Lessons

Decide what may be handed to a licensed practical nurse or to unlicensed assistive personnel, what may never leave the registered nurse, and what the RN still owes after delegating.

Work through a set of clients in the order that prevents the most harm, using airway-breathing-circulation, actual before potential, and unstable before stable.

Say who explains a procedure, what the nurse's signature attests to, when an advance directive takes effect, and whose decision counts when people disagree.

Choose airborne, droplet or contact precautions from how an organism travels, and name the equipment, the room and the transport rules each one requires.

Apply the checks that stop the common errors — wrong client, wrong site, wrong drug — and say what to do after one has happened.

Recognize the milestones that matter, name the age-appropriate safety advice, and say when a delay needs referring rather than watching.

Name the danger signs in pregnancy, read a fetal heart rate pattern, and assess a mother and newborn in the first days.

Choose the response that keeps a client talking, name the techniques that close a conversation down, and handle silence, anger and hopelessness.

Assess suicide risk and act on it, de-escalate escalating behavior, and apply the rules that govern seclusion and restraint.

Choose a position for a given client's risk, prevent pressure injury and contracture, and teach a client to use a cane, crutches or a walker.

Manage enteral feeding safely, recognize dehydration and overload, and care for a client with an ostomy or a catheter.

Apply the rights of administration, name the assessments that must precede specific drugs, and calculate a dose or an infusion rate reliably.

Name the drug reactions that are emergencies, distinguish them from expected effects, and say what the nurse does first for each.

Recall the reference ranges that decide nursing actions, and say which results are reported immediately rather than recorded.

Anticipate what goes wrong after surgery and when, distinguish expected findings from reportable ones, and name the prevention for each.

Name the disturbance from a set of arterial blood gas values, say whether it is compensated, and connect each pattern to the clients who produce it.

Identify compensated shock from findings other than blood pressure, tell the four types apart, and name the first action for each.

Predict the findings of each major electrolyte disturbance, name the clients who develop them, and say which are treated urgently.