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NCLEX-RN · 8 Essential Terms
NCLEX priority and delegation patterns: ABCs, unstable versus stable, acute versus chronic, UAP and LPN scope, RN-only work, and unexpected findings. The Nurse Practice Act still wins in real life.
These are licensure study notes, not orders for patient care. Follow your program, your facility policy, and the current test plan.
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Airway, breathing, and circulation, in that order, as the first screen for priority. A patent airway outranks a blood pressure, and breathing outranks a routine lab call.
Flip cards, the timed match, and the quiz open in this panel. The full glossary below is ready either way.
Every term, definition, memory hook, and exam trap is written out here so you can review the whole set or print it.
Airway, breathing, and circulation, in that order, as the first screen for priority. A patent airway outranks a blood pressure, and breathing outranks a routine lab call.
Mnemonic. Open the airway before you admire the monitor.
Exam trap. The trap is calling the provider while the airway is obstructed. Get help, but do the bedside act that opens the airway first. ABCs do not outrank a problem that is actually more urgent only when the stem says the ABCs are secure.
An unstable client has changing or unexpected findings and needs the RN now. A stable client has expected findings and predictable needs.
Mnemonic. Changing and unexpected beats chronic and predictable.
Exam trap. The trap is a loud chronic complaint outranking a quiet new change. New confusion, new chest pain, or a fresh drop in blood pressure moves the client to the unstable side.
When two clients are otherwise similar, the acute problem is seen before the chronic one. A brand-new post-operative client outranks a long-stable chronic illness.
Mnemonic. New and acute before old and chronic, if the chronic client is not suddenly unstable.
Exam trap. The trap is ignoring a chronic client who has a new acute change. Chronic illness does not make a new stroke expected. The rule applies when the chronic finding is the usual one.
Unlicensed assistive personnel may take routine vital signs, help with hygiene, and ambulate stable clients. They do not assess, teach, or take unstable clients.
Mnemonic. UAP do routine tasks on stable clients. They do not interpret what they measure.
Exam trap. The trap is delegating the first post-operative vital signs, a new admission, or a client with a new swallow problem. The RN assigns the stable, repetitive task and stays responsible for the outcome.
On the generic NCLEX, an LPN or LVN may care for stable clients, reinforce teaching, and perform routine medications and dressings allowed by that scope. State nurse-practice acts differ.
Mnemonic. LPN scope on the exam is stable, routine, and reinforcement, not the first assessment.
Exam trap. The trap is handing an LPN the unstable client, the new blood transfusion, or the first teaching of a fresh diagnosis. If your state is stricter than the item, the real job follows the state. The item follows its own generic scope.
The generic exam keeps initial assessment, care planning, teaching a new plan, caring for unstable clients, and evaluating outcomes with the RN. Many items also keep IV push and blood administration with the RN.
Mnemonic. If the client is new, unstable, or being evaluated, the RN keeps the work.
Exam trap. The trap is delegating evaluation because the task itself looks simple. Evaluating whether the plan worked is RN work even when a UAP collected one of the numbers.
A finding that does not belong to the known diagnosis. Unexpected beats expected when you are choosing who to see, because the unexpected finding may be a new emergency.
Mnemonic. Expected for the disease can wait behind unexpected for any disease.
Exam trap. The trap is rushing to the client whose findings are dramatic but typical, while another client's quiet new confusion does not fit any diagnosis on the chart. New and unexplained wins.
An actual problem that is happening now outranks a potential problem that might happen later, unless the potential problem is an immediate ABC threat.
Mnemonic. What is already broken beats what might break, unless what might break is the airway.
Exam trap. The trap is a risk for falls outranking a client who is already bleeding. Risks matter, and a potential airway loss is not a someday risk. Read whether the harm is present.