NCLEX Nursing Interventions Flashcards
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How to run these cards
Work in one direction first: read the front, say the answer out loud, then open the card. Saying it out loud is not a gimmick — recognising an answer and producing one are different skills, and the exam only rewards the second. Anything you get wrong goes into a pile you repeat at the end of the session, then again the next day.
Do not run a deck front-to-back every time. Order is itself a memory cue, so a deck you always run in sequence will feel mastered and then fall apart inside a mixed practice test.
Nursing Interventions
What the nurse does first, and why that action beats the others.
20 cards — 12 easy, 5 medium, 3 hard.
First action for a boggy postpartum fundus with heavy bleeding?
Massage the fundus.
Then empty the bladder, then give a uterotonic if tone does not return.
First action in a suspected transfusion reaction?
Stop the transfusion, then run normal saline through new tubing and stay with the client.
Return the bag and tubing to the blood bank afterwards.
First action for a prolapsed umbilical cord?
Lift the presenting part off the cord with a gloved hand and do not let go.
Then call for help, position knee-chest or Trendelenburg, and give oxygen.
First action in anaphylaxis?
Intramuscular epinephrine into the outer thigh.
Antihistamines and corticosteroids are adjuncts, never the first treatment.
First action for wound evisceration?
Cover with sterile saline-soaked gauze and position with knees flexed.
Never push the tissue back in. Keep nil by mouth and call the surgeon.
First action for a client with new shortness of breath?
Position upright and assess, then apply oxygen.
Positioning needs no order and improves ventilation within seconds.
What to do if a chest tube becomes disconnected?
Place the end of the tube in sterile water to create a water seal.
If the tube is pulled out, cover the site with a dressing taped on three sides.
Nursing actions during a seizure?
Protect the head, turn to the side, loosen clothing, time it, clear the area.
Never restrain the limbs and never place anything in the mouth.
Suctioning a tracheostomy: three rules
Hyperoxygenate first, suction only on withdrawal, limit to 10 seconds.
Routine saline instillation is not recommended.
Positioning after a lumbar puncture?
Flat, with encouraged fluid intake.
This reduces the incidence and severity of post-procedure headache.
Positioning for suspected air embolism?
Left side-lying with the head lowered.
Clamp the line, give oxygen and call for help.
Positioning after a liver biopsy?
Right side-lying to apply pressure to the site.
Monitor for bleeding, the main complication.
First action when a client falls?
Assess the client before moving them.
Then notify the provider, document objectively and complete a safety report.
First action after a medication error?
Assess the client.
Then notify the provider, then complete the incident report.
What to do when a monitor alarms?
Assess the client, not the machine.
Equipment troubleshooting comes after you know the client is perfusing.
Rule of 15 for hypoglycaemia
15 g of fast-acting carbohydrate, wait 15 minutes, recheck; repeat if still low.
Follow with a complex carbohydrate and protein. Never give oral carbohydrate to an unconscious client.
Order of treatment for hyperkalaemia with ECG changes?
Calcium gluconate to protect the heart, insulin and dextrose to shift, then a binder or dialysis to remove.
Calcium does not lower potassium but it prevents lethal dysrhythmias.
What to do if total parenteral nutrition is delayed?
Hang 10 percent dextrose at the same rate.
Never stop abruptly, which causes rebound hypoglycaemia, and never speed up to catch up.
First action if a tube feeding causes coughing and desaturation?
Stop the feeding.
Then suction, apply oxygen and assess. Do not lower the head of the bed.
Fire response sequence?
RACE: Rescue, Alarm, Confine, Extinguish or Evacuate.
Extinguisher use is PASS: Pull, Aim, Squeeze, Sweep.
What these cards cover
These 20 cards sit across 16 topics in the test plan. If a whole topic keeps coming back wrong, the problem is the underlying content rather than the recall — go and read that topic before you run the deck again.
| Topic | Focus | Cards | Client need category |
|---|---|---|---|
| Postpartum and Newborn Care | BUBBLE-HE, haemorrhage and newborn transition | 1 | Health Promotion and Maintenance |
| IV Therapy, Blood Products and TPN | Solutions, complications and transfusion safety | 2 | Pharmacological and Parenteral Therapies |
| Labour and Birth | Stages, fetal monitoring and complications | 1 | Health Promotion and Maintenance |
| Medical Emergencies | Shock, anaphylaxis, burns and trauma | 1 | Physiological Adaptation |
| Perioperative Nursing | Preparation, positioning and recovery | 1 | Reduction of Risk Potential |
| Respiratory Disorders | Asthma, COPD, pneumonia and pneumothorax | 1 | Physiological Adaptation |
| Tubes, Drains and Monitoring Devices | Chest tubes, nasogastric tubes and catheters | 2 | Reduction of Risk Potential |
| Restraints, Falls and Environmental Safety | Least restrictive intervention first | 2 | Safety and Infection Control |
| Diagnostic Tests and Procedures | Before, during and after | 2 | Reduction of Risk Potential |
| Mobility and Immobility | Positioning, transfers and the hazards of bed rest | 1 | Basic Care and Comfort |
| Error Prevention and Client Identification | Rights of medication, verification and time out | 1 | Safety and Infection Control |
| The Nursing Process | The order that decides the answer | 1 | Integrated Processes |
| Endocrine Disorders | Diabetes, thyroid and adrenal conditions | 1 | Physiological Adaptation |
| Fluid and Electrolyte Balance | Volume status and the six key electrolytes | 1 | Physiological Adaptation |
| Nutrition and Oral Hydration | Therapeutic diets, dysphagia and enteral feeding | 1 | Basic Care and Comfort |
| Emergency Response and Disaster Planning | Triage, evacuation and mass casualty | 1 | Safety and Infection Control |
Printable answer key
The same 20 cards laid flat, for revision on paper or a last pass the night before. Cover the right-hand columns with a sheet and work down.
| Prompt | Answer | Why it matters |
|---|---|---|
| First action for a boggy postpartum fundus with heavy bleeding? | Massage the fundus. | Then empty the bladder, then give a uterotonic if tone does not return. |
| First action in a suspected transfusion reaction? | Stop the transfusion, then run normal saline through new tubing and stay with the client. | Return the bag and tubing to the blood bank afterwards. |
| First action for a prolapsed umbilical cord? | Lift the presenting part off the cord with a gloved hand and do not let go. | Then call for help, position knee-chest or Trendelenburg, and give oxygen. |
| First action in anaphylaxis? | Intramuscular epinephrine into the outer thigh. | Antihistamines and corticosteroids are adjuncts, never the first treatment. |
| First action for wound evisceration? | Cover with sterile saline-soaked gauze and position with knees flexed. | Never push the tissue back in. Keep nil by mouth and call the surgeon. |
| First action for a client with new shortness of breath? | Position upright and assess, then apply oxygen. | Positioning needs no order and improves ventilation within seconds. |
| What to do if a chest tube becomes disconnected? | Place the end of the tube in sterile water to create a water seal. | If the tube is pulled out, cover the site with a dressing taped on three sides. |
| Nursing actions during a seizure? | Protect the head, turn to the side, loosen clothing, time it, clear the area. | Never restrain the limbs and never place anything in the mouth. |
| Suctioning a tracheostomy: three rules | Hyperoxygenate first, suction only on withdrawal, limit to 10 seconds. | Routine saline instillation is not recommended. |
| Positioning after a lumbar puncture? | Flat, with encouraged fluid intake. | This reduces the incidence and severity of post-procedure headache. |
| Positioning for suspected air embolism? | Left side-lying with the head lowered. | Clamp the line, give oxygen and call for help. |
| Positioning after a liver biopsy? | Right side-lying to apply pressure to the site. | Monitor for bleeding, the main complication. |
| First action when a client falls? | Assess the client before moving them. | Then notify the provider, document objectively and complete a safety report. |
| First action after a medication error? | Assess the client. | Then notify the provider, then complete the incident report. |
| What to do when a monitor alarms? | Assess the client, not the machine. | Equipment troubleshooting comes after you know the client is perfusing. |
| Rule of 15 for hypoglycaemia | 15 g of fast-acting carbohydrate, wait 15 minutes, recheck; repeat if still low. | Follow with a complex carbohydrate and protein. Never give oral carbohydrate to an unconscious client. |
| Order of treatment for hyperkalaemia with ECG changes? | Calcium gluconate to protect the heart, insulin and dextrose to shift, then a binder or dialysis to remove. | Calcium does not lower potassium but it prevents lethal dysrhythmias. |
| What to do if total parenteral nutrition is delayed? | Hang 10 percent dextrose at the same rate. | Never stop abruptly, which causes rebound hypoglycaemia, and never speed up to catch up. |
| First action if a tube feeding causes coughing and desaturation? | Stop the feeding. | Then suction, apply oxygen and assess. Do not lower the head of the bed. |
| Fire response sequence? | RACE: Rescue, Alarm, Confine, Extinguish or Evacuate. | Extinguisher use is PASS: Pull, Aim, Squeeze, Sweep. |
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