N170
Study Guide 2026–2027
Key Concepts and Review
Original educational study resource • Not an official course document
How to Use This Guide
Use this guide to organize your review, connect clinical findings with nursing priorities, and practice safe decision-making. It
is a broad nursing review because N170 course titles and syllabi vary by institution. Compare each topic with your current
syllabus, assigned readings, skills checklists, and instructor guidance.
1. Clinical Judgment and Prioritization
A practical sequence for clinical decisions is to recognize cues, analyze what they mean, prioritize likely problems, select
safe actions, implement them, and evaluate the response. Do not rely on a single number or symptom when the overall
pattern suggests deterioration.
• Immediate threats: Airway obstruction, severe respiratory distress, absent or abnormal breathing, major bleeding,
shock, sudden neurologic change, and unresponsiveness take priority over routine needs.
• ABCs and acute change: Assess airway, breathing, and circulation while considering the patient's baseline and the
speed of change. A new abnormal finding can be more urgent than a chronic stable problem.
• Safety before routine tasks: Pause an unsafe medication, clarify a conflicting order, protect a patient at risk of falling,
and escalate rapidly when the patient's condition worsens.
• Reassessment: After an intervention, reassess the specific problem, relevant vital signs, adverse effects, and whether
the intended outcome occurred.
2. Assessment and Vital Signs
Assessment includes the patient's reported symptoms, observed signs, focused examination, relevant history, medication
profile, allergies, and trends over time. Interpret vital signs in context; age, baseline, medications, activity, and the clinical
setting influence what is expected.
• Respiratory assessment: Observe rate, effort, ability to speak, mental status, skin color, breath sounds, and oxygen
saturation. New stridor, cyanosis, severe work of breathing, or falling saturation needs urgent attention.
• Circulation and perfusion: Assess pulse, blood pressure, skin temperature, capillary refill, mental status, urine
output, and symptoms such as chest pressure or syncope.
• Neurologic assessment: Compare with baseline; assess level of consciousness, speech, facial symmetry, limb
strength, pupils, and sudden changes. Record last-known-well time for suspected stroke.
• Pain assessment: When the patient can communicate reliably, self-report is the primary measure. Ask about location,
onset, quality, severity, timing, associated symptoms, and effect on function.
• Trends matter: A worsening respiratory rate, new confusion, reduced urine output, or falling blood pressure may be
important even before every parameter becomes abnormal.
N170 Study Guide 2026–2027 | Original Educational Review Resource
, 3. Medication Safety
Use the medication administration process required by your institution. Verify the correct patient, medication, dose, route,
time, indication, documentation, and response, along with allergies and any medication-specific checks.
• Identity and allergies: Use approved patient identifiers. Stop and clarify discrepancies or a documented severe allergy
before giving the medication.
• High-alert medications: Follow independent checks and monitoring requirements when policy or the medication
requires them. Verify calculations rather than relying on memory.
• Dose calculations: Confirm units, concentration, route, safe dose range, and relevant weight or renal function. For
pediatric calculations, use a current weight in kilograms and verify the recommended range.
• Do not improvise: Never give IV potassium by IV push. Do not crush extended-release or enteric-coated products
unless authoritative product guidance confirms it is safe.
• Adverse effects: New breathing difficulty, facial or tongue swelling, severe rash with blistering or mucosal sores,
marked sedation, or signs of serious bleeding require prompt assessment and escalation.
• Medication reconciliation: Include prescriptions, over-the-counter products, supplements, allergies, and how the
patient actually takes each medicine. Clarify missed-dose or stopping instructions with an appropriate clinician or
pharmacist.
4. Infection Prevention and Aseptic Practice
• Hand hygiene: Perform hand hygiene at recommended moments and after glove removal. Gloves do not replace hand
hygiene.
• Standard precautions: Use for every patient based on anticipated exposure risk. Add transmission-based precautions
when indicated.
• PPE: Choose PPE according to the anticipated exposure and isolation requirements; remove it safely to avoid
contaminating yourself or the environment.
• Sterile technique: Protect the sterile field, keep sterile items in view, and replace supplies when contamination is
suspected.
• Specimens: Verify patient identity and label specimens at the point of collection according to policy.
• Catheter care: Maintain a closed drainage system, keep the collection bag below bladder level, avoid unnecessary
disconnections, and remove the catheter when no longer indicated.
• Needlestick or exposure: Wash or flush the exposed area promptly as appropriate and report immediately under the
exposure protocol; do not apply caustic chemicals to tissue.
5. Respiratory and Airway Emergencies
Respiratory problems can deteriorate quickly. Assess the patient first, summon help when indicated, and provide
prescribed or protocol-based interventions within scope.
• Upper-airway warning signs: Stridor, tongue or facial swelling, hoarseness with swelling, and inability to handle
secretions may signal obstruction.
• Asthma or COPD: Assess work of breathing, mental status, oxygenation, and response to prescribed treatment. Use
oxygen according to the ordered target and clinical status; do not withhold indicated oxygen solely because COPD is
present.
• Pneumonia or hypoxemia: Increasing respiratory rate, new confusion, worsening oxygenation, and increased work of
breathing may signal deterioration.
• Aspiration risk: Follow the patient's swallowing recommendations, position safely for meals or tube feeding, pace
feeding appropriately, and stop feeding if coughing or respiratory distress occurs.
• Possible pulmonary edema or embolism: Sudden severe dyspnea, chest pain, widespread crackles, or pink frothy
sputum warrants urgent assessment and escalation.
N170 Study Guide 2026–2027 | Original Educational Review Resource
Study Guide 2026–2027
Key Concepts and Review
Original educational study resource • Not an official course document
How to Use This Guide
Use this guide to organize your review, connect clinical findings with nursing priorities, and practice safe decision-making. It
is a broad nursing review because N170 course titles and syllabi vary by institution. Compare each topic with your current
syllabus, assigned readings, skills checklists, and instructor guidance.
1. Clinical Judgment and Prioritization
A practical sequence for clinical decisions is to recognize cues, analyze what they mean, prioritize likely problems, select
safe actions, implement them, and evaluate the response. Do not rely on a single number or symptom when the overall
pattern suggests deterioration.
• Immediate threats: Airway obstruction, severe respiratory distress, absent or abnormal breathing, major bleeding,
shock, sudden neurologic change, and unresponsiveness take priority over routine needs.
• ABCs and acute change: Assess airway, breathing, and circulation while considering the patient's baseline and the
speed of change. A new abnormal finding can be more urgent than a chronic stable problem.
• Safety before routine tasks: Pause an unsafe medication, clarify a conflicting order, protect a patient at risk of falling,
and escalate rapidly when the patient's condition worsens.
• Reassessment: After an intervention, reassess the specific problem, relevant vital signs, adverse effects, and whether
the intended outcome occurred.
2. Assessment and Vital Signs
Assessment includes the patient's reported symptoms, observed signs, focused examination, relevant history, medication
profile, allergies, and trends over time. Interpret vital signs in context; age, baseline, medications, activity, and the clinical
setting influence what is expected.
• Respiratory assessment: Observe rate, effort, ability to speak, mental status, skin color, breath sounds, and oxygen
saturation. New stridor, cyanosis, severe work of breathing, or falling saturation needs urgent attention.
• Circulation and perfusion: Assess pulse, blood pressure, skin temperature, capillary refill, mental status, urine
output, and symptoms such as chest pressure or syncope.
• Neurologic assessment: Compare with baseline; assess level of consciousness, speech, facial symmetry, limb
strength, pupils, and sudden changes. Record last-known-well time for suspected stroke.
• Pain assessment: When the patient can communicate reliably, self-report is the primary measure. Ask about location,
onset, quality, severity, timing, associated symptoms, and effect on function.
• Trends matter: A worsening respiratory rate, new confusion, reduced urine output, or falling blood pressure may be
important even before every parameter becomes abnormal.
N170 Study Guide 2026–2027 | Original Educational Review Resource
, 3. Medication Safety
Use the medication administration process required by your institution. Verify the correct patient, medication, dose, route,
time, indication, documentation, and response, along with allergies and any medication-specific checks.
• Identity and allergies: Use approved patient identifiers. Stop and clarify discrepancies or a documented severe allergy
before giving the medication.
• High-alert medications: Follow independent checks and monitoring requirements when policy or the medication
requires them. Verify calculations rather than relying on memory.
• Dose calculations: Confirm units, concentration, route, safe dose range, and relevant weight or renal function. For
pediatric calculations, use a current weight in kilograms and verify the recommended range.
• Do not improvise: Never give IV potassium by IV push. Do not crush extended-release or enteric-coated products
unless authoritative product guidance confirms it is safe.
• Adverse effects: New breathing difficulty, facial or tongue swelling, severe rash with blistering or mucosal sores,
marked sedation, or signs of serious bleeding require prompt assessment and escalation.
• Medication reconciliation: Include prescriptions, over-the-counter products, supplements, allergies, and how the
patient actually takes each medicine. Clarify missed-dose or stopping instructions with an appropriate clinician or
pharmacist.
4. Infection Prevention and Aseptic Practice
• Hand hygiene: Perform hand hygiene at recommended moments and after glove removal. Gloves do not replace hand
hygiene.
• Standard precautions: Use for every patient based on anticipated exposure risk. Add transmission-based precautions
when indicated.
• PPE: Choose PPE according to the anticipated exposure and isolation requirements; remove it safely to avoid
contaminating yourself or the environment.
• Sterile technique: Protect the sterile field, keep sterile items in view, and replace supplies when contamination is
suspected.
• Specimens: Verify patient identity and label specimens at the point of collection according to policy.
• Catheter care: Maintain a closed drainage system, keep the collection bag below bladder level, avoid unnecessary
disconnections, and remove the catheter when no longer indicated.
• Needlestick or exposure: Wash or flush the exposed area promptly as appropriate and report immediately under the
exposure protocol; do not apply caustic chemicals to tissue.
5. Respiratory and Airway Emergencies
Respiratory problems can deteriorate quickly. Assess the patient first, summon help when indicated, and provide
prescribed or protocol-based interventions within scope.
• Upper-airway warning signs: Stridor, tongue or facial swelling, hoarseness with swelling, and inability to handle
secretions may signal obstruction.
• Asthma or COPD: Assess work of breathing, mental status, oxygenation, and response to prescribed treatment. Use
oxygen according to the ordered target and clinical status; do not withhold indicated oxygen solely because COPD is
present.
• Pneumonia or hypoxemia: Increasing respiratory rate, new confusion, worsening oxygenation, and increased work of
breathing may signal deterioration.
• Aspiration risk: Follow the patient's swallowing recommendations, position safely for meals or tube feeding, pace
feeding appropriately, and stop feeding if coughing or respiratory distress occurs.
• Possible pulmonary edema or embolism: Sudden severe dyspnea, chest pain, widespread crackles, or pink frothy
sputum warrants urgent assessment and escalation.
N170 Study Guide 2026–2027 | Original Educational Review Resource
