Free SNLE Exam Flashcards

Activate the ACS pathway and obtain a 12-lead ECG within 10 minutes of first medical contact. Give aspirin early unless contraindicated. Give oxygen for hypoxemia. Nitroglycerin may relieve ongoing ischemic pain after checking blood pressure and other contraindications, including recent PDE5 inhibitor use.

Basal crackles suggest pulmonary congestion. Dyspnea and orthopnea are common, and pink frothy sputum can occur with acute pulmonary edema. Jugular venous distention, peripheral edema, and hepatomegaly suggest systemic venous congestion.

Stop the infusion and escalate per protocol. Protamine sulfate rapidly neutralizes unfractionated heparin. Dose depends on how much heparin was given recently. Monitor bleeding and coagulation as directed.

When supplemental oxygen is needed, titrate to an initial SpO₂ of 88–92% while awaiting blood gases. Use controlled delivery, such as a Venturi mask or low-flow nasal cannula, and adjust using gases and clinical response. Excess oxygen can worsen hypercapnia.

Peaked T waves are a possible early sign. Severe hyperkalemia can also occur with a normal ECG. Escalate promptly, obtain an ECG and monitor rhythm. IV calcium stabilizes the myocardium when ECG changes are present. Insulin with glucose shifts potassium into cells while removal therapy lowers total body potassium.

DKA combines diabetes or hyperglycemia with ketosis and metabolic acidosis. It can occur with near-normal glucose. Start IV fluids and check potassium. If potassium is below 3.5 mmol/L, replace it and delay insulin until it rises above 3.5 mmol/L. Follow protocol for serial glucose, electrolytes and ketones.

Activate emergency help, support oxygenation, and prepare for immediate chest decompression by an authorized clinician. Unilateral absent breath sounds and acute respiratory or hemodynamic deterioration are clues. Tracheal deviation can be late. In an unstable patient, decompression takes priority over imaging.

Face drooping, Arm weakness, Speech difficulty, Time to activate emergency stroke care. Record last known well, assess airway and check bedside glucose. Follow the stroke pathway for blood pressure targets, which depend on reperfusion treatment and other emergencies.

Escalate promptly, measure lactate and obtain blood cultures before antibiotics if this avoids meaningful delay. Give antibiotics immediately, ideally within 1 hour, for shock or probable or definite sepsis. For possible sepsis without shock, rapidly investigate and treat within 3 hours if concern persists. For sepsis-induced hypoperfusion or shock, the 2026 SSC suggests at least 30 mL/kg IV crystalloid within 3 hours with individualization and frequent reassessment.

Use a negative-pressure airborne infection isolation room and a fit-tested N95 or higher respirator for staff. Mask the patient for necessary transport. Discontinue isolation only after infection prevention confirms local criteria, including treatment response and required microbiology.

Stay with the patient, summon help, and initiate observation and environmental safety measures under the facility protocol. Remove hazards when safe and arrange urgent suicide risk assessment and clinical review. Use supportive communication throughout.

Hypokalemia increases digoxin binding and toxicity risk. Early symptoms include nausea, vision changes (yellow halos), and bradycardia with arrhythmias. Hold digoxin, check potassium and digoxin level, and treat per protocol.

Assess airway and hemodynamic status, obtain large-bore IV access and send labs including CBC and a type and screen or crossmatch as indicated. Trend vital signs, perfusion and hemoglobin, keep the patient NPO and prepare for resuscitation and endoscopy.

In a patient with a spinal cord injury at T6 or above, a blocked catheter or bladder distension can trigger sudden hypertension, headache and sweating. Sit the patient upright, loosen restrictive clothing, monitor blood pressure frequently and check urinary causes first. Escalate persistent hypertension and follow the protocol for other triggers.

The classic formula estimates crystalloid for the first 24 hours using body weight and percent total body surface area burned. Half the estimate is allocated to the first 8 hours from injury. Actual resuscitation is titrated to perfusion and urine output under the burn protocol.

Muscle pump activity reduces venous stasis. Combine with mechanical prophylaxis and pharmacologic anticoagulation when ordered. Leg pain, unilateral swelling, or warmth warrants further evaluation.

Follow the renal team’s individualized phosphate advice. Review labels for phosphate additives, and take prescribed phosphate binders with meals as directed. Management is guided by serial labs and the CKD mineral and bone disorder plan.

Give 15 g fast-acting carbohydrate, recheck in 15 minutes, and repeat if glucose remains below 70 mg/dL. If swallowing is unsafe, use IV dextrose or glucagon per protocol. Once corrected, follow the meal or snack plan to prevent recurrence.

Sudden dyspnea, pleuritic chest pain, and tachycardia are clues. Hypoxemia, hemoptysis or unilateral leg swelling may occur. Escalate promptly for assessment and risk-based treatment. Hemodynamic instability requires immediate emergency management.

Target typically 20-30 cm H2O to prevent aspiration leak while avoiding tracheal mucosal ischemia and stenosis. Overinflation impairs perfusion; underinflation increases aspiration risk. Check per unit policy with manometer.

WHO starts active-phase monitoring at 5 cm cervical dilation. ACOG uses 6 cm as the start of active labor. The first stage ends at full dilation, the second at birth and the third at placental delivery.

Appearance, Pulse, Grimace, Activity and Respiration each score 0–2. Record the score at 1 and 5 minutes to describe newborn status and response to care. Start any needed resuscitation immediately based on breathing and heart rate without waiting for the score.

Call for help, quantify blood loss, assess vital signs and uterine tone, and activate the hemorrhage protocol. The WHO first-response bundle includes uterine massage, uterotonic treatment, tranexamic acid, IV fluids, examination for the source and escalation as indicated.

Systolic BP of at least 160 mmHg or diastolic BP of at least 110 mmHg is severe range. Repeat promptly and escalate persistent severe BP for urgent treatment under the obstetric protocol. Other symptoms or proteinuria may be absent. Magnesium sulfate is used for seizure prophylaxis when indicated.

Loss of deep tendon reflexes can precede respiratory depression. Stop the infusion and escalate for suspected toxicity. Calcium gluconate is the reversal agent per protocol. Monitor respiratory rate, reflexes and urine output, and obtain serum levels when indicated.

Large surface-area-to-weight ratio, thin skin, and limited subcutaneous fat cause rapid heat loss by conduction, convection, radiation, and evaporation. Dry immediately, skin-to-skin or radiant warmer, and monitor axillary temperature.

Feed on demand, ensure asymmetric latch with wide mouth and chin touching breast, and hand-express briefly before latch if areola is too firm. Avoid scheduled long gaps early postpartum. Report cracked nipples with signs of mastitis.

Reduced skin turgor and a sunken fontanelle can suggest dehydration. Assess them with mucous membranes, tears, urine output, vital signs, capillary refill and mental status. Weak pulses and lethargy warrant urgent evaluation for shock.

Croup commonly causes a barking cough, hoarseness and inspiratory stridor. Keep the child calm and give a corticosteroid as ordered. Moderate to severe croup may need nebulized epinephrine. Drooling or a toxic appearance warrants urgent airway assessment for other causes.

Place the child on their side when safe, protect them from injury, keep objects out of the mouth and time the event. Seek emergency help for a seizure lasting 5 minutes, difficulty breathing or failure to recover normally. A first seizure or a seizure below 6 months needs urgent assessment.

Migraine with aura contraindicates estrogen-containing combined contraception. At age 35 or older, combined methods are generally avoided with smoking and contraindicated at 15 or more cigarettes per day under CDC criteria. Check medical eligibility for the individual method.

Maximize skin exposure per device instructions, protect eyes, monitor bilirubin trends, and maintain hydration and feeding frequency. Phototherapy converts bilirubin to water-soluble isomers for excretion. Watch for bronze baby syndrome with certain conditions.

Objective factual description of injuries (size, shape, location, color), child statements in quotes, and behaviors. Do not confront alleged perpetrator in front of child. Follow mandatory reporting laws and facility policy immediately.

When both are indicated, give different injectable or intranasal live vaccines on the same day or at least 28 days apart. MMR and varicella vaccines are contraindicated during pregnancy and in severe immunodeficiency. Oral live vaccines follow their own spacing rules.

Missed period, unilateral pelvic pain and vaginal bleeding are clues in a person with a positive pregnancy test. Shoulder-tip pain, hypotension or syncope suggest possible rupture and require emergency escalation. Management depends on stability and specialist assessment.

Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Breaking any link prevents spread. Standard precautions apply to all patients regardless of known diagnosis.

Surgical asepsis maintains a sterile field and uses sterile equipment where required. Medical asepsis reduces microbial contamination and spread during routine care. Sterilization is the separate process that destroys microorganisms, including bacterial spores.

Right patient, drug, dose, route, time, documentation, reason, response, and form (plus facility-specific rights). Two identifiers before every dose. Independent double-check for high-alert medications per policy.

Infiltration is leakage of a nonvesicant infusion into tissue. Extravasation involves a drug that can cause significant tissue injury. Stop the infusion. For suspected extravasation, leave the access in place for possible aspiration, avoid flushing and follow the agent-specific protocol for compresses and antidotes.

Multiply patient weight in kg by ordered mg/kg/day for 24-hour total, then divide by number of doses per day. Verify concentration when converting to mL. Always have second nurse check high-risk calculations when policy requires.

Assessment, diagnosis, planning, implementation and evaluation (ADPIE). These steps guide routine nursing care and are revisited as the patient changes. During emergencies, assess and treat immediate threats as they are found.

Airway, breathing, circulation, and homeostasis come before safety, belonging, esteem, and self-actualization in acute care prioritization. A patient with airway compromise is addressed before psychosocial concerns.

Check that consent is voluntary and that the patient can ask questions in a language they understand. The responsible clinician explains the procedure, risks, benefits and alternatives. Witness or document consent as required by policy and raise unresolved questions before proceeding.

Stage 3 involves full-thickness skin loss with visible fat. Fascia, muscle, tendon, cartilage and bone are not exposed. Slough or eschar may be present, but the injury is unstageable if it obscures the extent of tissue loss.

Assess the abdomen, symptoms and aspiration risk, and follow the unit’s feeding protocol. ESPEN suggests delaying feeds when measured gastric residual exceeds 500 mL over 6 hours. Escalate suspected intolerance or an acute abdominal problem.

Check the right task, circumstances, person, directions and supervision. Under SCFHS scope guidance, the delegator is accountable for the delegation decision and oversight. The delegate is accountable for accepting and carrying out the task within their competence.

SCFHS recognizes both as registered nursing professionals with distinct scopes. The nurse specialist can practise autonomously and in collaboration. The technician provides care within the technician scope. Check the published scope, verified competence and facility policy before assigning a task.

Situation (concise problem), Background (relevant history), Assessment (your findings), Recommendation (requested action). Standardizes handoffs and provider calls to reduce errors during transitions of care.

An incident report records what happened for the safety system. Document the patient’s assessment, care and response in the clinical record. Root-cause analysis examines system contributors and defines actions to reduce recurrence.

Respect an informed refusal by an adult with decision-making capacity. Clarify their understanding, document the discussion and follow Saudi consent rules and facility policy. Escalate if capacity is uncertain or an emergency or compulsory-treatment exception may apply.