NCLEX-PN Cram Sheet

Normal Lab Values

• Na+ 135–145 mEq/L
• K+ 3.5–5.0 mEq/L
• Ca2+ 8.5–10.5 mg/dL
• Mg2+ 1.5–2.5 mEq/L
• Glucose 70–110 mg/dL
• BUN 10–20 mg/dL
• Creatinine 0.6–1.2 mg/dL
• Hgb (M) 14–18 g/dL
• Hgb (F) 12–16 g/dL
• Hct (M) 42–52%
• Hct (F) 37–47%
• Platelets 150,000–400,000
• WBC 5,000–10,000
• PT/INR (therapeutic) 2.0–3.0
• aPTT (therapeutic) 60–100 sec

ABG Values

• pH 7.35–7.45
• PaCO2 35–45 mmHg
• HCO3 22–26 mEq/L
• PaO2 80–100 mmHg
• SaO2 95–100%

ABG Quick Guide (ROME)

• Resp Acidosis: pH↓ CO2↑
• Resp Alkalosis: pH↑ CO2↓
• Met Acidosis: pH↓ HCO3↓
• Met Alkalosis: pH↑ HCO3↑

Vital Sign Norms

• HR 60–100 bpm
• RR 12–20 breaths/min
• BP <120/80 mmHg
• Temp 98.6°F / 37°C
• SpO2 ≥95%

Drug Antidotes

• Warfarin → Vitamin K
• Heparin → Protamine sulfate
• Opioids → Naloxone (Narcan)
• Benzodiazepines → Flumazenil
• Acetaminophen → N-acetylcysteine (Mucomyst)
• Digoxin → Digoxin immune Fab (Digibind)
• Magnesium toxicity → Calcium gluconate
• Iron → Deferoxamine

Therapeutic Drug Levels

• Digoxin 0.5–2.0 ng/mL
• Lithium 0.6–1.2 mEq/L
• Phenytoin 10–20 mcg/mL
• Theophylline 10–20 mcg/mL
• Vancomycin (trough) 10–20 mcg/mL
• PT/INR (Warfarin) 2.0–3.0
• aPTT (Heparin) 1.5–2.5× normal

Insulin Types

• Rapid (Lispro/Aspart): 15 min onset, peak 1–2h, duration 3–5h
• Short (Regular): 30–60 min onset, peak 2–4h, duration 5–8h
• Intermediate (NPH): 1–3h onset, peak 4–12h, duration 16–24h
• Long (Glargine/Detemir): 1–2h onset, NO peak, duration 24h
• Mixing: Clear before cloudy (regular before NPH)
• IV insulin: Regular insulin ONLY

LPN Scope of Practice

• ✅ Stable clients, predictable outcomes
• ✅ Routine medication administration
• ✅ Wound care, dressing changes
• ✅ Data collection and reporting
• ✅ Reinforce RN teaching
• ❌ Initial nursing assessment
• ❌ Developing/modifying care plans
• ❌ Initial client teaching
• ❌ Unstable or complex clients
• ❌ Interpreting complex rhythms/labs

Priority Rules

• ABCs first — Airway → Breathing → Circulation
• Maslow — Physiological before psychosocial
• Actual problems before potential
• Unstable before stable
• Life-threatening before comfort
• Assessment before implementation
• Report changes in condition immediately

Kübler-Ross Stages

• 1. Denial — "This can't be happening"
• 2. Anger — "Why me?" (may be directed at nurse)
• 3. Bargaining — "If I do X, maybe…"
• 4. Depression — Sadness, withdrawal
• 5. Acceptance — "I'm ready"
• Not linear — client may move back and forth
• Anger at nurse = displacement (don't take it personally)