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NCLEX-RN Nursing 考试速记表（2026）
免费、可打印的 NCLEX-RN Nursing 考试速记表：140 个最高频要点，按考试的内容领域分成 7 个板块，每个板块标注其公布权重。
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Management of Care
占考试 15%- Apply ABC first
- Address airway, then breathing, then circulation problems before other needs, because these threaten life most rapidly.
- Use Maslow when no ABC threat exists
- Meet physiological needs before safety, then love and belonging, esteem, and self-actualization.
- Prioritize the unstable client
- The least stable or most rapidly changing client is generally seen first.
- Acute over chronic
- A new, acute problem usually takes priority over a stable chronic condition.
- Delegate routine tasks to UAP
- Vital signs on stable clients, hygiene, ambulation, and intake and output are appropriate for unlicensed assistive personnel.
- Reserve nursing judgment for the RN
- Initial assessment, care planning, teaching, and evaluation stay with the registered nurse.
- Match acuity to competency
- Assign stable, predictable clients to less experienced staff and complex clients to experienced nurses.
- Accountability is not transferred
- Delegation moves the task, not the responsibility; the RN supervises and follows up.
- Respect autonomy
- Competent clients may accept or refuse treatment; document refusals and notify the provider.
- Clarify consent roles
- The provider explains risks and alternatives; the nurse witnesses that consent is voluntary and informed.
- Advocate for the client
- Speak up when a plan may harm the client or conflicts with the client's expressed wishes.
- Protect confidentiality
- Share protected health information only with those involved in the client's care.
- Practice veracity
- Document only care that was actually provided; falsification is an ethical and legal violation.
- Report errors and near-misses
- Complete an incident report for quality improvement; do not file it in the medical record.
- Apply nonmaleficence
- Avoid actions that could harm the client, and question unsafe orders.
- Ensure justice
- Distribute care and resources fairly regardless of the client's background.
- Give structured handoff
- Emphasize the least stable clients and use a consistent format to ensure continuity.
- Plan discharge early
- Arrange home health, equipment, and follow-up appointments before the client leaves.
- Coordinate the team
- Communicate with providers, therapists, and social workers to align the plan of care.
- Reconcile medications
- Verify the client's medication list at transitions to prevent omissions and duplications.
Safety and Infection Control
占考试 13%- Use standard precautions always
- Perform hand hygiene and use PPE whenever contact with blood or body fluids is possible.
- Airborne precautions
- Tuberculosis, measles, and varicella require a negative-pressure room and an N95 respirator.
- Droplet precautions
- Influenza and meningococcal meningitis require a mask and a private room when possible.
- Contact precautions
- MRSA, C. difficile, and scabies require gowns and gloves; use soap and water for C. difficile.
- Donning order
- Apply gown, then mask or respirator, then goggles, then gloves.
- Doffing order
- Remove gloves, then goggles, then gown, then mask, performing hand hygiene between and after.
- Hand hygiene bookends PPE
- Wash or sanitize hands before donning and after doffing every time.
- Right PPE for the task
- Select PPE based on anticipated exposure to blood, secretions, or airborne particles.
- Screen for fall risk
- Assess age, mobility, cognition, and medications; use bed alarms and frequent rounding for high-risk clients.
- Modify the environment
- Remove clutter, improve lighting, and keep the call light and needed items within reach.
- Restraints need an order
- Obtain a current provider order and use the least restrictive device for the shortest time.
- Monitor restrained clients
- Check circulation, skin, and needs every 15 to 30 minutes and use a quick-release knot on the bed frame.
- Follow RACE for fire
- Rescue, Alarm, Confine, then Extinguish, in that order.
- Prevent oxygen fires
- Prohibit smoking and open flames near oxygen and use only water-based lubricants.
- Prepare for seizures
- Keep suction and oxygen at the bedside, pad rails, and never place objects in the mouth.
- Decontaminate before care
- Remove hazardous chemicals from the client before other treatment to protect the client and staff.
- Verify two identifiers
- Confirm client identity with two identifiers before medications, procedures, and transfusions.
- Double-check high-alert items
- Two qualified staff verify blood products, insulin, and other high-risk agents.
- Honor allergy alerts
- Provide latex-free or allergen-free supplies and hold any drug the client is allergic to.
- Store medications safely
- Keep drugs in original labeled containers, locked away from children, and discard expired medications.
Health Promotion and Maintenance
占考试 12%- Colorectal screening at 45
- Average-risk adults begin colorectal cancer screening at age 45.
- Cervical screening
- Women aged 30 may have a Pap test every three years or human papillomavirus co-testing at extended intervals.
- Do not wait for symptoms
- Screening aims to detect disease before symptoms appear.
- Individualize by risk
- Family history and personal risk factors may warrant earlier or more frequent screening.
- Avoid live vaccines in pregnancy
- MMR and varicella are live attenuated vaccines contraindicated during pregnancy.
- Recommend inactivated vaccines in pregnancy
- Inactivated influenza and Tdap protect the mother and newborn.
- Screen for contraindications
- Assess for immunosuppression and severe allergy before administering vaccines.
- Educate on schedules
- Teach the recommended childhood and adult immunization timelines.
- Infant milestones
- By 12 months, infants pull to stand, cruise, and may take first steps.
- Introduce solids around 6 months
- Start solid foods when the infant sits with support and has lost the tongue-thrust reflex.
- Toddler and preschool language
- A 4-year-old speaks in short sentences that strangers can understand.
- Recognize red flags
- Loss of skills or major delays warrant further developmental evaluation.
- Guide pregnancy weight gain
- A woman of normal weight is advised to gain about 25 to 35 pounds.
- Support breastfeeding
- Six or more wet diapers a day indicate adequate infant hydration.
- Teach newborn feeding cues
- Encourage feeding on demand and monitor output and weight.
- Promote prenatal nutrition
- Encourage folic acid intake and a balanced diet to support fetal development.
- Promote heart-healthy diet
- Encourage fish, vegetables, and whole grains while limiting saturated fat and sodium.
- Recommend regular activity
- Most adults benefit from about 150 minutes of moderate activity weekly plus balance and strength work.
- Support tobacco cessation
- Help clients set a quit date and use behavioral and pharmacologic support.
- Advise moderate alcohol
- Moderate intake is up to one drink daily for women and two for men.
Psychosocial Integrity
占考试 12%- Acknowledge feelings
- Reflect and validate the client's emotions to encourage expression.
- Use open-ended questions
- Invite the client to share more rather than asking yes-or-no questions.
- Use silence
- Allow pauses so the client has time to process and respond.
- Avoid communication blocks
- Do not give false reassurance, advice, or change the subject.
- Present reality kindly
- For hallucinations, acknowledge the client's experience without confirming or arguing about the perception.
- Reduce stimulation in mania
- Provide a calm environment and portable high-calorie foods for manic clients.
- Watch physiology in eating disorders
- Bradycardia and electrolyte imbalance in anorexia can be life-threatening and take priority.
- Support panic clients
- Stay present, remain calm, and use short, simple statements during a panic attack.
- Ask directly about suicide
- Directly asking about suicidal ideation assesses risk and does not increase self-harm.
- Assess safety in abuse
- Evaluate immediate safety and provide resources for clients disclosing violence.
- Monitor withdrawal
- Seizures during alcohol withdrawal are an emergency requiring immediate intervention.
- De-escalate anger
- Acknowledge feelings and invite discussion rather than commanding or threatening.
- Recognize grief stages
- Denial, anger, bargaining, depression, and acceptance may occur in any order.
- Support the grieving
- Use presence and silence and encourage expression of feelings.
- Identify postpartum depression
- Persistent sadness and disinterest in the infant beyond two weeks warrant evaluation.
- Support families at end of life
- Provide privacy and encourage families to express feelings.
- Reorient in delirium
- Provide frequent reorientation, familiar objects, and consistent caregivers.
- Avoid overstimulation
- Reduce noise and clutter that can worsen confusion and agitation.
- Minimize restraints
- Use nonpharmacologic strategies before considering restraints for confused clients.
- Ensure a safe environment
- Prevent wandering and injury while preserving dignity.
Basic Care and Comfort
占考试 12%- Know clear liquids
- Clear liquids include apple juice, broth, and plain gelatin, which leave little residue.
- Prevent aspiration in dysphagia
- Position the client upright and use chin-tuck swallowing; avoid thin liquids as ordered.
- Provide comfort during NPO
- Offer oral care and lip moisture without giving fluids to an NPO client.
- Verify tube feeding placement
- Confirm nasogastric tube placement per protocol using pH or radiographic methods before feeding.
- Treat constipation conservatively
- Increase fluids, fiber, and activity before using enemas or laxatives.
- Report low urine output
- Output below 30 mL per hour may indicate poor perfusion or obstruction and should be reported.
- Provide correct perineal care
- Clean from the urethra outward toward the anus using a clean cloth section per stroke.
- Maintain catheter safety
- Keep the drainage bag below the bladder and the system closed to prevent infection.
- Fit crutches correctly
- The crutch top rests about two finger-widths below the axilla with weight on the hands.
- Prevent venous thromboembolism
- Encourage leg exercises and apply sequential compression devices for immobile clients.
- Apply antiembolism stockings correctly
- Apply while the client is lying down before rising, without wrinkles or rolling.
- Reposition regularly
- Change position at least every two hours to maintain circulation and prevent breakdown.
- Reposition to prevent injury
- Turn and reposition at least every two hours and use the 30-degree lateral position.
- Stage pressure injuries
- Stage 1 is nonblanchable redness, stage 2 is partial-thickness loss, and deeper stages involve full-thickness loss.
- Avoid harmful practices
- Do not massage bony prominences or use doughnut cushions, which cause tissue damage.
- Keep skin clean and dry
- Manage moisture and incontinence to protect skin integrity.
- Protect the airway during oral care
- Position unconscious clients side-lying and use minimal fluid to prevent aspiration.
- Promote rest
- Cluster care and reduce nighttime interruptions to support sleep.
- Manage pain and comfort
- Use pharmacologic and nonpharmacologic measures to relieve discomfort.
- Maintain dignity
- Provide privacy and involve the client in hygiene decisions when possible.
Pharmacological and Parenteral Therapies
占考试 15%- Apply the rights
- Verify the right client, drug, dose, route, time, and documentation.
- Honor allergies
- Hold any drug the client is allergic to and notify the prescriber.
- Verify identity
- Use two identifiers before administering medications.
- Document accurately
- Record administration promptly and never chart a drug before giving it.
- Use desired over available
- Divide the ordered dose by the dose on hand and multiply by the quantity.
- Double-check high-alert drugs
- Have a second nurse verify insulin, heparin, and pediatric doses.
- Convert units carefully
- Ensure consistent units before calculating to avoid tenfold errors.
- Question unusual doses
- Verify any dose that seems too high or requires many tablets or vials.
- Monitor anticoagulants
- Use PT and INR for warfarin and aPTT for heparin; protamine reverses heparin and vitamin K reverses warfarin.
- Check cardiac drugs
- Hold digoxin for an apical rate below 60 and assess heart rate and blood pressure before beta-blockers.
- Watch diuretics
- Loop diuretics such as furosemide can cause hypokalemia; monitor potassium.
- Monitor nephrotoxic antibiotics
- Check renal function and peak and trough levels with aminoglycosides.
- Recognize opioid effects
- Assess respiratory rate and sedation and initiate a bowel regimen to prevent constipation.
- Detect lithium toxicity
- Vomiting, coarse tremors, and confusion signal toxicity due to the narrow therapeutic range.
- Teach ACE inhibitor cough
- A persistent dry cough is common, and angioedema is a rare emergency.
- Taper corticosteroids
- Do not stop long-term steroids abruptly; taper to prevent adrenal insufficiency.
- Never IV push potassium
- Dilute IV potassium and infuse slowly with a pump; rapid administration can be fatal.
- Time insulin with food
- Ensure rapid-acting insulin such as lispro is followed by food within about 15 minutes.
- Give blood with saline
- Infuse blood products with normal saline only and verify with a second nurse.
- Teach food and drug interactions
- Avoid tyramine with MAOIs and separate tetracycline from dairy and antacids.
Physiological Adaptation and Reduction of Risk
占考试 21%- Know normal potassium
- Normal serum potassium is about 3.5 to 5.0 mEq/L; values above or below signal danger.
- Interpret cardiac markers
- Troponin is the most specific marker for myocardial injury and rises within hours.
- Assess coagulation
- An INR of 5.0 indicates a high bleeding risk; normal is near 1.0 without anticoagulation.
- Recognize anemia
- A low hemoglobin causes fatigue, pallor, and compensatory tachycardia.
- Recognize fluid overload
- Rapid weight gain and lung crackles suggest fluid volume overload.
- Recognize dehydration
- Poor skin turgor and concentrated urine indicate fluid volume deficit.
- Prioritize hyperkalemia
- Peaked T waves with high potassium require immediate intervention.
- Interpret hypocalcemia
- Positive Trousseau and Chvostek signs reflect increased neuromuscular excitability.
- Identify respiratory acidosis
- A low pH with an elevated PaCO2 reflects hypoventilation.
- Identify respiratory alkalosis
- A high pH with a low PaCO2 reflects hyperventilation.
- Identify metabolic acidosis
- Diabetic ketoacidosis lowers pH and bicarbonate and triggers Kussmaul respirations.
- Identify metabolic alkalosis
- Loss of gastric acid through suction causes alkalosis with hypokalemia.
- Act fast in stroke
- Facial droop, slurred speech, and weakness require immediate stroke protocol activation and onset time documentation.
- Suspect pulmonary embolism
- Sudden dyspnea, chest pain, and tachycardia after surgery signal a possible embolism.
- Detect early increased ICP
- A change in level of consciousness is the earliest sign of increased intracranial pressure.
- Recognize compensated shock
- Tachycardia and cool, clammy skin appear as the body compensates for hypovolemia.
- Treat hypoglycemia promptly
- Give about 15 grams of fast-acting carbohydrate to a conscious client, then recheck glucose.
- Recognize thyroid patterns
- Hypothyroidism causes fatigue, cold intolerance, and bradycardia; hyperthyroidism causes the opposite.
- Prevent adrenal crisis
- Severe hypotension and hyperkalemia in Addison's disease require immediate fluids and hydrocortisone.
- Support organ failure
- Lower ammonia in hepatic encephalopathy and implement bleeding precautions in liver failure.
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