NP I: Community Health Nursing
20%of exam
NP II: Maternal & Child Nursing
20%of exam
Stages of LaborAPGAR ScoreEPI Immunization ScheduleNewborn & Postpartum CareGrowth & Development MilestonesPlacenta Previa vs Abruptio
NP III: Surgery, Infection, Oxygenation
20%of exam
NP IV: Nutrition, GI & Endocrine
20%of exam
NP V: Psychiatric & Emergency Care
20%of exam
Quick Facts
- Exam
- PNLE / NLE
- Body
- PRC Board of Nursing
- Items
- 500 (5x100)
- Time
- 10 hrs / 2 days
- Pass
- 75% avg, no <60%
- Level
- Entry-Level RN Licensure
- Skill
- Clinical judgment + safety
- Blueprint
- Nov 2025 Enhanced TOS
Nursing Process
Assess, Diagnose, Plan, Implement, Evaluate
A: Assess dataD: Diagnose problemP: Plan goalsI: Implement careE: Evaluate outcome
Active vs Passive Immunity
Active Immunity
- From vaccine or infection
- Body makes own antibodies
- Long-lasting protection
Passive Immunity
- Antibodies given directly
- Maternal or immunoglobulin source
- Short-term protection only
Body-made vs received antibodies
Community Referral Picker
- Minor stable illness→Manage at BHS/RHU(First-level care)
- High-risk pregnancy or complication→Refer to hospital(Higher-level facility)
- Suspected notifiable disease→Report per RA 11332(Surveillance duty)
- Community-wide health need→Plan health education(NP I outcome)
- Local disaster event→Activate disaster response(Disaster nursing role)
Nursing Process (ADPIE)
- Assessment
- Collect and validate data
- Diagnosis
- Analyze and name problem
- Planning
- Set goals and priorities
- Implementation
- Carry out nursing care
- Evaluation
- Check if goals met
TB Treatment Strategy
Directly Observed Treatment, Short-course
Worker watches each dose6-month first-line regimenPrevents drug resistance
Community Health Systems
- RHU
- First-level referral facility
- BHS
- Barangay-level health outpost
- UHC
- Universal Health Care Act
- PHC
- Primary health care approach
- Epidemiologic triad
- Host, agent, environment
- Levels of care
- Primary, secondary, tertiary
Disease Control & Surveillance
- DOTS
- Directly observed TB treatment
- Notifiable disease law
- RA 11332 reporting
- Dengue warning signs
- Bleeding, persistent vomiting, abdominal pain
- Outbreak response
- Investigate, contain, report cases
- Disaster nursing
- Prepare, respond, rehabilitate communities
- School health
- Health exams, deworming, immunization
Ethics & Nursing Law
- RA 9173
- Philippine Nursing Act 2002
- Scope of practice
- Independent and collaborative care
- Informed consent
- Voluntary, informed, competent patient
- Patient advocacy
- Protect rights and safety
- CPD
- Required for license renewal
APGAR Score
Appearance, Pulse, Grimace, Activity, Respiration
Score 0-2 per signScored at 1 and 5 minTotal ranges 0 to 10
Placenta Previa vs Abruptio Placentae
Placenta Previa
- Painless, bright red bleeding
- Placenta covers cervix
- No uterine rigidity
Abruptio Placentae
- Painful, dark red bleeding
- Placenta separates early
- Rigid, tender abdomen
Painless vs painful bleeding
Stages of Labor
- Stage 1
- Cervical dilation, longest stage
- Stage 2
- Full dilation to birth
- Stage 3
- Placental delivery, active management
- Stage 4
- First 1-2 hrs postpartum
- Uterine involution
- Fundus descends daily
Postpartum Wound Check
Redness, Edema, Ecchymosis, Discharge, Approximation
Check episiotomy or incisionAssess every postpartum visitDocument any deviation found
Preeclampsia vs Eclampsia
Preeclampsia
- BP 140/90 plus proteinuria
- After 20 weeks gestation
- No seizure activity
Eclampsia
- Preeclampsia plus new seizures
- Obstetric emergency
- MgSO4, seizure precautions
Seizures mark eclampsia
APGAR Score
- Appearance
- Skin color 0-2
- Pulse
- Heart rate 0-2
- Grimace
- Reflex irritability 0-2
- Activity
- Muscle tone 0-2
- Respiration
- Breathing effort 0-2
- Timing
- Score at 1 and 5 min
EPI Immunization Schedule
- BCG
- At birth, single dose
- Hepatitis B
- Birth dose within 24 hrs
- Pentavalent
- 6, 10, 14 weeks
- OPV/IPV
- Polio doses, same schedule
- PCV
- 6, 10, 14 weeks
- MMR
- 9 months, then 12-15 mo
Newborn & Postpartum Care
- EINC
- Dry, skin-to-skin, delayed clamping
- Newborn screening
- Heel prick, 24-72 hrs
- REEDA
- Redness, edema, ecchymosis, discharge, approximation
- Rooming-in
- Non-separation, early breastfeeding
- Postpartum hemorrhage
- Blood loss over 500 mL
Growth & Development Milestones
- Infant
- Head control by 3-4 mo
- 6 months
- Sits with support
- 12 months
- Walks, says few words
- Toddler
- Parallel play, tantrums common
- Preschool
- Associative play, magical thinking
Droplet vs Airborne Precautions
Droplet
- Mask within 3 feet
- Flu, mumps, pertussis
- Standard door is fine
Airborne
- N95 respirator required
- TB, measles, varicella
- Negative pressure room needed
Distance vs airflow control
Isolation Precaution Picker
- TB, measles, or varicella→Airborne precautions(N95, negative pressure room)
- Flu, mumps, or pertussis→Droplet precautions(Mask within 3 feet)
- MRSA, C. diff, or scabies→Contact precautions(Gown and gloves)
- Any patient encounter→Standard precautions(Always, every patient)
- Suspected outbreak cluster→Report to surveillance(RA 11332 duty)
Adult Vital Sign Norms
- HR
- 60-100 bpm
- RR
- 12-20 breaths per min
- BP
- Below 120/80 mmHg
- Temp
- 36.5-37.5C average
- SpO2
- 95-100% normal range
- Pain
- 0-10 self-report scale
Subjective vs Objective Data
Subjective Data
- Patient states or reports
- Cannot be directly measured
Objective Data
- Nurse observes or measures
- Vital signs and lab results
Reported vs measured data
Isolation Precautions
- Standard
- Every patient, every time
- Contact
- MRSA, C. diff, scabies
- Droplet
- Flu, mumps, pertussis, rubella
- Airborne
- TB, measles, varicella
- PPE doffing order
- Gloves, gown, goggles, mask
- Hand hygiene
- Before and after contact
Medication Rights & Safety
- Right patient
- Verify two identifiers
- Right drug
- Match order exactly
- Right dose
- Calculate, double-check high-alert
- Right route
- Match ordered route
- Right time
- Give within window
- Right documentation
- Chart immediately after giving
Fluid, Electrolyte & Acid-Base
- Hypokalemia
- Weakness, dysrhythmia, below 3.5
- Hyperkalemia
- Peaked T waves, above 5.0
- Metabolic acidosis
- Low pH, low bicarbonate
- Respiratory alkalosis
- High pH, low CO2
- Fluid overload
- Crackles, edema, weight gain
Stroke Warning Signs
Face droop, Arm weak, Speech slurred, Time to call
Sudden onset is an emergencyNote the last-known-well timeTime lost is brain lost
DKA vs HHS
DKA
- Usually type 1 diabetes
- Ketones present, acidosis
- Rapid onset, Kussmaul breathing
HHS
- Usually type 2 diabetes
- No significant ketones
- Slower onset, older adult
Ketones present versus absent
Endocrine & Metabolic Priorities
- DKA
- Ketones, acidosis, Kussmaul breathing
- HHS
- Extreme glucose, no ketones
- Hypoglycemia
- Below 70 mg/dL, give sugar
- Thyroid storm
- Fever, tachycardia, agitation
- Addisonian crisis
- Hypotension, weakness, hyperkalemia
GI & Nutrition Priorities
- GERD
- Avoid late meals, elevate head
- Peptic ulcer
- Epigastric pain, H. pylori
- Pancreatitis
- Elevated amylase, lipase, NPO
- Cirrhosis
- Ascites, jaundice, bleeding risk
- Enteral feeding
- Check placement before use
Neuro & Perception Priorities
- Stroke FAST
- Face, arm, speech, time
- GCS
- Eye, verbal, motor response
- Increased ICP
- Headache, vomiting, altered LOC
- Seizure precautions
- Pad rails, suction ready
- Glaucoma
- Increased intraocular pressure risk
Delegation vs Assignment
Delegation
- RN to UAP
- Task-level only
- RN keeps accountability
Assignment
- RN to RN or LPN
- Full client responsibility
- Within own license
Who keeps accountability
Prioritization: ABC + Maslow
- Airway compromised→Fix first(ABC step 1)
- Breathing problem, airway open→Fix second(ABC step 2)
- Circulation problem, A and B ok→Fix third(ABC step 3)
- Physiologic need unmet→Treat before psychosocial(Maslow base first)
- Unexpected new finding→Assess before acting(ADPIE order)
Defense Mechanisms
- Denial
- Refuse to accept reality
- Projection
- Blame own feelings on others
- Displacement
- Redirect feelings to safer target
- Rationalization
- Justify with logical excuses
- Regression
- Return to earlier behavior
- Reaction formation
- Act opposite of true feeling
- Sublimation
- Channel impulse into acceptable act
Delegation Picker
- Stable, predictable task→Delegate to trained UAP(Task-level only)
- Assessment or teaching needed→RN performs directly(Cannot delegate judgment)
- Unstable or unpredictable client→Assign to RN(Match higher acuity)
- IV medication administration→RN performs directly(Licensed scope only)
Therapeutic Communication
- Open-ended question
- Invites full patient response
- Reflecting
- Mirror feeling back to patient
- Silence
- Allows patient to process
- Active listening
- Full attention, verify understanding
- Non-therapeutic
- False reassurance, giving advice
- Blocking technique
- Asking why, changing subject
Triage & Emergency Priorities
- Airway
- Highest priority, address first
- Hypovolemic shock
- Tachycardia, hypotension, cool skin
- Restraints
- Last resort, needs order
- Suicide risk
- Ask directly, ensure safety
- Crisis intervention
- Reduce danger, restore coping
Common Traps
General Average vs Subject Rating
75% overall required ≠ Each subject needs 60%+
Standard vs Transmission-Based Precautions
Standard applies to everyone ≠ Transmission-based needs a diagnosis
Sign vs Symptom
Sign is nurse-observed ≠ Symptom is patient-reported
Delegation vs Abandonment
Delegate within scope only ≠ RN stays accountable always
Assessment vs Diagnosis Order
Assessment collects the data ≠ Diagnosis analyzes the problem
EINC vs Old Nursery Routine
EINC keeps mother and baby together ≠ Old routine separated them at birth
Consent vs Assent
Consent needs a competent adult ≠ Assent is a minor's agreement
Last Minute
- 1.500 items across five 100-item subjects
- 2.Pass: 75% average, none below 60%
- 3.Retake only the subject below 60%
- 4.ADPIE = Assess, Diagnose, Plan, Implement, Evaluate
- 5.Airborne = TB, measles, varicella; use N95
- 6.Droplet = flu, mumps, pertussis; wear mask
- 7.EINC = dry, skin-to-skin, delayed clamping, rooming-in
- 8.Screening = heel prick at 24-72 hrs
- 9.DKA has ketones; HHS has none
- 10.Delegate tasks, not assessment or teaching
- 11.RA 9173 = Nursing Act of 2002
- 12.ABC first, then Maslow's physiologic needs
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