lOMoARcPSD|26582732
Lomoarcpsd|26582732
1
HESI Hints & Nclex GEMS –
2025-2026
ESI Hints And NCLEX Gems
• Answering NCLEX Questions O Maslow’s Hierarchy Of Needs
Physiologic
Safety
Love And Belonging
Esteem
Self-Actualization O Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation O Abcs
Airway
Breathing
Circulation
• Normal Values O Hgb
Males 14 – 18
Females 12 – 16 O Hct
Males 42 – 52
Females 37 – 47 O Rbcs
Males: 4.7 – 6.1million
Females: 4.2 – 5.4 Million
o Wbcs
4.5 – 11K O
Platelets
150 – 400K O PT
(Coumadin/Warfarin)
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2
11 – 12.5 Sec
INR And PT TR = 1.5-2
Times Normal) O Aptt (Heparin)
60 – 70 Sec O BUN:
10 – 20 O Creatinine: 0.5 – 1.2 O
Glucose: 70 – 110 O
Cholesterol: <200 O
Bilirubin Newborn: 1 – 12 O
Phenylalanine
Newborn: <2
Adult: <6 O Na:
135 – 145 O K: 3.5 – 5.0
Hypokalemia:
Prominent U Waves, Depresses ST
Segment, Flat T Waves
Hyperkalemia: Tented T
Waves, Prolonged PR Interval, Wide
QRS
o Calcium: 9 – 10.5
Hypocalcemia: Muscle Spasms, Convulsions, Cramping, Tetany, Pos Trousseau’s, Pos Chvostek’s,
Prolonged ST Interval, Prolonged QT Segments
o Mg: 1.5 – 2.5 O Cl: 96 – 106 O Phos: 3 – 4.5 O Albumin: 3.5 – 5 O Specific Gravity: 1.005 –
1.030 O Hgba1c:
Ideal = 4-6%
Ok (120 Days) <7% O Dilantin TR: 10 – 20 O Lithium TR: 0.5 – 1.5 O Arterial Blood Gas
Ph = 7.35 – 7.45
CO2 = 35 – 45
HCO3 = 22 – 28
O2 = 80 – 100
O2 Sat = 95 – 100%
• Antidotes O Digoxin – Digiband O Coumadin – Vit K O Benzos –
Flumzaemil (Tomazicon) O Heparin – Protamine Sulfate (Keep
Aptt And PTT At 1.5-2 Times Normal) O Tylenol – Mucomyst
(Loading Dose + 17 Doses) O Opiates (Narcotics Analgesics,
Heroin, Morphine) – Narcan (Naloxone) O Cholinergic Meds
(Myesthenic Bradycardia) – Atropine O Methotrexate –
Leucovorin
• Delegation O RN Only
Blood Products (2 Rns Must Check)
Clotting Factors
Sterile Dressing Changes And Procedures
Assessments That Require Clinical Judgment
Ultimately Responsible For All Delegated Duties O Unlicensed Assistive Personnel
Non-Sterile Procedures
• Precautions And Room Assignments O Universal
(Standard) Precautions – HIV Initiated
Wash Hands
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, lOMoARcPSD|26582732
3
Wear Gloves
Gowns For Splashes
Masks And Eye Protection For Splashes And Droplets
Don’t Recap Needles
Mouthpiece Of Ambu-Bag For Resuscitation
Refrain From Giving Care If You Have Skin Lesions O Droplet (Respiratory) Precautions – Wear Mask
Sepsis, Scarlet Fever, Strep, Fifth Disease (Parvo B19), Pertusis, Pneumonia, Influenza, Diphtheria,
Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma, Adenovirus, Rhinovirus
RSV (Needs Contact Precautions Too)
TB (Respiratory Isolation) O Contact Precautions = Universal + Goggles, Mask, And Gown O
No Infectious Patients With Immunosuppressed Patients
Clean With Clean
Dirty With Dirty Misc.
o Rifampin (For TB) – Rust/Orange/Red Urine And Body Fluids O Pyridium (For Bladder Infection) …
Orange/Red/Pink Urine O Glasgow Coma Scale … < 8 = Coma O Myasthenia Gravis
Myasthenic Crisis = Weakness With Change In Vitals (Give More Meds)
Cholinergic Crisis = Weakness With No Change In Vitals (Reduce Meds) O Diabetic
Coma Vs. Insulin Shock … Give Glucose First – If No Help, Give Insulin O Fruity Breath = Diabetic
Ketoacidosis O Acid-Base Balance
If It Comes Out Of Your Ass, It’s Acidosis.
Vomiting = Alkalosis O Skin Tastes Salty = Cystic Fibrosis O Lipitor (Statins) In Pms
Only – No Grapefruit Juice O Stroke
Tongue Points Toward Side Of Lesion (Paralysis)
Uvula Deviates Away From The Side Of Lesion (Paralysis) O Hold Digoxin If HR <
60 O Stay In Bed For 3 Hours After First ACE Inhibitor Dose O Avoid Grapefruit Juice With
Ccbs O Anthrax = Multi-Vector Biohazard O Pulmonary Air Embolism Prevention =
Trendelenberg (HOB Down) + On Left Side (To Trap Air In Right Side Of Heart) O Head
Trauma And Seizures – Maintain Airway = Primary Concern O Peptic Ulcers
Feed A Duodenal Ulcer (Pain Relieved By Food)
Starve A Gastric Ulcer O Acute Pancreatitis
Fetal Position, Bluish Discoloration Of Flanks (Turner’s Sign), Bluish Discoloration Of
Pericumbelical Region (Cullen’s Sign), Board Like Abdomen With Guarding Self Digestion Of
Pancreas By Trypsin. O Hold Tube Feeding If Residual > 100ml O In Case Of Fire – RACE And
PASS O Check Restraints Every 30 Minutes – 2 Fingers Room Underneath O Gullian-Barre
Syndrome
Weakness Progresses From Legs Upward – Leads To Resp Arrest O Trough Draw
= ~30 Min Before Scheduled Administration O Peak Draw = 30-60 Min After Drug
Administration.
• Mental Health And Psychiatry O Most Suicides Occur After
Beginning Of Improvement With Increase In Energy Levels O
Maois
Hypertensive Crisis With Tyramine Foods
Nardil, Marplan, Parnate
Need 2 Wk Gap From Ssris And Tcas To Admin Maois
o Lithium Therapeutic Range = 0.5-1.5 O Phenothiazines (Typical Antipsychotics) – EPS, Photosensitivity O
Atypical Antipsychotics – Work On Positive And Negative Symptoms, Less EPS O Benzos (Ativan,
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Lomoarcpsd|26582732
1
HESI Hints & Nclex GEMS –
2025-2026
ESI Hints And NCLEX Gems
• Answering NCLEX Questions O Maslow’s Hierarchy Of Needs
Physiologic
Safety
Love And Belonging
Esteem
Self-Actualization O Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation O Abcs
Airway
Breathing
Circulation
• Normal Values O Hgb
Males 14 – 18
Females 12 – 16 O Hct
Males 42 – 52
Females 37 – 47 O Rbcs
Males: 4.7 – 6.1million
Females: 4.2 – 5.4 Million
o Wbcs
4.5 – 11K O
Platelets
150 – 400K O PT
(Coumadin/Warfarin)
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
2
11 – 12.5 Sec
INR And PT TR = 1.5-2
Times Normal) O Aptt (Heparin)
60 – 70 Sec O BUN:
10 – 20 O Creatinine: 0.5 – 1.2 O
Glucose: 70 – 110 O
Cholesterol: <200 O
Bilirubin Newborn: 1 – 12 O
Phenylalanine
Newborn: <2
Adult: <6 O Na:
135 – 145 O K: 3.5 – 5.0
Hypokalemia:
Prominent U Waves, Depresses ST
Segment, Flat T Waves
Hyperkalemia: Tented T
Waves, Prolonged PR Interval, Wide
QRS
o Calcium: 9 – 10.5
Hypocalcemia: Muscle Spasms, Convulsions, Cramping, Tetany, Pos Trousseau’s, Pos Chvostek’s,
Prolonged ST Interval, Prolonged QT Segments
o Mg: 1.5 – 2.5 O Cl: 96 – 106 O Phos: 3 – 4.5 O Albumin: 3.5 – 5 O Specific Gravity: 1.005 –
1.030 O Hgba1c:
Ideal = 4-6%
Ok (120 Days) <7% O Dilantin TR: 10 – 20 O Lithium TR: 0.5 – 1.5 O Arterial Blood Gas
Ph = 7.35 – 7.45
CO2 = 35 – 45
HCO3 = 22 – 28
O2 = 80 – 100
O2 Sat = 95 – 100%
• Antidotes O Digoxin – Digiband O Coumadin – Vit K O Benzos –
Flumzaemil (Tomazicon) O Heparin – Protamine Sulfate (Keep
Aptt And PTT At 1.5-2 Times Normal) O Tylenol – Mucomyst
(Loading Dose + 17 Doses) O Opiates (Narcotics Analgesics,
Heroin, Morphine) – Narcan (Naloxone) O Cholinergic Meds
(Myesthenic Bradycardia) – Atropine O Methotrexate –
Leucovorin
• Delegation O RN Only
Blood Products (2 Rns Must Check)
Clotting Factors
Sterile Dressing Changes And Procedures
Assessments That Require Clinical Judgment
Ultimately Responsible For All Delegated Duties O Unlicensed Assistive Personnel
Non-Sterile Procedures
• Precautions And Room Assignments O Universal
(Standard) Precautions – HIV Initiated
Wash Hands
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
3
Wear Gloves
Gowns For Splashes
Masks And Eye Protection For Splashes And Droplets
Don’t Recap Needles
Mouthpiece Of Ambu-Bag For Resuscitation
Refrain From Giving Care If You Have Skin Lesions O Droplet (Respiratory) Precautions – Wear Mask
Sepsis, Scarlet Fever, Strep, Fifth Disease (Parvo B19), Pertusis, Pneumonia, Influenza, Diphtheria,
Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma, Adenovirus, Rhinovirus
RSV (Needs Contact Precautions Too)
TB (Respiratory Isolation) O Contact Precautions = Universal + Goggles, Mask, And Gown O
No Infectious Patients With Immunosuppressed Patients
Clean With Clean
Dirty With Dirty Misc.
o Rifampin (For TB) – Rust/Orange/Red Urine And Body Fluids O Pyridium (For Bladder Infection) …
Orange/Red/Pink Urine O Glasgow Coma Scale … < 8 = Coma O Myasthenia Gravis
Myasthenic Crisis = Weakness With Change In Vitals (Give More Meds)
Cholinergic Crisis = Weakness With No Change In Vitals (Reduce Meds) O Diabetic
Coma Vs. Insulin Shock … Give Glucose First – If No Help, Give Insulin O Fruity Breath = Diabetic
Ketoacidosis O Acid-Base Balance
If It Comes Out Of Your Ass, It’s Acidosis.
Vomiting = Alkalosis O Skin Tastes Salty = Cystic Fibrosis O Lipitor (Statins) In Pms
Only – No Grapefruit Juice O Stroke
Tongue Points Toward Side Of Lesion (Paralysis)
Uvula Deviates Away From The Side Of Lesion (Paralysis) O Hold Digoxin If HR <
60 O Stay In Bed For 3 Hours After First ACE Inhibitor Dose O Avoid Grapefruit Juice With
Ccbs O Anthrax = Multi-Vector Biohazard O Pulmonary Air Embolism Prevention =
Trendelenberg (HOB Down) + On Left Side (To Trap Air In Right Side Of Heart) O Head
Trauma And Seizures – Maintain Airway = Primary Concern O Peptic Ulcers
Feed A Duodenal Ulcer (Pain Relieved By Food)
Starve A Gastric Ulcer O Acute Pancreatitis
Fetal Position, Bluish Discoloration Of Flanks (Turner’s Sign), Bluish Discoloration Of
Pericumbelical Region (Cullen’s Sign), Board Like Abdomen With Guarding Self Digestion Of
Pancreas By Trypsin. O Hold Tube Feeding If Residual > 100ml O In Case Of Fire – RACE And
PASS O Check Restraints Every 30 Minutes – 2 Fingers Room Underneath O Gullian-Barre
Syndrome
Weakness Progresses From Legs Upward – Leads To Resp Arrest O Trough Draw
= ~30 Min Before Scheduled Administration O Peak Draw = 30-60 Min After Drug
Administration.
• Mental Health And Psychiatry O Most Suicides Occur After
Beginning Of Improvement With Increase In Energy Levels O
Maois
Hypertensive Crisis With Tyramine Foods
Nardil, Marplan, Parnate
Need 2 Wk Gap From Ssris And Tcas To Admin Maois
o Lithium Therapeutic Range = 0.5-1.5 O Phenothiazines (Typical Antipsychotics) – EPS, Photosensitivity O
Atypical Antipsychotics – Work On Positive And Negative Symptoms, Less EPS O Benzos (Ativan,
Downloaded by NELSON KIIRU ()
