Mucomist (17 doses + loading dose)
o Opiates (narcotic analgesics, heroin, morphine) … Narcan (Naloxone)
o Cholinergic Meds (Myesthenic Bradycardia) … Atropine
o Methotrexate … Leucovorin
• Delegation
o RN Only
• Blood Products (2 RNs must check)
• Clotting Factors
• Sterile dressing changes and procedures
, NUR 224study guid HESi &NCLEX
• Assessments that require clinical judgment
• Ultimately responsible for all delegated duties
o Unlicensed Assistive Personnel
• Non-sterile procedures
• Precautions & Room Assignments
o Universal (Standard) Precautions … HIV initiated
• Wash hands
• Wear Gloves
• Gowns for splashes
• Masks and Eye Protection for splashes and droplets
• Don’t recap needles
• Mouthpiece or Ambu-bag for resuscitation
• Refrain from giving care if you have skin lesion
o Droplet (Respiratory) Precautions (Wear Mask)
• Sepsis, Scarlet Fever, Strep, Fifth Disease (Parvo B19), Pertussis, Pneumonia,
Influenza, Diptheria, Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma,
Adenovirus, Rhinovirus
• RSV (needs contact precautions too)
• TB … Respiratory Isolation
o Contact Precautions = Universal + Goggles, Mask and Gown
o No infection patients with immunosuppressed patients
• Weird Miscellaneous Stuff
o Rifampin (for TB) … Rust/orange/red urine and body fluids
o Pyridium (for bladder infection) … Orange/red/pink urine
o Glasgow Coma Scale … < 8 = coma
o Myesthenia Gravis
• Myesthenic Crisis = Weakness with change in vitals (give more meds)
• Cholinergic Crisis = Weakness with no change in vitals (reduce meds)
o Diabetic Coma vs. Insulin Shock … Give glucose first – If no help, give insulin
o Fruity Breath = Diabetic Ketoacidosis
o Acid-Base Balance
• If it comes out of your ass, it’s Acidosis.
• Vomiting = Alkalosis
o Skin Tastes Salty = Cystic Fibrosis
o Lipitor (statins) in PMs only – No grapefruit juice
o Stroke … Tongue points toward side of lesion (paralysis), Uvula deviates away
from the side of lesion (paralysis)
o Hold Digoxin if HR < 60
o Stay in bed for 3 hours after first ACE Inhibitor dose
o Avoid Grapefruit juice with Ca++ Channel Blockers
o Anthrax = Multi-vector biohazard
o Pulmonary air embolism prevention = Trendelenburg (HOB down) + on left side
(to
Here is a study guide composed by 3 students to help us pass the HESI exit and
NCLEX exams.
All three of us passed the first time with 75 questions.
If you know everything on this guide you will do well.
Kind of long but worth studying.
HESI Hints & NCLEX Gems
• Answering NCLEX Questions
o Maslow’s Hierarchy of
Needs
• Physiologic
• Safety
• Love and Belonging
• Esteem
• Self-actualization
o Nursing Process
• Assessment
• Diagnosis (Analysis)
• Planning
• Implementation (treatment)
• Evaluation
o ABCs
• Airway
• Breathing
• Circulation
• Normal
Values o Hgb
• Males 14-18
• Females 12-
16 o Hct
• Males 42-52
• Females 37-
47 o RBCs
• Males 4.7-6.1 million
• Females 4.2-5.4 million
o WBCs
• 4.5-11k
o Platelets
• 150-400k
o PT (Coumadin/Warfarin)
• 11-12.5 sec (INR and PT TR = 1.5-2 times normal)
o APTT (Heparin)
• 60-70 sec (APTT and PTT TR = 1.5-2.5 times normal)
,NUR 224study guid HESi &NCLEX
o BUN 10-20
o Creatinine 0.5-1.2
o Glucose 70-110
o Cholesterol < 200
o Bilirubin Newborn 1-12
o Phenylalanine Newborn < 2, Adult < 6
o Na+ 136-145
o K+ 3.5-5
• HypoK+ . . . Prominent U waves, Depressed ST segment, Flat T waves
• HyperK+ . . . Tall T-Waves, Prolonged PR interval, wide QRS
o Ca++ 9-10.5
• Hypocalcemia … muscle spasms, convulsions, cramps/tetany, + Trousseau’s, +
Chvostek’s, prolonged ST interval, prolonged QT segment
o Mg+ 1.5-2.5
o Cl- 96-106
o Phos 3-4.5
o Albumin 3.5-5
o Spec Gravity 1.005-1.030
o Glycosylated Hemoglobin (Hgb A1c): 4-6% ideal, < 7.5% = OK (120 days)
o Dilantin TR = 10-20
o Lithium TR = 0.5-1.5
o Arterial Blood Gases … Used for Acidosis vs. Alkalosis
• PH 7.35-7.45
• CO2 35-45 (Respiratory driver) … High = Acidosis
• HCO3 21-28 (Metabolic driver) … High = Alkalosis
• O2 80-100
• O2 Sat 95-100%
• Antidotes
o Digoxin … Digiband
o Coumadin … Vitamin K (Keep PT and INR @ 1-1.5 X normal)
o Benzodiazapines … Flumzaemil (Tomazicon)
o Magnesium Sulfate … Calcium Gluconate?
o Heparin … Protamine Sulfate (Keep APTT and PTT @ 1.5-2.5 X normal)
o Tylenol … Mucomist (17 doses + loading dose)
o Opiates (narcotic analgesics, heroin, morphine) … Narcan (Naloxone)
o Cholinergic Meds (Myesthenic Bradycardia) … Atropine
o Methotrexate … Leucovorin
• Delegation
o RN Only
• Blood Products (2 RNs must check)
• Clotting Factors
• Sterile dressing changes and procedures
, NUR 224study guid HESi &NCLEX
• Assessments that require clinical judgment
• Ultimately responsible for all delegated duties
o Unlicensed Assistive Personnel
• Non-sterile procedures
• Precautions & Room Assignments
o Universal (Standard) Precautions … HIV initiated
• Wash hands
• Wear Gloves
• Gowns for splashes
• Masks and Eye Protection for splashes and droplets
• Don’t recap needles
• Mouthpiece or Ambu-bag for resuscitation
• Refrain from giving care if you have skin lesion
o Droplet (Respiratory) Precautions (Wear Mask)
• Sepsis, Scarlet Fever, Strep, Fifth Disease (Parvo B19), Pertussis, Pneumonia,
Influenza, Diptheria, Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma,
Adenovirus, Rhinovirus
• RSV (needs contact precautions too)
• TB … Respiratory Isolation
o Contact Precautions = Universal + Goggles, Mask and Gown
o No infection patients with immunosuppressed patients
• Weird Miscellaneous Stuff
o Rifampin (for TB) … Rust/orange/red urine and body fluids
o Pyridium (for bladder infection) … Orange/red/pink urine
o Glasgow Coma Scale … < 8 = coma
o Myesthenia Gravis
• Myesthenic Crisis = Weakness with change in vitals (give more meds)
• Cholinergic Crisis = Weakness with no change in vitals (reduce meds)
o Diabetic Coma vs. Insulin Shock … Give glucose first – If no help, give insulin
o Fruity Breath = Diabetic Ketoacidosis
o Acid-Base Balance
• If it comes out of your ass, it’s Acidosis.
• Vomiting = Alkalosis
o Skin Tastes Salty = Cystic Fibrosis
o Lipitor (statins) in PMs only – No grapefruit juice
o Stroke … Tongue points toward side of lesion (paralysis), Uvula deviates away
from the side of lesion (paralysis)
o Hold Digoxin if HR < 60
o Stay in bed for 3 hours after first ACE Inhibitor dose
o Avoid Grapefruit juice with Ca++ Channel Blockers
o Anthrax = Multi-vector biohazard
o Pulmonary air embolism prevention = Trendelenburg (HOB down) + on left side
(to
