Client Needs Categories

~38% of exam

Safe & Effective Care Environment

Ensures nurses protect clients and manage care safely across all settings.

Subcategory 1 — Management of care (~17–23%)

Management of Care

Directing/evaluating nursing care for multiple clients. Includes delegation, prioritization, legal/ethical issues, and advance directives.

DelegationPriority settingInformed consentConfidentialityAdvance directivesCase managementReferrals

Subcategory 2 — Safety & infection control (~9–15%)

Safety & Infection Control

Protecting clients and staff from health and environmental hazards.

Standard precautionsIsolationFall preventionRestraintsError reportingSurgical asepsis

~43% of exam

Physiological Integrity

The largest category. Tests physiological care across basic needs, pharmacology, risk reduction, and adaptation.

Basic care & comfort (~6–12%)

Basic Care & Comfort

Non-pharmacological comfort measures, nutrition, elimination, mobility, sleep, personal hygiene.

NutritionWound careOstomyMobilityPalliative care

Pharmacological & parenteral (~13–19%)

Pharmacological & Parenteral

Drug administration, dosage calculation, adverse effects, IV therapy, blood products, TPN.

Drug classesSide effectsIV calculationsHigh-alert medsBlood admin

Reduction of risk potential (~9–15%)

Reduction of Risk Potential

Preventing complications from disease, treatments, or procedures. Lab interpretation, diagnostic tests, vital sign monitoring.

Lab valuesVital signsPre/post-op careDiagnostic tests

Physiological adaptation (~11–17%)

Physiological Adaptation

Managing illness and recovery. Fluid/electrolyte balance, hemodynamics, alteration in body systems.

Fluids/electrolytesAcid-baseShockRespiratory failureCardiac arrest

~9% of exam

Health Promotion & Maintenance

Disease prevention, growth and development across the lifespan, and health education.

Health Promotion & Maintenance

Growth/development milestones, prenatal/postnatal care, health screening, immunizations, lifestyle modifications, family planning.

Developmental milestonesImmunizationsPrenatal careContraceptionScreeningHealth teaching

~9% of exam

Psychosocial Integrity

Mental health, behavioral disorders, coping, and end-of-life care. Therapeutic communication is heavily tested.

Psychosocial Integrity

Mental health disorders, therapeutic communication, coping mechanisms, grief/loss, abuse, addiction, cultural sensitivity, crisis intervention, end-of-life care.

Therapeutic communicationGrief/lossAbuseSubstance useAnxiety/depressionSchizophreniaCrisis

High-yield normal lab values (memorize these)

Lab	Normal range	Critical low	Critical high	Key clinical significance
Na⁺ (Sodium)	136–145 mEq/L	<120	>160	Fluid balance, neurological status
K⁺ (Potassium)	3.5–5.0 mEq/L	<2.5	>6.5	Cardiac rhythm — most commonly tested
Ca²⁺ (Calcium)	8.5–10.5 mg/dL	<7.0	>13.0	Neuromuscular, cardiac, bone
Glucose	70–100 mg/dL (fasting)	<40	>500	Hypoglycemia s/s: confusion, diaphoresis
HgB (Hemoglobin)	M: 14–18 · F: 12–16 g/dL	<7	—	Oxygen carrying capacity, anemia
WBC	5,000–10,000 /mm³	<2,000	>30,000	Infection, immunocompromise
Platelets	150,000–400,000 /mm³	<50,000	>1,000,000	Bleeding risk below 50,000
INR	0.8–1.1 (therapeutic 2–3)	—	>4	Warfarin monitoring — antidote: Vit K
pH (arterial)	7.35–7.45	<7.20	>7.60	Acid-base balance — <7.35 = acidosis
PaO₂	80–100 mmHg	<60	—	O₂ supplementation below 60
Creatinine	0.6–1.2 mg/dL	—	>10	Kidney function — rising = renal failure
BUN	10–20 mg/dL	—	>100	Renal function, hydration status