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Cheat sheet

NCLEX-PN Cheat Sheet

Practice this exam

Coordinated Care

  • 18-24% of exam
  • LPN Scope Delegation Client Rights Handoff Priority Picker

Safety + Infection

  • 10-16% of exam
  • Precautions Falls PPE Emergencies Isolation Picker

Health Promotion

  • 6-12% of exam
  • Prevention Development Pregnancy Aging Screening

Psychosocial Integrity

  • 9-15% of exam
  • Communication Coping Grief Crisis Culture

Basic Care

  • 7-13% of exam
  • Nutrition Mobility Elimination Pain ADLs

Pharmacological Therapies

  • 10-16% of exam
  • Med Rights Calculations High Alert IV Therapy Drug Classes

Risk Reduction

  • 9-15% of exam
  • Vital Signs Lab Values Diagnostics Complications Procedure Prep

Physiological Adaptation

  • 7-13% of exam
  • Fluids Cardiac Respiratory Neuro Endocrine

Quick Facts

  • Exam NCLEX-PN
  • Credential LPN/LVN license
  • Format CAT + NGN
  • Items 85-150
  • Time 5 hours
  • Case studies 3 sets
  • Pretest 15 unscored
  • Fee $200 ($350 from Feb. 1, 2027)
  • Result Pass/fail

NCJMM Loop CO

  • Recognize, Analyze, Prioritize, Generate, Act, Evaluate
  • Recognize cues Analyze cues Prioritize hypotheses Generate solutions Take action Evaluate outcomes

LPN vs RN CO

LPN/VN

  • Collects data
  • Implements plan
  • Reports changes

RN

  • Comprehensive assessment
  • Creates care plan
  • Evaluates outcomes
  • Assist vs lead

Priority Picker CO

  • Airway problem → Assess first ( ABC )
  • Breathing impaired → Oxygen, notify ( ABC )
  • Circulation unstable → Supine, legs up
  • Acute change → See before chronic
  • Unstable client → RN/provider now
  • Pain only → After ABCs

CAT + NGN CO

  • CAT Adaptive item selection
  • Minimum 85 items
  • Maximum 150 items
  • Time 5 hours total
  • Case study 6 linked items
  • Pretest 15 unscored items
  • Length Not pass/fail clue
  • Results NRB releases

Delegation Rights CO

  • Task, circumstance, person, direction, supervision
  • Right task Right circumstance Right person Right direction Right supervision

UAP vs LPN CO

UAP

  • Stable routine tasks
  • ADLs
  • Vital signs

LPN

  • Medications
  • Focused data
  • Sterile skills
  • Routine vs licensed

Clinical Judgment CO

  • Recognize cues Find relevant data
  • Analyze cues Connect findings
  • Prioritize hypotheses Rank likely problems
  • Generate solutions Choose interventions
  • Take action Implement priority care
  • Evaluate outcomes Compare expected results

LPN Scope CO

  • Collect data Focused findings
  • Contribute plan Under RN direction
  • Implement care Assigned interventions
  • Reinforce teaching Established plan
  • Report changes RN/provider promptly
  • Know limits State practice act

Delegation CO

  • Right task Routine predictable
  • Right circumstance Stable client
  • Right person Competent delegatee
  • Right direction Clear instructions
  • Right supervision Monitor results
  • Accountability Nurse retains

Rights + Legal CO

  • Autonomy Right to choose
  • Refusal Document, notify
  • Consent Provider explains
  • HIPAA Minimum necessary
  • Abuse Report suspected
  • Incident report Not charted

PPE Order SA

  • On: gown, mask, goggles, gloves
  • Off: gloves first Mask last Hand hygiene Avoid self-contamination

Standard vs Transmission SA

Standard

  • All clients
  • Hand hygiene
  • Body fluids

Transmission

  • Known risk
  • Extra PPE
  • Isolation room
  • Baseline vs added

Isolation Picker SA

  • Blood/body fluids → Standard ( Always )
  • Draining wound → Contact ( Gown/gloves )
  • C. diff stool → Contact ( Soap/water )
  • Influenza cough → Droplet ( Mask )
  • TB suspected → Airborne ( N95 )
  • Measles/varicella → Airborne ( Negative pressure )

Precautions SA

  • Standard Every client
  • Contact Gown + gloves
  • Droplet Surgical mask
  • Airborne N95 + negative pressure
  • C. diff Soap and water
  • TB Airborne isolation
  • Influenza Droplet isolation
  • MRSA wound Contact isolation

Fire Response SA

  • RACE then PASS
  • Rescue Alarm Contain Extinguish Pull/aim/squeeze/sweep

Contact vs Droplet SA

Contact

  • Touch spread
  • Gown/gloves
  • MRSA, C. diff

Droplet

  • Large droplets
  • Surgical mask
  • Influenza, pertussis
  • Touch vs splash

Safety Basics SA

  • Two identifiers Before care
  • Falls Bed low
  • Call light Within reach
  • Restraints Last resort
  • Seizure Protect, time
  • Fire RACE Rescue alarm contain extinguish
  • PASS Pull aim squeeze sweep

Primary vs Secondary HE

Primary

  • Before disease
  • Immunizations
  • Safety teaching

Secondary

  • Early detection
  • Screenings
  • Prompt treatment
  • Prevent vs detect

Prevention + Development HE

  • Primary Prevent disease
  • Secondary Detect early
  • Tertiary Prevent complications
  • Infant Trust vs mistrust
  • Toddler Autonomy vs shame
  • School-age Industry vs inferiority
  • Older adult Integrity vs despair
  • Pregnancy danger Bleeding, headache, edema

Therapeutic vs Nontherapeutic PS

Therapeutic

  • Open questions
  • Reflection
  • Silence

Nontherapeutic

  • Why questions
  • False reassurance
  • Personal advice
  • Explore vs block

Psych Communication PS

  • Open-ended Encourage sharing
  • Silence Allow processing
  • Reflection Mirror feelings
  • False reassurance Avoid
  • Suicide talk Assess safety
  • Crisis Ensure safety first
  • Interpreter Professional preferred
  • Grief Nonlinear process

Basic Comfort BA

  • Tube feeds HOB 30-45
  • Aspiration Side-lying risk clients
  • Pressure injury Turn q2h
  • Braden Skin risk scale
  • Catheter bag Below bladder
  • Stoma Pink, moist
  • Enema Left Sims
  • PQRST Pain assessment

Infiltration vs Phlebitis PH

Infiltration

  • Cool swelling
  • Pale site
  • Fluid in tissue

Phlebitis

  • Warm redness
  • Tender vein
  • Possible cord
  • Leak vs inflammation

Med Action Picker PH

  • Wrong dose ordered → Clarify first
  • Med error occurs → Assess client
  • Digoxin pulse low → Hold, notify
  • Opioid RR low → Hold, notify
  • Warfarin INR high → Bleeding precautions
  • Blood reaction → Stop transfusion

Med Safety PH

  • Three checks Before administration
  • Right patient Two identifiers
  • Medication error Assess first
  • Digoxin Apical pulse first
  • Opioids Assess respirations
  • KCl IV Never push
  • Warfarin Monitor INR
  • Heparin Monitor aPTT
  • Insulin Clear before cloudy
  • TPN Central line

Calculations PH

  • Dose Desired/have x quantity
  • kg lb divided by 2.2
  • mL/hr Volume divided hours
  • gtt/min Volume x drop/time
  • Safe range Verify dose
  • Units Carry through

Priority Frame RI

  • ABC, acute, unstable, actual
  • Airway first Breathing next Circulation next Acute beats chronic

Diagnostic Picker RI

  • Iodinated contrast → Check allergy/kidneys
  • Post cath → Check pulses
  • Post liver biopsy → Right side
  • After endoscopy → Check gag
  • MRI ordered → Remove metal
  • Colonoscopy tomorrow → Bowel prep

Labs + Vitals RI

  • SpO2 <90 critical
  • Urine output 30 mL/hr minimum
  • K+ 3.5-5.0 mEq/L
  • Na+ 135-145 mEq/L
  • WBC 5,000-10,000/mm3
  • Platelets 150,000-400,000/mm3
  • INR 2-3 warfarin
  • BNP Heart failure marker
  • Troponin Myocardial injury

Procedure Prep RI

  • Contrast Check allergy, kidneys
  • Metformin Hold around contrast
  • Cardiac cath Check distal pulses
  • Liver biopsy Right side after
  • Throat sedation NPO until gag
  • MRI Screen metal

Hypo vs Hyperglycemia PH

Hypoglycemia

  • Fast onset
  • Sweaty, shaky
  • Give glucose

Hyperglycemia

  • Slow onset
  • Thirst, polyuria
  • Check ketones
  • Low now kills

Adaptation Emergencies PH

  • Hypoglycemia 15 g glucose
  • DKA Kussmaul, fruity breath
  • Stroke Time onset
  • Anaphylaxis Epinephrine first-line
  • Shock Tachycardia early
  • ICP HOB 30, midline
  • COPD O2 Use ordered flow
  • Transfusion reaction Stop blood

DI vs SIADH PH

DI

  • Too little ADH
  • High urine
  • High sodium

SIADH

  • Too much ADH
  • Low urine
  • Low sodium
  • Dry vs diluted

Body Systems PH

  • Left HF Pulmonary symptoms
  • Right HF Systemic edema
  • Arterial disease Pale, weak pulses
  • Venous disease Edema, present pulses
  • Chest tube leak Continuous bubbling
  • Meningitis Droplet first 24h
  • Hyperthyroid Heat, tachycardia
  • Hypothyroid Cold, bradycardia

Arterial vs Venous PH

Arterial

  • Weak pulses
  • Pale, cool
  • Elevate worsens

Venous

  • Present pulses
  • Brown edema
  • Dependent worsens
  • Supply vs return

Common Traps

Item maximum

  • 150 since April 2023 ≠ Not new in 2026

Exam length myth

  • 85 can fail ≠ 150 can pass

Scope confusion

  • LPN collects data ≠ RN assesses comprehensively

Teaching confusion

  • RN initiates teaching ≠ LPN reinforces teaching

Consent confusion

  • Provider obtains consent ≠ Nurse witnesses signature

C. diff trap

  • Alcohol gel insufficient ≠ Soap/water required

Warfarin antidote

  • Vitamin K reverses ≠ Protamine reverses heparin

Transfusion reaction

  • Stop blood first ≠ Keep saline line

Stroke timing

  • Note onset time ≠ Keep NPO

IV potassium

  • Never IV push ≠ Monitor cardiac rhythm

Last Minute

  • 1. Coordinated care is largest
  • 2. Exam length: 85-150 items
  • 3. Three NGN case studies
  • 4. Clinical judgment has six steps
  • 5. LPN collects; RN assesses
  • 6. Assign stable routine aide tasks
  • 7. ABC before pain
  • 8. Airborne = N95
  • 9. C. diff = soap/water
  • 10. Digoxin: apical pulse first
  • 11. Opioids: assess respirations
  • 12. KCl: never IV push
  • 13. Hypoglycemia: 15 g glucose
  • 14. Transfusion reaction: stop blood