NCLEX Signs and Symptoms 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.
Signs & Symptoms
Classic presentations and the eponymous signs the exam expects.
20 cards — 10 easy, 9 medium, 1 hard.
Chvostek sign
Facial twitching when the cheek is tapped over the facial nerve. Indicates hypocalcaemia.
Pairs with the Trousseau sign as the classic tetany findings.
Trousseau sign
Carpal spasm when a blood pressure cuff is inflated above systolic. Indicates hypocalcaemia.
Also seen in hypomagnesaemia, which often has to be corrected first.
Cushing triad
Rising blood pressure with widening pulse pressure, bradycardia, irregular respirations. Late sign of raised intracranial pressure.
By this point herniation may be imminent.
Kussmaul respirations
Deep, rapid breathing compensating for metabolic acidosis.
Classic in diabetic ketoacidosis. The lungs are blowing off carbon dioxide.
Cheyne-Stokes respirations
Cycles of progressively deeper then shallower breaths with apnoeic pauses.
Seen in heart failure, brain injury and at the end of life.
Halo or yellow-green vision
Digoxin toxicity
Occurs with nausea, anorexia and new dysrhythmias.
Pink frothy sputum
Acute pulmonary oedema
Sit the client upright with legs dependent and call for help.
Fruity or acetone breath odour
Ketosis, most often diabetic ketoacidosis
Accompanied by Kussmaul respirations and dehydration.
Asterixis
A flapping tremor of the outstretched hands, seen in hepatic encephalopathy.
Tracks with rising ammonia; improves with lactulose.
Petechial rash across the chest and axillae after a long bone fracture
Fat embolism syndrome
Appears with dyspnoea and confusion 24 to 72 hours after injury.
Acrocyanosis in a newborn
Blue hands and feet with a pink trunk. Normal in the first 24 hours.
Central cyanosis of the trunk and mucous membranes is never normal.
Boggy uterus after birth
Uterine atony, the leading cause of postpartum haemorrhage. Massage first.
A fundus deviated to one side usually means a full bladder.
Late decelerations on fetal monitoring
Uteroplacental insufficiency. Stop oxytocin, reposition, oxygen, increase fluids, notify.
VEAL CHOP: Late equals Placental insufficiency.
Non-blanchable redness over a bony prominence
Stage 1 pressure injury
Skin is intact. Offload immediately; this stage is reversible.
Cool, pale, swollen IV site with a slowing infusion
Infiltration
Phlebitis is the opposite picture: warm, red and tender along the vein.
Continuous bubbling in the water seal chamber
An air leak in the chest drainage system.
Tidalling with respiration is expected; continuous bubbling is not.
Pinpoint pupils with a respiratory rate of 6
Opioid toxicity. Give naloxone and support ventilation.
Dilated pupils with agitation suggests stimulant intoxication instead.
Sudden severe headache with hypertension in a client with a T4 injury
Autonomic dysreflexia
Sit them up first, then look for a bladder or bowel trigger.
Narrowing pulse pressure with tachycardia and cool clammy skin
Compensated shock
Hypotension is a late sign, especially in children.
Sunken anterior fontanelle in an infant
Dehydration
Also look for no tears, dry mucous membranes and fewer wet nappies.
What these cards cover
These 20 cards sit across 17 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 |
|---|---|---|---|
| Fluid and Electrolyte Balance | Volume status and the six key electrolytes | 2 | Physiological Adaptation |
| Neurological Disorders | Stroke, seizures, spinal cord and raised pressure | 2 | Physiological Adaptation |
| Acid-Base Balance | Reading a blood gas in four steps | 1 | Physiological Adaptation |
| Respiratory Disorders | Asthma, COPD, pneumonia and pneumothorax | 1 | Physiological Adaptation |
| Cardiovascular Medications | Digoxin, beta blockers, ACE inhibitors and nitrates | 1 | Pharmacological and Parenteral Therapies |
| Cardiac Disorders | Coronary syndrome, heart failure and dysrhythmias | 1 | Physiological Adaptation |
| Endocrine Disorders | Diabetes, thyroid and adrenal conditions | 1 | Physiological Adaptation |
| Renal and Gastrointestinal Disorders | Kidney injury, dialysis, liver and bowel disease | 1 | Physiological Adaptation |
| Recognising Complications | The findings that mean act now | 1 | Reduction of Risk Potential |
| Postpartum and Newborn Care | BUBBLE-HE, haemorrhage and newborn transition | 2 | Health Promotion and Maintenance |
| Labour and Birth | Stages, fetal monitoring and complications | 1 | Health Promotion and Maintenance |
| Hygiene and Skin Integrity | Pressure injury prevention and wound care | 1 | Basic Care and Comfort |
| IV Therapy, Blood Products and TPN | Solutions, complications and transfusion safety | 1 | Pharmacological and Parenteral Therapies |
| Tubes, Drains and Monitoring Devices | Chest tubes, nasogastric tubes and catheters | 1 | Reduction of Risk Potential |
| Substance Use and Withdrawal | Alcohol, opioid and stimulant withdrawal | 1 | Psychosocial Integrity |
| Vital Signs and Early Warning | Recognising deterioration before it declares itself | 1 | Reduction of Risk Potential |
| Growth and Development | Milestones, play and age-appropriate teaching | 1 | Health Promotion and Maintenance |
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 |
|---|---|---|
| Chvostek sign | Facial twitching when the cheek is tapped over the facial nerve. Indicates hypocalcaemia. | Pairs with the Trousseau sign as the classic tetany findings. |
| Trousseau sign | Carpal spasm when a blood pressure cuff is inflated above systolic. Indicates hypocalcaemia. | Also seen in hypomagnesaemia, which often has to be corrected first. |
| Cushing triad | Rising blood pressure with widening pulse pressure, bradycardia, irregular respirations. Late sign of raised intracranial pressure. | By this point herniation may be imminent. |
| Kussmaul respirations | Deep, rapid breathing compensating for metabolic acidosis. | Classic in diabetic ketoacidosis. The lungs are blowing off carbon dioxide. |
| Cheyne-Stokes respirations | Cycles of progressively deeper then shallower breaths with apnoeic pauses. | Seen in heart failure, brain injury and at the end of life. |
| Halo or yellow-green vision | Digoxin toxicity | Occurs with nausea, anorexia and new dysrhythmias. |
| Pink frothy sputum | Acute pulmonary oedema | Sit the client upright with legs dependent and call for help. |
| Fruity or acetone breath odour | Ketosis, most often diabetic ketoacidosis | Accompanied by Kussmaul respirations and dehydration. |
| Asterixis | A flapping tremor of the outstretched hands, seen in hepatic encephalopathy. | Tracks with rising ammonia; improves with lactulose. |
| Petechial rash across the chest and axillae after a long bone fracture | Fat embolism syndrome | Appears with dyspnoea and confusion 24 to 72 hours after injury. |
| Acrocyanosis in a newborn | Blue hands and feet with a pink trunk. Normal in the first 24 hours. | Central cyanosis of the trunk and mucous membranes is never normal. |
| Boggy uterus after birth | Uterine atony, the leading cause of postpartum haemorrhage. Massage first. | A fundus deviated to one side usually means a full bladder. |
| Late decelerations on fetal monitoring | Uteroplacental insufficiency. Stop oxytocin, reposition, oxygen, increase fluids, notify. | VEAL CHOP: Late equals Placental insufficiency. |
| Non-blanchable redness over a bony prominence | Stage 1 pressure injury | Skin is intact. Offload immediately; this stage is reversible. |
| Cool, pale, swollen IV site with a slowing infusion | Infiltration | Phlebitis is the opposite picture: warm, red and tender along the vein. |
| Continuous bubbling in the water seal chamber | An air leak in the chest drainage system. | Tidalling with respiration is expected; continuous bubbling is not. |
| Pinpoint pupils with a respiratory rate of 6 | Opioid toxicity. Give naloxone and support ventilation. | Dilated pupils with agitation suggests stimulant intoxication instead. |
| Sudden severe headache with hypertension in a client with a T4 injury | Autonomic dysreflexia | Sit them up first, then look for a bladder or bowel trigger. |
| Narrowing pulse pressure with tachycardia and cool clammy skin | Compensated shock | Hypotension is a late sign, especially in children. |
| Sunken anterior fontanelle in an infant | Dehydration | Also look for no tears, dry mucous membranes and fewer wet nappies. |
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