US nursing glossary

The NCLEX-RN tests US nursing practice. These are the terms and rules that most often trip up internationally educated nurses, explained in plain English.

Roles and delegation

Registered nurse (RN): A nurse who has passed the NCLEX-RN and holds a license from a state board of nursing. RNs may enter practice with a diploma, an associate degree or a bachelor's degree.; RNs keep responsibility for nursing judgment, so on the NCLEX the RN performs the comprehensive assessment, develops the care plan, does initial teaching and evaluates outcomes, and these cannot be delegated; the RN also takes the lead with unstable clients, while exact scope is set by state law and facility policy.
Licensed practical nurse / licensed vocational nurse (LPN/LVN): A nurse with about one year of practical nursing education who has passed the NCLEX-PN. The title is LVN in California and Texas and LPN in the other states.; LPNs generally care for stable clients with predictable outcomes, give oral, subcutaneous and IM medications, collect data, contribute to the care plan and reinforce teaching, while the RN keeps comprehensive assessment and nursing judgment; exact duties, including IV therapy, vary by state nurse practice act and facility policy.
Unlicensed assistive personnel (UAP): Trained health care workers without a nursing license, such as nursing assistants and patient care technicians. They help with routine, basic care under the direction of a nurse.; When trained and allowed by state law and facility policy, UAPs can bathe, feed clients without swallowing problems, ambulate, reposition, take routine vital signs and measure I&O, but they do not assess, teach, evaluate or give medications, and the nurse manages any unstable client even if a UAP helps with a specific task.
Certified nursing assistant (CNA): A type of UAP who has finished a state-approved training program and passed a competency exam. Titles and certification rules vary by state, for example state-tested nursing assistant (STNA).; CNAs give much of the hands-on daily care in nursing homes; the CNA is accountable for doing assigned tasks safely and reporting findings, and the nurse is accountable for appropriate assignment, direction and follow-up.
Charge nurse: A nurse, usually an experienced RN, who coordinates a unit during a shift. Duties vary by facility but often include making client assignments, managing admissions and discharges, and helping staff solve problems.; NCLEX questions often put you in the charge nurse role, asking you to match clients to staff by stability and scope within facility policy, or to act when you see unsafe practice.
Case manager: A professional, often an RN or a social worker, who coordinates a client's care across settings. Case managers plan discharges, arrange services and work with insurance companies.; When a client needs home health, medical equipment, placement in a skilled nursing facility or insurance approval before discharge, the nurse refers to the case manager or whichever discharge planner or social worker the facility uses for this.
Advanced practice registered nurse (APRN): An RN with a graduate degree and national certification in an advanced role. The four APRN roles are nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist and certified nurse-midwife.; APRNs are licensed by state boards of nursing, and how independently they may practice and prescribe depends on the state.
Nurse practitioner (NP): An APRN who assesses, diagnoses, orders tests and prescribes treatment, including medications. NPs work in primary care, hospitals and specialty clinics.; NCLEX questions treat an NP as a provider who can write orders, but an NP's prescribing and order authority depends on state law and facility credentials, and the nurse clarifies any unsafe or incomplete order just as with a physician.
Physician assistant (PA): A licensed clinician with a master's-level degree who diagnoses, treats and prescribes. Some states now use the title physician associate.; PA scope, prescribing authority and required physician collaboration or supervision vary by state and facility, and the nurse follows authorized PA orders and clarifies any order that seems unsafe or unclear.
Primary health care provider (HCP): The general term the NCLEX uses for the clinician who is authorized to make medical decisions and write orders for the client, most often a physician, an NP or a PA.; When an answer says to notify the primary health care provider, it is the right choice when a change needs a new order or a medical decision that is outside nursing scope.
Hospitalist: A physician, NP or PA whose main work is caring for clients while they are admitted to the hospital.; In many US hospitals the hospitalist, not the client's outpatient doctor, manages the hospital stay, so the nurse follows the facility's coverage and escalation process to reach the right clinician about new problems.
Respiratory therapist (RT): A respiratory care professional who manages breathing treatments, oxygen devices, ventilators and airway care. RTs often draw arterial blood gases, and licensing rules vary by state.; RTs often give nebulizer treatments and adjust ventilator settings according to orders, protocols and facility policy, but the nurse still assesses breathing and responds first when a client is in distress.
Physical therapist (PT): A licensed professional who helps clients regain strength, balance and mobility. PTs teach gait training and the safe use of walkers, canes and crutches.; The nurse refers clients with new problems walking or transferring to PT and then reinforces the exercises and techniques PT has taught.
Occupational therapist (OT): A licensed professional who helps clients do daily tasks such as dressing, eating and bathing. OTs recommend adaptive equipment such as long-handled reachers and plate guards.; As an exam cue, OT commonly focuses on self-care and fine motor skills while PT commonly focuses on walking and transfers, although both may work on overlapping goals in the care plan.
Speech-language pathologist (SLP): A licensed professional who evaluates and treats problems with swallowing, speech, language and thinking skills. Clients often call this person a speech therapist.; After a stroke the client usually stays NPO until passing a swallow screen, and a client who fails the screen is referred to the SLP for a full swallow evaluation and diet texture advice.
Social worker: A professional who helps clients and families with emotional, financial, housing and legal concerns. Social workers connect clients to community resources.; The nurse refers to the social worker for problems such as no insurance, an unsafe home, follow-up after suspected abuse or the need for placement after discharge.
Chaplain: A trained spiritual care provider who supports clients and families of any faith or of no faith. Chaplains help with grief, end-of-life concerns and religious requests.; The nurse can offer a chaplain visit for spiritual distress but should respect a client's wish to see their own religious leader instead.
Registered dietitian (RD): A credentialed nutrition expert who assesses nutritional needs and recommends or helps develop nutrition plans, including therapeutic diets, tube feedings and parenteral nutrition, together with the care team.; The nurse screens for nutrition risk and refers to the dietitian for problems such as weight loss, new diabetes, kidney diets or calorie counts, and what an RD may order on their own varies by state and facility.
Pharmacist: A licensed medication expert who reviews medication orders for problems such as wrong dose, interactions and allergies.; Nurses call the pharmacist about IV compatibility, dose questions and interactions, but the nurse who gives a drug is still responsible for giving it safely.
Medical interpreter: A trained professional who interprets spoken or sign language between clients and health care staff. Interpreting can be in person, by phone or by video.; Under federal civil rights rules, facilities that receive federal funds must offer qualified language assistance at no cost to people with limited English proficiency, and the NCLEX expects a trained interpreter rather than family members, especially children, for health information and consent.
Sitter (one-to-one observer): A staff member assigned to observe a client closely, often continuously, to keep them safe, for example a client at risk of suicide, falls or pulling out tubes. Sitter roles and qualifications vary by facility.; A sitter is often a UAP who watches and reports but does not do nursing assessment, so any change in the client must be reported to the RN right away.
Assignment: Giving a staff member responsibility for clients or tasks that are already part of their job description and within their license or training.; An RN may assign routine care to LPNs and UAPs when it fits their role and proven competence under the state nurse practice act and facility policy, and the RN is accountable for making an appropriate assignment and supervising it.
Delegation: Allowing another person to perform a specific nursing task that is not routinely part of their role. The nurse who delegates keeps accountability for the outcome.; An RN may never delegate nursing judgment or any responsibility the state prohibits, and on the NCLEX this usually means assessment, care planning, teaching and evaluation stay with the RN; follow the state nurse practice act and facility policy for everything else.
Supervision: Guiding, directing and checking the work of others to make sure care is safe and correct.; After delegating, the RN must follow up, for example by reassessing a client whose vital signs, as reported by a UAP, are outside the expected range.
Five rights of delegation: A safety checklist for delegating: right task, right circumstance, right person, right directions and communication, and right supervision and evaluation.; On delegation questions, check every right: the task is routine and low risk, the client is stable, the person is trained, the instructions are clear and the RN follows up.
Accountability: Being answerable for your own actions and decisions, including the decision to delegate.; The delegatee is accountable for their own actions, while the RN stays accountable for the decision to delegate, for appropriate supervision and for the client's nursing care.

Legal and ethical

Scope of practice: The actions a licensed professional is legally allowed to perform, based on education, training and license.; Each state's nurse practice act sets scope, so what an LPN or UAP may do varies by state, and the NCLEX tests general national principles rather than one state's rules.
Nurse practice act: The state law that defines nursing practice, licensing requirements and reasons for discipline. Every state has its own.; Your license and legal duties come from the nurse practice act of the state where you practice, and the state board of nursing enforces it.
HIPAA: The Health Insurance Portability and Accountability Act, a 1996 federal law that protects the privacy and security of health information.; HIPAA allows sharing for treatment, payment, health care operations and other legal purposes, but beyond that the client's permission is needed, so never discuss clients in public places or post about them on social media, even without names.
Protected health information (PHI): Health information held or shared by a health care organization or its business partners that identifies a person or could reasonably identify them, such as name, date of birth, diagnosis, photos or record number.; Log off computers, keep screens and papers out of public view, and share only the minimum information needed for the task.
Informed consent: A client's voluntary agreement to a procedure after learning its purpose, risks, benefits and alternatives. It must come from an adult with decision-making capacity or, if the client lacks capacity, from a legally authorized representative as state law allows.; The provider doing the procedure explains it and obtains consent, the nurse often witnesses the signature as facility policy allows, and if the client has questions or seems confused or sedated, the nurse notifies the provider before the procedure.
Advance directive: A legal document in which a person states their health care wishes or names someone to decide for them if they cannot speak for themselves. Living wills and health care powers of attorney are types of advance directives.; The federal Patient Self-Determination Act requires facilities that receive Medicare or Medicaid funds to give clients information about advance directives at admission, ask whether they have one and document the answer, but a client is never required to have one.
Living will: A type of advance directive that states which life-sustaining treatments, such as CPR, ventilation or tube feeding, a person wants or refuses if they become terminally ill or permanently unconscious.; A living will guides care when the client lacks decision-making capacity under the conditions stated in the document, and its legal form and rules vary by state.
Health care proxy (durable power of attorney for health care): A legal document naming a person, called the agent or proxy, to make health care decisions if the client loses the ability to decide.; The agent generally acts only once the client lacks decision-making capacity, as determined under state law and the document's terms, should follow the client's known wishes, and is not the same as a financial power of attorney.
POLST: A medical order form, originally named Physician Orders for Life-Sustaining Treatment, signed by a clinician for people with serious illness or frailty, that turns their treatment goals into orders about CPR and other care.; Unlike an advance directive, a POLST is an actual order that travels with the client between home, ambulance and facilities, and its name, eligibility, signing rules and portability vary by state (for example MOLST or POST).
Do not resuscitate (DNR): A provider's order that CPR will not be started if the client's heart or breathing stops. Some facilities call it allow natural death (AND) or do not attempt resuscitation (DNAR).; A DNR is a medical order, with state and facility rules on who may sign it and how it is honored outside the hospital, and it limits only CPR during an arrest, so the client still receives pain relief, oxygen, medications and nursing care based on their goals and needs.
Mandatory reporting: Laws that require certain professionals, including nurses, to report suspected abuse and certain conditions to the authorities.; Nurses must report suspected child abuse, and in most states elder or dependent adult abuse, on reasonable suspicion without needing proof, and reportable diseases go to public health, though exact rules vary by state.
EMTALA: The Emergency Medical Treatment and Labor Act, a federal law requiring hospitals that have emergency departments and take Medicare to screen and stabilize anyone with an emergency condition, including active labor.; Care cannot be delayed to ask about insurance or ability to pay, and an unstable client may be transferred only under strict conditions.
Restraint orders: A restraint is any device or method that limits a client's free movement, or a drug used to control behavior or restrict movement that is not standard treatment for the client's condition. Restraints require a provider's order and are a last resort after less restrictive measures fail.; Under federal CMS rules a restraint order can never be PRN or a standing order, each order for violent or self-destructive behavior lasts at most 4 hours for adults, 2 hours for ages 9 to 17 and 1 hour under age 9 with an in-person evaluation within 1 hour, nonviolent restraint orders follow state law and facility policy, and the nurse ties restraints to the bed frame with a quick-release knot and monitors often.
Good Samaritan law: State laws that protect people, sometimes including off-duty health care professionals, who give emergency help in good faith and without pay from being sued for ordinary mistakes.; Protections and exceptions vary by state and generally do not cover gross or willful misconduct, so give only care you are trained to give and hand the person over to emergency responders when they arrive.
Negligence: Failing to do what a reasonably careful person would do in the same situation, which causes harm. Anyone, not only professionals, can be negligent.; When the person is a licensed professional acting in their role, negligence is called malpractice.
Malpractice: Professional negligence: failing to meet the standard of care that a reasonably prudent nurse would give, which causes harm to a client.; To prove malpractice, four elements must be shown: a duty to the client, a breach of that duty, causation and actual harm.
Assault and battery: Assault is threatening a person so they fear harmful touching. Battery is touching a person without consent, such as giving a treatment the client refused.; A competent adult can refuse any treatment, so forcing care on them, even helpful care, can be battery.
False imprisonment: Confining a person or stopping them from leaving without legal authority, using force, restraints or threats.; Restraining a client without a required order or a lawful emergency reason, or blocking a client who wants to leave when there is no legal authority to hold them, can be false imprisonment.
Against medical advice (AMA): When a client leaves a facility before the provider discharges them.; A client with decision-making capacity has the right to leave, so the nurse notifies the provider, explains the risks, asks the client to sign an AMA form (which they may decline) and documents the discussion, but does not physically stop them unless a lawful hold applies.
Involuntary admission: Admission to a psychiatric facility without the client's consent, usually because they are a danger to themselves or others and, in many states, because they cannot meet their basic needs.; Each state sets its own criteria, time limits for emergency holds (often a few days, such as 72 hours) and procedures, and clients keep legal rights such as access to legal help and treatment in the least restrictive setting.
Emancipated minor: A person under 18 who is legally treated as an adult, for example through a court order or marriage, depending on state law.; Emancipated minors can consent to their own care, and many states also let other minors consent to certain services such as STI testing, contraception or prenatal care, with criteria that vary by state and service.
Decision-making capacity: A client's ability to understand information, weigh choices and communicate a decision about care. Competence is a related legal status that only a court decides.; Sedation, intoxication or acute confusion may impair capacity, so the nurse checks whether the client can understand, weigh and communicate a choice and alerts the provider before consent is obtained if there is doubt.
Chain of command: The formal line of authority for raising concerns, from the nurse to the charge nurse, nurse manager and higher administrators or medical leaders.; If an order seems unsafe or a provider does not respond to a serious change, the nurse first clarifies with the provider and then moves up the chain of command instead of following the order or waiting.

Documentation and communication

SBAR: A structured way to report about a client: Situation, Background, Assessment and Recommendation.; Use SBAR when calling a provider or giving a handoff, and have key data such as vital signs, allergies and recent labs ready, but never delay an urgent call to gather every detail.
Incident report: An internal report of an event that caused or could have caused harm, such as a fall or a medication error. It may also be called an occurrence, variance or safety event report.; Complete it promptly with facts only, and in the client's chart document the event itself, your assessment, who was notified and the care given, but do not mention that an incident report was filed; reporting rules vary by facility and state.
Charting by exception: A documentation method in which the nurse records only findings that differ from defined normal standards.; It saves time but depends on clear written standards, so every abnormal finding must still be fully described.
Intake and output (I&O): Measuring and recording all fluids that go into the body, such as oral, IV and tube feeding, and all that come out, such as urine, vomit, drainage and liquid stool, over a set time.; UAPs can usually measure and record I&O when allowed by state rules and facility policy, but the RN interprets it, and an adult urine output below about 30 mL/hr (0.5 mL/kg/hr) is a common warning sign to report, judged in context.
Electronic health record (EHR): The digital chart that holds a client's history, orders, results, notes and MAR.; Never share your login or chart under someone else's name, and open only the records of clients you care for, because every access is tracked.
Handoff report: The transfer of information and responsibility for a client from one nurse to another, such as at shift change or transfer. Many facilities do bedside shift report, which includes the client when appropriate.; A safe handoff includes code status, allergies, recent changes, pending tests and safety risks, often organized as SBAR or I-PASS, while protecting the client's privacy.
Verbal and telephone orders: Orders a provider gives by speaking, in person or by phone, instead of entering them in the EHR.; Limit them to the situations allowed by law and facility policy, write the order down and read it back to confirm, and make sure the provider signs it within the time the rules require.
Do Not Use list: The Joint Commission list of abbreviations that must never be used because they cause errors: U, IU, Q.D., Q.O.D., trailing zeros, missing leading zeros, MS, MSO4 and MgSO4.; Write 5 mg, not 5.0 mg, and 0.5 mg, not .5 mg, and spell out units, daily, every other day, morphine sulfate and magnesium sulfate.
Correcting a charting error: The approved way to fix a mistake in the medical record so the original entry can still be read.; The correction must leave the original entry readable and follow facility policy, which on paper commonly means one line through the error with the date, time and your initials, and in the EHR means the system's correction process; never erase, use correction fluid or delete entries.
Military time (24-hour clock): A way of writing time from 0000 to 2359, so 2:00 p.m. is 1400 and midnight is 0000.; Many US hospitals document in 24-hour time while clients talk in a.m. and p.m., so be ready to convert both ways.
US date format: The common US way to write dates is month/day/year, so 03/04/2026 usually means March 4, 2026, not April 3.; Read dates on orders, labels and expiration dates carefully, since many other countries write the day first and some systems use other formats, and clarify any date that is unclear.
Nursing care plan: A written plan listing a client's nursing problems, goals, interventions and expected outcomes.; The RN is responsible for developing the care plan and keeps accountability for it, while LPNs may contribute to or help update it as state law and facility policy allow, and UAPs report data and follow it.
Subjective and objective data: Subjective data is what the client tells you, such as pain or nausea. Objective data is what the nurse observes or measures, such as blood pressure or wound size.; Chart subjective data in the client's own words in quotation marks, and chart objective data as facts without labels such as rude or uncooperative.

Medications

Generic name: The official, nonproprietary name of a drug, such as metoprolol or acetaminophen. It is written in lowercase.; NCLEX questions generally use generic names, sometimes with a brand name in parentheses, so learn drugs by generic name and by class endings such as -olol and -pril.
Brand name (trade name): The name a company gives its version of a drug, such as Tylenol for acetaminophen. It is capitalized and may differ from country to country.; A brand you know from another country may have a different US brand name or may not be sold in the US at all, which is why relying on generic names is safer.
Over-the-counter (OTC) medication: A medication people can buy without a prescription, such as acetaminophen, ibuprofen, diphenhydramine or omeprazole.; Clients often forget to mention OTC drugs, so ask about them directly, because they can cause interactions or overdose, such as extra acetaminophen hidden in cold remedies.
Prescription drug (Rx): A medication that can be dispensed only with an order from a licensed prescriber.; US prescribers include physicians, NPs, PAs and dentists within the authority their state grants, and an RN license alone does not allow prescribing.
Dietary supplement: Products such as vitamins, herbs and fish oil sold without a prescription. The FDA does not approve them for safety or effectiveness before they are sold.; Ask about supplements in every medication history, because products such as St. John's wort, ginkgo and garlic can interact with antidepressants and anticoagulants.
Controlled substance: A drug with potential for misuse or dependence that is regulated under federal law by the Drug Enforcement Administration (DEA).; Nurses store, count and waste controlled substances according to federal and state law and facility policy, which commonly require locked storage, regular counts and a witness for wasted doses.
Controlled substance schedules: The five DEA categories based on potential for abuse: Schedule I drugs have no accepted medical use, and Schedule II drugs such as morphine, oxycodone and fentanyl have the highest abuse potential among prescribed drugs. Schedules III to V have decreasing potential for abuse, for example buprenorphine (III), lorazepam (IV) and pregabalin (V).; Federal law generally does not allow refills of Schedule II prescriptions, and some states add stricter rules for prescribing and storage.
Medication administration record (MAR): The record where the nurse documents each medication given, held or omitted, with dose, route and time. Most hospitals use an electronic MAR (eMAR).; Check the MAR against the order and the client before every dose, and document promptly after giving a drug, never before, following facility policy.
High-alert medications: Drugs that can cause serious harm if given in error, as listed by the Institute for Safe Medication Practices (ISMP). Examples are insulin, heparin and other anticoagulants, opioids, concentrated potassium chloride, IV magnesium sulfate and chemotherapy.; Many US facilities require an independent double check by a second nurse for high-alert drugs, and potassium chloride is never given by IV push.
Rights of medication administration: Checks done before every dose: right client, right drug, right dose, right route and right time, plus right documentation, right reason and right response.; Identify the client with two identifiers, such as full name and date of birth, never the room number, and remember that a client with decision-making capacity may refuse a medication, except in limited legal or emergency situations.
Look-alike, sound-alike drugs (LASA): Drugs whose names look or sound similar and are easy to confuse, such as hydroxyzine and hydralazine.; Some US labels and medication systems use tall man lettering, such as hydrOXYzine and hydrALAZINE, to make the difference stand out.
Boxed warning (black box warning): The strongest warning the FDA requires on a drug label, printed inside a box, about a serious or life-threatening risk.; For example, antidepressants carry a boxed warning about an increased risk of suicidal thoughts and behaviors in children, adolescents and young adults, so the nurse monitors mood closely and teaches families to report worrying changes right away.
Automated dispensing cabinet: A locked, computerized cabinet on the unit that stores medications and records who removes them. Common brands are Pyxis and Omnicell.; Remove medications only for the client you are about to medicate, and use the override function only in the urgent situations your facility's policy allows.
Barcode medication administration (BCMA): A system in which the nurse scans the client's wristband and each medication's barcode before giving it.; BCMA helps catch mismatches such as the wrong client or wrong dose but cannot catch every error, so never ignore an alert, never scan a copy of a barcode instead of the client's own wristband, and follow facility policy when a barcode will not scan.
Medication reconciliation: Comparing a client's current medication list with new orders to find drugs that were left out, duplicated or likely to interact.; Joint Commission-accredited organizations must reconcile medications at transitions of care such as admission and discharge, including OTC drugs and supplements, following their own policy.
Sliding scale (correctional) insulin: Extra rapid- or short-acting insulin given according to a prescribed scale based on the current blood glucose reading.; Check the glucose right before the dose, and know that US guidelines favor scheduled basal and mealtime insulin with correction doses rather than sliding scale alone.

US units

Fahrenheit and Celsius (°F and °C): The two temperature scales. To convert, °F = (°C × 9/5) + 32 and °C = (°F − 32) × 5/9.; US clients and many US charts use Fahrenheit, normal body temperature is about 98.6°F (37°C), a fever is commonly 100.4°F (38°C) or higher, and NCLEX items show °F with °C in parentheses.
Pounds and kilograms (lb and kg): Units of weight. One kilogram equals 2.2 pounds, so divide pounds by 2.2 to get kilograms.; US clients know their weight in pounds while doses are calculated in kilograms, and a client with heart failure should report a gain of more than 2 to 3 lb in a day or 5 lb in a week.
Ounce (oz): A US unit used for both volume and weight. A fluid ounce is about 30 mL, and a weight ounce is one-sixteenth of a pound.; Clients describe what they drink in ounces, and a standard US cup is 8 fl oz, about 237 mL (usually rounded to 240 mL), so nurses convert to mL for I&O; newborn weights are often given in pounds and weight ounces.
Milliliter (mL): The standard unit of liquid volume in US clinical practice. One mL equals one cubic centimeter (cc).; Write mL rather than cc, because cc is on the ISMP list of error-prone abbreviations and can be misread as u for units.
Milliliters per hour (mL/hr): The rate at which an IV fluid or medication runs, used to program an infusion pump. Calculate it as total volume divided by the number of hours.; For example, 1,000 mL over 8 hours runs at 125 mL/hr, and NCLEX calculation items ask for this kind of answer.
Drops per minute (gtt/min): The rate of an IV infusion that runs by gravity without a pump. Calculate it as volume in mL times the drop factor, divided by time in minutes.; NCLEX calculation items expect you to round gtt/min to a whole number, because you cannot count part of a drop.
Drop factor: The number of drops that make 1 mL for a specific IV tubing, printed on the package. Macrodrip tubing is usually 10, 15 or 20 gtt/mL, and microdrip tubing is 60 gtt/mL.; Microdrip tubing can be useful when flow rates are low, and with it the gtt/min equals the mL/hr, although most hospitals use infusion pumps for precise rates as policy requires.
Milligrams per deciliter (mg/dL): The US unit for many lab values, including glucose, BUN, creatinine and calcium. Many other countries report glucose in mmol/L; multiply mmol/L by 18 to get mg/dL.; Learn US ranges in mg/dL, such as a fasting glucose of about 70 to 99 mg/dL, and treat a glucose below 70 mg/dL as hypoglycemia.
Milliequivalents per liter (mEq/L): A unit that expresses electrolyte concentration as chemical equivalents. For sodium and potassium, the number in mEq/L is the same as in mmol/L.; Common US reference ranges, which vary slightly by lab, are sodium 135 to 145 mEq/L and potassium 3.5 to 5.0 mEq/L, and potassium chloride doses are ordered in mEq.
Millimeters of mercury (mmHg): The unit for pressures such as blood pressure, arterial blood gases and intracranial pressure.; Expect values such as a PaCO2 of 35 to 45 mmHg and a PaO2 of 80 to 100 mmHg, and know that US guidelines define stage 1 hypertension as starting at 130/80 mmHg.
Units (insulin and heparin): A measure of biological activity, rather than weight, used for drugs such as insulin and heparin.; Always write the full word units, never U or IU, and draw up U-100 insulin only in an insulin syringe marked in units.
Microgram (mcg): One-thousandth of a milligram, so 1 mg equals 1,000 mcg. Drugs such as levothyroxine, digoxin and fentanyl are often dosed in mcg.; Write mcg, not μg, because the Greek letter can be misread as mg and cause a thousand-fold overdose.
Household measures (teaspoon and tablespoon): Kitchen measurements still used by many US families. One teaspoon (tsp) equals 5 mL and one tablespoon (tbsp) equals 15 mL.; Teach clients and parents to measure liquid medicines with an oral syringe or dosing cup marked in mL, not with kitchen spoons.
Weight-based dosing (mg/kg): A dose calculated from body weight, such as 10 mg/kg. Some continuous infusions are ordered by weight and time, such as mcg/kg/min.; Convert pounds to kilograms first, and check every pediatric dose against the safe dose range before giving it.

US health system

Medicare: The federal health insurance program for people 65 and older, some younger people with disabilities, and people with end-stage kidney disease.; Part A covers hospital stays, short-term skilled nursing, hospice and some home health, Part B covers outpatient care, Part D covers drugs, and Medicare does not pay for long-term custodial care.
Medicaid: A joint federal and state program that pays for health care for people with low income. Each state sets its own eligibility rules and benefits.; Medicaid is the largest payer for long-term services and supports in the US, including nursing home care, and many people qualify only after their own savings are used up, depending on state rules.
Skilled nursing facility (SNF): A facility that provides short-term skilled care, such as rehabilitation therapy, IV antibiotics or wound care, usually after a hospital stay.; Original Medicare Part A generally covers up to 100 days in a SNF per benefit period after a qualifying inpatient stay of at least 3 consecutive days (not counting the discharge day), when skilled care is needed. It pays the full approved amount for days 1 to 20, with daily coinsurance for days 21 to 100. Medicare Advantage plans and some programs may waive the 3-day rule.
Long-term care facility (nursing home): A facility where people live when they need ongoing help with daily activities and nursing care, often for months or years.; Much of the hands-on care is commonly given by CNAs and LPNs supervised by RNs, with staffing and delegation governed by state law and facility rules, so delegation and supervision questions often take place in this setting.
Home health care: Skilled nursing and therapy services given in the client's home through scheduled visits.; Medicare covers home health when the client is homebound and needs part-time skilled care ordered by a provider, and the home health nurse also checks the home for safety risks.
Hospice: Comfort-focused care for people with a terminal illness who are no longer seeking treatment to cure it. It also supports the family, including after the death.; The Medicare hospice benefit requires a physician to certify a life expectancy of 6 months or less if the illness runs its usual course, and the client can leave hospice at any time.
Palliative care: Care that relieves the symptoms and stress of a serious illness, at any stage and at any age.; Unlike hospice, palliative care can be given at the same time as curative treatment such as chemotherapy or dialysis.
Rapid response team (RRT): A team, often a critical care nurse, a respiratory therapist and a provider, that comes to the bedside quickly when a client shows early signs of getting worse.; Any staff member, and in many hospitals the client or family, can call the RRT for acute changes such as new confusion, falling oxygen saturation or dropping blood pressure without waiting for a provider to call back.
Code blue: A common hospital alert for cardiac or respiratory arrest that calls the resuscitation team to the bedside.; Emergency code names differ between hospitals and many now use plain-language alerts such as medical emergency, so learn each facility's codes.
The Joint Commission (TJC): An independent nonprofit organization that accredits most US hospitals and many other health care organizations.; Its National Performance Goals and Do Not Use list shape daily nursing practice, such as using two client identifiers and the surgical time-out.
National Performance Goals (NPGs): The Joint Commission's core performance and safety requirements, which replaced the National Patient Safety Goals (NPSGs) starting January 1, 2026.; Many NCLEX resources still say National Patient Safety Goals, and the familiar safety practices such as using two client identifiers, reporting critical results on time, reconciling medications, preventing infection and screening for suicide risk remain part of US accreditation expectations.
NCSBN: The National Council of State Boards of Nursing, a nonprofit organization made up of the boards of nursing of US states and territories.; NCSBN writes the NCLEX and its test plan but does not issue licenses, which come from a state board of nursing.
State board of nursing: The state agency that licenses nurses, enforces the nurse practice act and disciplines nurses who violate it.; Internationally educated nurses apply to the board of the state where they want a license, and requirements such as credentials evaluation and English testing vary by state.
Authorization to Test (ATT): The email Pearson VUE sends once your board of nursing confirms you are eligible and your exam registration is complete. It contains your ATT (authorization) number and the dates you may test.; You must schedule and take the NCLEX within the ATT validity period set by your board, which varies (roughly 90 days on average) and cannot be extended.
Pearson VUE: The company that handles NCLEX registration and runs the testing centers, including centers outside the US.; You need both an application to a board of nursing and a paid registration with Pearson VUE before you receive an ATT.
Next Generation NCLEX (NGN): The current version of the NCLEX, launched in April 2023, which measures clinical judgment with case studies and item types such as matrix, bowtie, highlight and drag-and-drop.; Many NGN items give partial credit, so answer every part of a question carefully rather than rushing.
Computerized adaptive testing (CAT): The method the NCLEX uses to choose each new question based on how you answered the earlier ones.; The NCLEX-RN gives between 85 and 150 items in up to 5 hours and stops when the computer is confident that your ability is above or below the passing standard.
Nurse Licensure Compact (NLC): An agreement among member states that lets a nurse with a multistate license practice in other compact states without getting another license.; Your primary state of residence must be a compact state to hold a multistate license, and not every state belongs to the compact.
CGFNS and VisaScreen: CGFNS International is an organization that evaluates nursing education completed outside the US and offers the VisaScreen certificate.; Many foreign-educated nurses need a VisaScreen certificate for certain occupational visas or employment-based immigration, and many boards require a credentials evaluation from CGFNS or another approved agency, so check the rules for your visa and your state.
Observation status: An outpatient status in which a client stays in the hospital, sometimes overnight, while providers decide whether admission is needed.; Days spent in observation do not count toward Medicare's 3-day inpatient stay requirement for skilled nursing facility coverage, which often surprises clients and families.

Clinical shorthand

NPO: Nothing by mouth, from the Latin nil per os. The client may not eat or drink, usually before surgery or a procedure or when swallowing is unsafe.; NPO usually includes water, gum and hard candy, so check with the provider about which essential oral medications to give and keep providing mouth care.
PRN (prn): As needed, from the Latin pro re nata. A PRN order lets the nurse give a medication or treatment when the client needs it, within the limits of the order.; A PRN order must state the reason and the minimum time between doses, such as every 4 hours as needed for pain, and the nurse documents why it was given and how the client responded.
Stat: Immediately. A stat order is carried out right away, usually within minutes, and is given only once.; Stat orders come before routine tasks, and the exact time limit is set by facility policy.
q4h (every 4 hours): The letter q means every, so q4h means every 4 hours and q2h means every 2 hours. These intervals run around the clock.; A q4h drug is given about six times in 24 hours, turning a bedbound client about every 2 hours is a common pressure injury intervention that is adjusted to the client's needs, and q.d. and q.o.d. are banned, so write daily and every other day.
BID, TID and QID: Twice a day, three times a day and four times a day.; These doses usually follow facility schedules during waking hours, unlike q12h, q8h or q6h, which must be spaced evenly around the clock.
ac and pc: ac means before meals and pc means after meals.; Blood glucose checks and rapid-acting insulin are commonly timed ac, while drugs that upset the stomach are often given with or after meals.
Activities of daily living (ADLs): Basic self-care tasks: bathing, dressing, eating, toileting, grooming and moving around. Instrumental activities of daily living (IADLs) are more complex tasks such as cooking, shopping, managing money and taking medications.; Helping stable clients with ADLs is commonly delegated to UAPs as state law and facility policy allow, but assessing a client's ability to perform ADLs stays with the RN.
Range of motion (ROM): The full movement possible at a joint. Active ROM is done by the client, and passive ROM is done by someone else moving the client's joints.; UAPs can usually perform ROM exercises for stable clients when the care plan, state law and facility policy allow, and anyone doing ROM should stop at the point of pain or resistance.
Head of bed (HOB): The top end of the bed, often written with an angle, such as HOB at 30 degrees.; Keep the HOB at 30 degrees or higher for clients on tube feedings or at risk of aspiration, and raise it for clients who are short of breath.
Fowler's position: A sitting position with the head of the bed raised. Common conventions, which vary slightly by source, are low Fowler's at about 15 to 30 degrees, semi-Fowler's at about 30 to 45 degrees and high Fowler's at about 60 to 90 degrees.; High Fowler's helps a client in respiratory distress breathe, and semi-Fowler's is common for tube feeding and after many surgeries.
PO, SL, IM and subcut: Abbreviations for medication routes: PO is by mouth, SL is under the tongue, IM is into a muscle and subcut is into the fatty tissue under the skin.; ISMP advises writing subcut or subQ instead of SC or SQ, and many facilities spell routes out to prevent errors.
IV push and IV piggyback (IVPB): IV push is a drug injected directly into an IV line, usually over a few minutes. IV piggyback is a small bag of medication that runs through the main IV line.; Check the recommended push rate, because pushing drugs such as furosemide or phenytoin too fast can cause harm, and IV push medications are outside LPN scope in many states.
Alert and oriented x4 (A&O x4): The client is awake and knows person, place, time and situation.; A drop from A&O x4 to x3 or lower is a change in mental status that needs further assessment and reporting.
Code status: The client's documented wishes about resuscitation, such as full code, meaning all measures including CPR, or DNR.; Confirm code status in the chart and at handoff. In an emergency the team follows current valid orders and directives. A client with decision-making capacity can change their wishes at any time, so report any change right away so the provider can update the order, following state law and facility policy.
Standard precautions: Infection control practices used with every client: hand hygiene, PPE based on the expected exposure, safe injection practices and cleaning of shared equipment.; Alcohol-based hand rub is fine for most hand hygiene, but wash with soap and water when hands are visibly soiled, and many facilities and NCLEX items expect soap and water after caring for a client with C. difficile.
Transmission-based precautions: Extra precautions added to standard precautions for specific infections. The three types are contact, droplet and airborne.; Use gown and gloves for contact (such as MRSA or C. difficile), a surgical mask for droplet (such as influenza or pertussis), and an N95 respirator with a negative-pressure room for airborne (such as tuberculosis or measles), and for chickenpox use both airborne and contact precautions, adjusting PPE to the exposure and facility policy.
Fall precautions: Safety measures for clients at risk of falling, based on a fall risk assessment score.; Measures are chosen to fit the client's risk and facility policy and often include a low bed with wheels locked, call light within reach, nonskid socks, a bed alarm, frequent rounding and a clear path to the bathroom, and UAPs can carry out many of them.
OOB and BRP: OOB means out of bed. BRP means bathroom privileges, so the client may get up to use the bathroom.; An order for bed rest with BRP allows only trips to the bathroom, so always check the activity order before helping a client walk.
Triage: Sorting clients by urgency so the sickest are seen first. Many US emergency departments use the five-level Emergency Severity Index (ESI), where level 1 is the most urgent.; In mass casualty events, common triage systems use colored tags such as red for immediate, yellow for delayed, green for minor and black for expectant or deceased, though details vary by system.
Time-out: A pause right before a procedure when the whole team confirms the correct client, procedure and site. It is part of the Joint Commission Universal Protocol, along with a pre-procedure check and site marking.; Any team member, including the nurse, can and should stop the procedure if anything does not match.
ABCs: Airway, breathing and circulation, the order used to set priorities when a client has several problems.; On the NCLEX an airway problem usually comes first, but in cardiac arrest CPR starts with chest compressions (CAB).
Postoperative day (POD): The number of days since surgery. By common convention the day of surgery is POD 0 and the next day is POD 1.; The NCLEX may give the POD as a clue, since a low fever in the first day or two is common, while a new fever later in recovery needs assessment for causes such as infection.
Foley catheter: An indwelling urinary catheter held in the bladder by a small inflated balloon. Foley is a product name that people often use for any such catheter.; Hospitals track catheter-associated urinary tract infections (CAUTI) closely, so nurses check every day whether the catheter is still needed and keep the bag below the level of the bladder.
Clear liquid diet: A diet of fluids you can see through, such as water, broth, apple juice, gelatin and ice pops. A full liquid diet adds milk, pudding, cream soups and ice cream.; After some surgeries and procedures, the diet is advanced step by step as the provider orders, sometimes written as advance diet as tolerated, based on the procedure and how the client is doing.

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