National Council Licensure Examination for Practical Nurses (NCLEX-PN®) — Information & Free Practice

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Coordinated Care — Official range: 18–24% (Practice allocation: 21%)

  • Use data from various credible sources in making clinical decisions
  • Contribute to the development of and/or update of the client plan of care
  • Assign client care and/or related tasks (e.g., assistive personnel or LPN/VN)
  • Organize and prioritize care based on client needs
  • Recognize and report staff conflict
  • Advocate for client rights and needs
  • Promote client self-advocacy
  • Participate in quality improvement activities (e.g., collecting data, serving on quality improvement committee)
  • Involve client in care decision-making
  • Follow up with client after discharge
  • Participate in staff education (e.g., in-services, continued competency)
  • Recognize self-limitations and seek assistance when needed (e.g., tasks, assignments)
  • Respond to the unsafe practice of health care personnel (e.g., intervene, report)
  • Participate in client discharge or transfer
  • Participate in client referral process
  • Follow regulation/policy for reporting specific issues (e.g., abuse, neglect, gunshot wound, communicable disease)
  • Participate in client consent process
  • Maintain client confidentiality
  • Provide for privacy needs
  • Provide information about advance directives
  • Participate in client data collection
  • Use information technology in client care
  • Apply evidence-based practice when providing care
  • Participate as a member of an interdisciplinary team
  • Monitor activities of assistive personnel
  • Participate in providing quality cost-effective care
  • Provide and receive report
  • Practice in a manner consistent with code of ethics for nurses
  • Provide care within the legal scope of practice
  • Verify and process health care provider orders
  • Perform care for clients to support unbiased treatment and equal access to care, regardless of culture/ethnicity, sexual orientation, gender identity and/or gender expression
  • Advance Directives
  • Review client understanding of advance directives (e.g., living will, health care proxy, durable power of attorney for health care [DPAHC])
  • Verify client advance directives status
  • Advocacy
  • Discuss identified treatment options with client and respect the decisions made
  • Use interpreters to assist in achieving client understanding
  • Assignments/Delegation
  • Compare needs of client to knowledge, skills and abilities of assistive personnel prior to making client care assignments
  • Organize information for client assignments
  • Provide information to supervisor when client care assignments need to be changed (e.g., change in client status)
  • Utilize the rights of delegation (e.g., right task, right circumstances, right person, right direction/communication, right supervision/evaluation)
  • Client Rights
  • Inform client of individual rights (e.g., confidentiality, informed consent)
  • Intervene if client rights are violated
  • Recognize client right to refuse treatment/procedure
  • Collaboration with Interdisciplinary Team
  • Identify roles/responsibilities of health care team members
  • Identify need for nursing or interdisciplinary client care conference
  • Contribute to planning interdisciplinary client care conferences
  • Serve as resource person to other staff
  • Concepts of Management and Supervision
  • Verify abilities of staff members to perform assigned tasks (e.g., job description, scope of practice, training, experience)
  • Provide input for performance evaluation of other staff
  • Confidentiality/Information Security
  • Identify staff actions that impact client confidentiality and intervene as needed (e.g., access to medical records, discussions at nurses’ station, change-of-shift reports)
  • Recognize staff member and client understanding of confidentiality requirements
  • Apply knowledge of facility regulations when accessing client records
  • Continuity of Care
  • Follow up on unresolved issues regarding client care (e.g., laboratory results, client requests)
  • Record client information (e.g., medical record, referral/transfer form)
  • Use agency guidelines to guide client care (e.g., clinical pathways, care maps, care plans)
  • Establishing Priorities
  • Participate in planning client care based on client needs (e.g., diagnosis, abilities, prescribed treatment)
  • Use effective time management skills
  • Ethical Practice
  • Identify ethical issues affecting staff or client
  • Inform client and staff members of ethical issues affecting client care
  • Intervene to promote ethical practice
  • Informed Consent
  • Identify appropriate person to provide informed consent for client (e.g., client, parent, legal guardian)
  • Describe components of informed consent (e.g., purpose for procedure, risks of procedure)
  • Recognize that informed consent was obtained (e.g., completed consent form, client understanding of procedure)
  • Information Technology
  • Access data for client or staff through online databases and journals
  • Enter computer documentation accurately, completely and in a timely manner
  • Legal Rights and Responsibilities
  • Identify legal issues affecting staff and client (e.g., refusing treatment)
  • Document client care
  • Performance Improvement (Quality Improvement)
  • Identify impact of performance improvement/quality improvement activities on client care outcomes
  • Document performance improvement/quality improvement activities
  • Report identified performance improvement/quality improvement concerns to appropriate personnel (e.g., nurse manager, risk manager)
  • Referral Process
  • Recognize need for client referral for actual or potential problem (e.g., physical therapy, speech therapy)
  • Use appropriate documents to contribute information needed for client referral (e.g., medical record, referral form)
  • Resource Management
  • Recognize client need for materials and equipment (e.g., oxygen, suction machine, wound care supplies)
  • Review effective use of client care materials by assistive personnel (e.g., supplies)
• Safety and Infection Prevention and Control — Official range: 10–16% (Practice allocation: 13%)

  • Ensure availability and safe functioning of client care equipment
  • Evaluate the appropriateness of health care provider's order for client
  • Verify the identity of client
  • Use safe client handling techniques (e.g., body mechanics)
  • Identify client allergies and intervene as appropriate
  • Prepare for and participate in internal and external disaster responses (e.g., fire, natural disaster)
  • Identify and address unsafe conditions in health care and home environments
  • Implement least restrictive restraints or seclusion
  • Follow protocol for timed client monitoring (e.g., safety checks)
  • Assist in and/or reinforce education to client about safety precautions
  • Initiate and participate in security alerts (e.g., infant abduction, flight risk)
  • Acknowledge and document practice errors and near misses (e.g., incident report)
  • Use transfer assistive devices (e.g., gait/transfer belt, slide board, mechanical lift)
  • Apply principles of infection control (e.g., personal protective equipment (PPE), aseptic technique, isolation, standard precautions)
  • Accident/Error/Injury Prevention
  • Identify and facilitate correct use of infant and child car seats by client
  • Identify client factors that influence accident/error/injury prevention (e.g., age, developmental stage, lifestyle)
  • Recognize what factors related to mental status may contribute to the client potential for accident or injury (e.g., confusion, altered thought processes, diagnosis)
  • Determine client and staff member knowledge of safety procedures
  • Use facility client identification procedures (e.g., client name band, allergy bands)
  • Monitor client care environment for safety hazard and report problems to appropriate personnel
  • Remove fire hazards from client care areas
  • Protect client from accident/error/injury (e.g., protect from another individual, falls, environmental hazards, burns)
  • Provide client with appropriate method to signal staff members
  • Emergency Response Plan
  • Identify nursing and assistive personnel roles during internal and external disasters
  • Contribute to selection of client to recommend for discharge in disaster situation
  • Ergonomic Principles
  • Provide instruction and information to client about body positions that prevent stress injuries
  • Handling Hazardous and Infectious Materials
  • Identify and employ methods to control the spread of infectious agents (e.g., cleaning with appropriate solutions)
  • Demonstrate knowledge of facility protocols for handling hazardous and infectious materials
  • Home Safety
  • Identify fire and environmental hazards (e.g., frayed electrical cords, small area rugs, inadequate footwear)
  • Determine client understanding of home safety needs
  • Provide client with information on home safety
  • Reinforce client education on home safety precautions (e.g., home disposal of syringes, lighting, handrails, kitchen safety)
  • Least Restrictive Restraints and Safety Devices
  • Demonstrate knowledge of appropriate application of restraints/safety devices
  • Document use of restraints/safety devices and client response
  • Check for proper functioning of restraints/safety devices
  • Reporting of Incident/Event/Irregular Occurrence/Variance
  • Identify situations requiring completion of incident/event/irregular occurrence/variance report (e.g., medication administration error, client fall)
  • Monitor client response to error/event/occurrence
  • Safe Use of Equipment
  • Follow facility protocols/procedures for safe use of equipment
  • Provide safe equipment use for client care (e.g., continuous passive motion [CPM] device, oxygen, mobility aids)
  • Security Plan
  • Use principles of triage and evacuation protocols and procedures
  • Monitor effectiveness of security plan
  • Standard Precautions/Transmission-Based Precautions/Surgical Asepsis
  • Identify communicable diseases and modes of transmission (e.g., airborne, droplet, contact)
  • Identify client knowledge of infection control procedures
  • Use appropriate supplies to maintain asepsis (e.g., gloves, mask, sterile supplies)
  • Use correct techniques to apply and remove gloves, mask, gown and protective eyewear
  • Use correct hand hygiene techniques
  • Prevent environmental spread of infectious disease through correct use of equipment
  • Protect immunocompromised client from exposure to infectious diseases/organisms
  • Monitor client care area for sources of infection
  • Set up a sterile field
  • Reinforce appropriate infection control procedures with client and staff members
• Health Promotion and Maintenance — Official range: 6–12% (Practice allocation: 9%)

  • Assist with care for the antepartum client
  • Identify community resources for clients
  • Assist with monitoring a client in labor
  • Monitor recovery of stable postpartum client
  • Compare client to developmental milestones
  • Assist client with expected life transition (e.g., attachment to newborn, parenting, retirement)
  • Participate in health screening or health promotion programs
  • Provide information for prevention of high-risk behaviors (e.g., substance misuse, sexual practices, smoking cessation)
  • Collect data for health history (e.g., client medical history, family medical history)
  • Collect baseline physical data (e.g., skin/tissue integrity, height and weight)
  • Identify clients in need of immunizations (required and voluntary)
  • Provide care that meets the needs of the newborn less than 1 month old through the infant or toddler client through 2 years
  • Provide care that meets the needs of the preschool, school age and adolescent client ages 3 through 17 years
  • Provide care that meets the needs of the adult client ages 18 through 64 years
  • Provide care that meets the needs of the adult client ages 65 and over
  • Identify barriers to communication
  • Identify barriers to learning
  • Aging Process
  • Identify client knowledge on aging process and assist in reinforcing teaching on expected changes related to aging
  • Ante-/Intra-/Postpartum and Newborn Care
  • Identify client emotional preparedness for pregnancy (e.g., support systems, perception of pregnancy)
  • Assist in performing client nonstress test
  • Perform care of postpartum client (e.g., perineal care, assistance with infant feeding)
  • Contribute to newborn plan of care
  • Reinforce client teaching on infant care skills (e.g., feeding, bathing, positioning)
  • Monitor client ability to care for infant
  • Community Resources
  • Assist and/or participate in community health education
  • Reinforce teaching with client about health risks based on family, population and/or community characteristics
  • Data Collection Techniques
  • Prepare client for physical examination (e.g., reinforce explanation of procedure, provide privacy and comfort)
  • Document findings according to agency/facility policies/procedures
  • Report client physical examination results to health care provider
  • Developmental Stages and Transitions
  • Identify and report client deviations from expected growth and development
  • Identify occurrence of expected body image changes
  • Assist client to select age-appropriate activities
  • Modify approaches to care in accordance with client development stage
  • Determine client acceptance of expected body image change (e.g., aging, pregnancy, menopause)
  • Determine impact of expected body image changes on client (e.g., temperament)
  • Health Promotion/Disease Prevention
  • Identify risk factors for disease/illness (e.g., age, gender, lifestyle)
  • Identify precautions and contraindications to immunizations
  • Identify client health-seeking behaviors (e.g., breast and testicular self-examinations)
  • Gather data on client health history and risk for disease (e.g., lifestyle, family and genetic history)
  • Check results of client health screening tests (e.g., Papanicolaou [Pap] test or smear, stool occult blood test)
  • Provide assistance for screening examinations (e.g., scoliosis, breast and testicular self- examinations, blood pressure check)
  • Assist client in disease prevention activities
  • Monitor client actions to maintain health and prevent disease (e.g., smoking cessation, exercise, diet, stress management)
  • Monitor incorporation of healthy behaviors into lifestyle by client (e.g., screening examinations, immunizations, limiting risk-taking behaviors)
  • Recognize client unexpected response to immunizations
  • High-Risk Behaviors
  • Assist client to identify high-risk behaviors
  • Monitor client lifestyle practice risks that may impact health (e.g., excessive sun exposure, lack of regular exercise)
  • Reinforce client teaching related to client high-risk behavior (e.g., unprotected sexual relations, needle sharing)
  • Lifestyle Choices
  • Identify client lifestyle practices that may have an impact on health
  • Identify contraindications to chosen contraceptive method (e.g., cigarette smoking, adherence, medical conditions)
  • Identify client attitudes/perceptions on sexuality
  • Recognize client need/desire for contraception
  • Recognize expected outcomes for client family planning methods
  • Recognize client need to discuss sensitive issues related to sexuality
  • Support client in family planning
  • Respect client lifestyle choices (e.g., child-free, homeschooling, rural or urban living)
  • Reinforce teaching with client on healthy lifestyle choices (e.g., exercise regimen, smoking cessation)
  • Self-Care
  • Determine client ability and support for performing self-care (e.g., feeding, dressing, hygiene)
  • Consider client self-care needs before contributing to changes in plan of care
  • Monitor client ability to perform instrumental activities of daily living (e.g., using telephone, shopping, preparing meals)
• Psychosocial Integrity — Official range: 9–15% (Practice allocation: 12%)

  • Provide emotional support to client
  • Collect data regarding client psychosocial functioning
  • Identify client use of effective and ineffective coping mechanisms
  • Promote positive self-esteem of client
  • Collect data on client's potential for violence to self and others
  • Identify signs and symptoms of substance misuse, substance use disorder, withdrawal and overdose
  • Reinforce education to caregivers/family on ways to manage client with behavioral disorders
  • Explore reasons for client nonadherence with treatment plan
  • Participate in client group session
  • Plan care with consideration of client spiritual, cultural beliefs and/or gender identity
  • Assist in managing the care of an angry and/or agitated client (e.g., de-escalation techniques)
  • Participate in reminiscence therapy, validation therapy or reality orientation
  • Assist in the care of the cognitively impaired client
  • Assist client to cope/adapt to stressful events and changes in health status
  • Use therapeutic communication techniques with client
  • Assist in the care of a client experiencing sensory/perceptual alterations
  • Promote a therapeutic environment
  • Incorporate behavioral management techniques when caring for a client
  • Recognize and reduce stressors that affect client care
  • Provide end-of-life care and education to clients
  • Abuse or Neglect
  • Identify client risk factors for abusing or neglecting others
  • Identify signs and symptoms of physical, psychological or financial abuse in client (e.g., family involvement, inadequate weight gain, poor hygiene)
  • Recognize risk factors for domestic, child and/or elder abuse or neglect and sexual abuse
  • Provide safe environment for abused or neglected client
  • Provide emotional support to client who experienced abuse or neglect
  • Reinforce client teaching on coping strategies to prevent abuse or neglect
  • Evaluate client response to interventions
  • Behavioral Management
  • Monitor client appearance, mood and psychomotor behavior and observe for changes
  • Explore cause of client behavior
  • Assist client with achieving self-control of behavior (e.g., contract, behavior modification)
  • Assist client in using behavioral strategies to decrease anxiety
  • Reinforce client participation in therapy
  • Use behavioral management techniques when caring for a client (e.g., positive reinforcement, setting limits)
  • Evaluate client response to behavioral management interventions
  • Coping Mechanisms
  • Identify client support systems and available resources
  • Recognize abilities of client to adapt to temporary/permanent role changes
  • Recognize client response to illness (e.g., rationalization, hopelessness, anger)
  • Provide support to the client with unexpected altered body image (e.g., alopecia)
  • Use therapeutic techniques to assist client with coping ability
  • Assist client in maintaining level of independence after unexpected body image changes (e.g., amputation, paralysis)
  • Monitor client progress toward achieving improved body image (e.g., mastectomy, colostomy)
  • Crisis Intervention
  • Identify client in crisis
  • Identify client risk for self-injury and/or violence (e.g., suicide or violence precaution)
  • Use crisis intervention techniques to assist client in coping
  • Provide opportunities for client to understand why the crisis occurred
  • Guide client to resources for recovery from crisis (e.g., social supports)
  • Reinforce client teaching on suicide/violence prevention
  • Report changes in client behavior (indicating a developing crisis) to supervisor
  • Cultural Awareness
  • Identify importance of client self-reported culture/ethnicity when planning/providing/monitoring care
  • Recognize client self-reported cultural practices that may affect interventions for procedures/surgery (e.g., direct eye contact)
  • Respect self-reported cultural background/practices of client (does not include dietary preferences)
  • Document how client language needs are met
  • End-of-Life Care Concepts
  • Identify client end-of-life needs (e.g., financial concerns, fear, loss of control, role changes)
  • Identify client ability to cope with end-of-life interventions
  • Provide care or support for client/family at end of life
  • Assist client in resolution of end-of-life issues
  • Grief and Loss
  • Identify client reaction to loss (e.g., denial, fear)
  • Support the client in anticipatory grieving
  • Reinforce client teaching on expected client reactions to grief and loss (e.g., denial, fear)
  • Provide client with resources to adjust to loss/bereavement (e.g., individual counseling, support groups)
  • Mental Health Concepts
  • Identify expected behaviors of client with independent or dependent personality
  • Identify client symptoms of acute or chronic mental illness (e.g., schizophrenia, depression, bipolar disorder)
  • Recognize client use of defense mechanisms
  • Recognize change in client mental status
  • Recognize client symptoms of relapse
  • Assist in promoting client independence
  • Religious and Spiritual Influences on Health
  • Identify client emotional problems related to self-reported religious/spiritual beliefs (e.g., spiritual distress, conflict between recommended treatment and beliefs)
  • Recognize effect of client’s self-reported religious/spiritual beliefs on plan of care
  • Assist client to meet self-reported religious/spiritual needs (e.g., referral to pastoral care)
  • Assist in evaluation of client’s self-reported religious/spiritual needs related to necessary nursing interventions
  • Sensory/Perceptual Alterations
  • Identify needs of client with altered sensory perception (e.g., hallucinations, delirium)
  • Verify client ability to effectively communicate needs
  • Stress Management
  • Identify actual/potential stressors for client (e.g., fear, lack of information)
  • Implement measures to reduce environmental stressors (e.g., noise, temperature, pollution)
  • Monitor client effective use of stress management techniques
  • Substance Use and Other Disorders and Dependencies
  • Plan and provide care to client experiencing substance-related withdrawal or toxicity (e.g., nicotine, opioid, sedative)
  • Provide care and support for client with impulse-control disorders (e.g., gambling, sexual addiction, pornography)
  • Reinforce provided information on substance use diagnosis and treatment plan to client
  • Encourage client participation in support groups (e.g., Alcoholics Anonymous, Narcotics Anonymous)
  • Monitor client response to treatment plan and contribute to revision of plan as needed
  • Support Systems
  • Determine client abilities to provide client support
  • Identify client support systems/resources
  • Identify family response to client illness (e.g., acute episodes, chronic disorder, terminal illness)
  • Therapeutic Communication
  • Assist client in communicating needs to health care staff
  • Develop and maintain therapeutic relationships with client
  • Respect client personal values and beliefs
  • Establish a trusting nurse-client relationship
  • Encourage client to appropriately use verbal and nonverbal communication
  • Monitor effectiveness of communications with client
  • Therapeutic Environment
  • Identify external factors that may interfere with client recovery (e.g., stressors, noise)
  • Participate in community meetings
  • Contribute to maintaining a safe and supportive environment for client
  • Monitor client response to environmental factors
• Basic Care and Comfort — Official range: 7–13% (Practice allocation: 10%)

  • Provide site care for client with enteral tubes
  • Promote alternative/complementary therapy in providing client care (e.g., music therapy, pet therapy)
  • Provide for mobility needs (e.g., ambulation, range of motion, transfer, repositioning, use of adaptive equipment)
  • Provide feeding for client with enteral tubes
  • Monitor and provide for nutritional needs of client
  • Provide nonpharmacological measures for pain relief (e.g., imagery, massage, repositioning)
  • Assist with activities of daily living
  • Provide care to client with bowel or bladder (urinary) management protocol
  • Evaluate pain using standardized rating scales
  • Provide measures to promote sleep and rest
  • Use measures to maintain or improve client skin/tissue integrity
  • Provide postmortem care
  • Perform irrigation (e.g., urinary catheter, bladder, wound, ear, nose, eye)
  • Assist in the care and comfort for a client with a visual and/or hearing impairment
  • Monitor client intake/output
  • Provide care to an immobilized client based on need
  • Assistive Devices
  • Identify appropriate use of assistive devices (e.g., cane, walker, crutches)
  • Contribute to care of client using assistive device (e.g., feeding devices, telecommunication devices, touch pad, communication board)
  • Reinforce teaching for client using assistive device
  • Review correct use of assistive devices to client and staff members
  • Elimination
  • Identify client at risk for impaired elimination (e.g., medication, hydration status)
  • Monitor client bowel sounds
  • Provide skin care to client who is incontinent (e.g., wash frequently, barrier creams/ointments)
  • Mobility/Immobility
  • Identify signs and symptoms of venous insufficiency and intervene to promote venous return (e.g., elastic stockings, sequential compression device)
  • Check client for mobility, gait, strength, motor skills
  • Reinforce client teaching on methods to maintain mobility (e.g., active/passive range of motion [ROM], strengthening, isometric exercises)
  • Maintain correct client body alignment
  • Nonpharmacological Comfort Interventions
  • Identify client need for palliative/comfort care
  • Assist in planning comfort interventions for client with impaired comfort
  • Apply therapies for comfort and treatment of inflammation/swelling (e.g., apply heat and cold treatments, elevate limb)
  • Provide palliative/comfort care interventions to client
  • Respect client palliative care choices
  • Reinforce client teaching on stress management techniques (e.g., relaxation exercises, exercise, meditation)
  • Reinforce client teaching on palliative/comfort care
  • Monitor client nonverbal signs of pain/discomfort (e.g., grimacing, restlessness)
  • Monitor client response to nonpharmacological interventions
  • Monitor outcome of palliative care interventions
  • Nutrition and Oral Hydration
  • Identify client potential for aspiration (e.g., feeding tube, sedation, swallowing difficulties)
  • Check client feeding tube placement and patency
  • Monitor client ability to eat (e.g., chew, swallow)
  • Monitor impact of disease/illness on client nutritional status
  • Reinforce client teaching on special diets based on client diagnosis/nutritional needs and cultural considerations (e.g., high protein, kosher diet, calorie restriction)
  • Promote client independence in eating
  • Personal Hygiene
  • Determine client usual personal hygiene habits/routine
  • Reinforce teaching to client on required adaptations for performing activities of daily living (e.g., shower chair, handrails)
  • Postmortem Care
  • Provide comfort to family
  • Incorporate cultural practice in postmortem care
  • Prepare the client for viewing by the family
  • Ensure proper identification of client prior to transport to morgue/funeral home
  • Rest and Sleep
  • Identify client usual rest and sleep patterns (e.g., bedtime, sleep rituals)
  • Schedule client care activities to promote adequate rest and sleep
• Pharmacological Therapies — Official range: 10–16% (Practice allocation: 13%)

  • Follow the rights of medication administration
  • Reconcile and maintain medication list or medication administration record (e.g., prescribed medications, herbal supplements, over-the-counter medications)
  • Monitor transfusion of blood product
  • Calculate and monitor intravenous flow rate
  • Administer medication by oral route
  • Administer medication by various gastrointestinal tubes
  • Administer a subcutaneous, intradermal or intramuscular medication
  • Administer medication by ear, eye, nose, inhalation, rectum, vagina or topical route
  • Count controlled substances and report discrepancies
  • Maintain pain control devices (e.g., epidural, patient-controlled analgesia, peripheral nerve catheter)
  • Administer intravenous piggyback (secondary) medications
  • Collect required data prior to medication administration (e.g., contraindications, current medications)
  • Evaluate client response to medication (e.g., adverse reactions, interactions, therapeutic effects, critical laboratory values)
  • Reinforce education to client regarding medications
  • Maintain medication safety practices (e.g., storage, checking for expiration dates, compatibility)
  • Perform calculations needed for medication administration
  • Adverse Effects/Contraindications/Side Effects/Interactions
  • Identify potential and actual incompatibilities of client medications
  • Identify a contraindication to the administration of a prescribed or over-the-counter medication to the client
  • Identify symptoms of an allergic reaction (e.g., to medication)
  • Implement procedures to counteract adverse effects of medications
  • Withhold medication dose if client experiences adverse effect to medication
  • Monitor and document client response to actions taken to counteract adverse effects of medications
  • Monitor client for actual and potential adverse effects of medications (e.g., prescribed, over-the-counter and/or herbal supplements)
  • Monitor anticipated interactions among client prescribed medications and fluids (e.g., oral, intravenous, subcutaneous, intramuscular, topical)
  • Monitor and document client side effects to medications
  • Monitor and document client response to management of medication side effects including prescribed, over-the-counter and herbal supplements
  • Reinforce client teaching on possible effects of medications (common side effects or adverse effects, when to notify primary health care provider)
  • Notify primary health care provider of actual/potential adverse effects of client medications
  • Dosage Calculations
  • Use clinical decision-making when calculating doses
  • Expected Actions/Outcomes
  • Identify client expected response to medication
  • Use resources to check on purposes and actions of pharmacological agents
  • Apply knowledge of pathophysiology when addressing client pharmacological agents
  • Monitor client use of medications over time (e.g., prescription, over-the-counter, home remedies)
  • Reinforce client teaching on actions and therapeutic effects of medications and pharmacological interactions
  • Medication Administration
  • Identify client need for p.r.n. medications
  • Mix client medication from two vials as necessary (e.g., insulin)
  • Assist in preparing client for insertion of a central venous access device
  • Dispose of client unused medications according to facility/agency policy
  • Reinforce client teaching on client self-administration of medications (e.g., insulin, subcutaneous insulin pump)
  • Pharmacological Pain Management
  • Identify client need for pain medication
  • Monitor and document client response to pharmacological interventions (e.g., pain rating scale, verbal reports)
• Reduction of Risk Potential — Official range: 9–15% (Practice allocation: 12%)

  • Identify client risk and implement interventions
  • Check for urinary retention (e.g., bladder scan, ultrasound, palpation)
  • Collect specimen for diagnostic testing (e.g., blood, urine, stool, sputum)
  • Monitor continuous or intermittent suction of nasogastric (NG) tube
  • Monitor diagnostic or laboratory test results
  • Identify signs or symptoms of potential prenatal complication
  • Perform point-of-care testing (e.g., pregnancy test, troponin, urine dipstick)
  • Monitor and evaluate client vital signs (e.g., oxygen saturation, blood pressure)
  • Use precautions to prevent injury and/or complications associated with a procedure or diagnosis
  • Perform an electrocardiogram (EKG/ECG)
  • Assist with the performance of a diagnostic or invasive procedure
  • Perform venipuncture for blood draws
  • Apply and monitor proper use of compression stockings and/or sequential compression devices
  • Assist with care for client before and after surgical procedure
  • Insert, maintain and remove urinary catheter
  • Insert, maintain and remove nasogastric (NG) tube
  • Perform blood glucose monitoring
  • Maintain central venous catheter
  • Maintain and remove peripheral intravenous catheter
  • Perform focused data collection based on client condition (e.g., neurological checks, circulatory checks)
  • Monitor client responses to procedures and treatments
  • Reinforce client education about procedures, treatments, equipment
  • Changes/Abnormalities in Vital Signs
  • Compare vital signs to client baseline vital signs
  • Reinforce client teaching about normal and abnormal vital signs (e.g., hypertension, tachypnea, bradycardia, fever)
  • Diagnostic Tests
  • Perform diagnostic testing (e.g., blood glucose, oxygen saturation, testing for occult blood)
  • Reinforce client teaching about diagnostic test
  • Laboratory Values
  • Compare client laboratory values to normal laboratory values
  • Reinforce client teaching on purposes of laboratory tests
  • Notify primary health care provider about client laboratory test results
  • Potential for Alterations in Body Systems
  • Identify client with increased risk for insufficient blood circulation (e.g., immobilized limb, diabetes)
  • Recognize change in client neurologic status (level of consciousness, orientation, muscle strength)
  • Compare current client clinical data to baseline information
  • Monitor client output for changes from baseline (e.g., emesis, stool, urine)
  • Reinforce client teaching on methods to prevent complications associated with activity level/diagnosed illness/disease (e.g., foot care for client with diabetes mellitus)
  • Potential for Complications of Diagnostic Tests/Treatments/Procedures
  • Identify client response to diagnostic tests/treatments/procedures
  • Maintain client tube patency (e.g., chest tube, tracheostomy tube)
  • Provide care for client receiving electroconvulsive therapy (ECT)
  • Provide appropriate follow-up after incident (e.g., fall, client elopement or medication error)
  • Reinforce teaching to prevent complications due to client diagnostic tests/treatments/procedures
  • Notify primary health care provider if client has signs of potential complications (e.g., fever, hypotension, limb pain, thrombus formation)
  • Suggest change in interventions based on client response to diagnostic tests/treatments/procedures
  • Potential for Complications from Surgical Procedures and Health Alterations
  • Identify client response to surgery or health alterations
  • Reinforce teaching to prevent complications due to surgery or health alterations (e.g., cough and deep breathing, elastic stockings)
  • Suggest change in interventions based on client response to surgery or health alterations
  • Therapeutic Procedures
  • Reinforce client teaching on treatments and procedures
• Physiological Adaptation — Official range: 7–13% (Practice allocation: 10%)

  • Reinforce education to client regarding care and condition
  • Provide care for client drainage device (e.g., wound drain, chest tube)
  • Assist with client wound drainage device removal
  • Provide cooling/warming measures to restore normal body temperature
  • Perform wound care and/or dressing change
  • Respond and intervene to a client life-threatening situation (e.g., cardiopulmonary resuscitation)
  • Intervene to improve client respiratory status (e.g., breathing treatment, suctioning, repositioning)
  • Provide care for a client with a tracheostomy
  • Remove wound sutures or staples
  • Provide care to client on ventilator
  • Assist in the care of a client with a pacing device
  • Recognize and report basic abnormalities on a client cardiac monitor strip
  • Provide care to client with an ostomy (e.g., colostomy, ileostomy, urostomy)
  • Identify signs and symptoms related to acute or chronic illness
  • Recognize and report change in client condition
  • Provide care for a client with a fluid and electrolyte imbalance
  • Provide care for a client receiving peritoneal dialysis or hemodialysis
  • Alterations in Body Systems
  • Identify signs and symptoms of an infection (e.g., temperature changes, swelling, redness, mental confusion or foul-smelling urine)
  • Provide care to correct client alteration in body system
  • Provide care to client undergoing peritoneal dialysis
  • Provide care to client experiencing increased intracranial pressure
  • Provide care to client who has experienced a seizure
  • Provide care for client experiencing complications of pregnancy/labor and/or delivery (e.g., eclampsia, precipitous labor, hemorrhage)
  • Reinforce client teaching on ostomy care
  • Notify primary health care provider of a change in client status
  • Document client response to interventions for alteration in body systems (e.g., pacemaker, chest tube)
  • Basic Pathophysiology
  • Consider general principles of client disease process when providing care (e.g., injury and repair, immunity, cellular structure)
  • Apply knowledge of pathophysiology to monitoring client for alterations in body systems
  • Fluid and Electrolyte Imbalances
  • Identify signs and symptoms of client fluid and/or electrolyte imbalances
  • Monitor client response to interventions to correct fluid and/or electrolyte imbalance
  • Medical Emergencies
  • Provide emergency care for wound disruption (e.g., evisceration, dehiscence)
  • Notify primary health care provider about client unexpected response/emergency situation
  • Recommend change in emergency treatment based upon client response to interventions
  • Reinforce teaching of emergency intervention explanations to client
  • Review and document client response to emergency interventions (e.g., restoration of breathing, pulse)
  • Unexpected Response to Therapies
  • Identify and treat a client intravenous line infiltration
  • Intervene in response to client unexpected negative response to therapy (e.g., unexpected bleeding)
  • Document client unexpected response to therapy
  • Promote recovery from client unexpected negative response to therapy (e.g., urinary tract infection)