LNA Memory Pager

The mnemonics

Say them out loud. Rhythm is what makes them survive under pressure.

1The opening bookend — "Five fingers at the door"

Knock · Introduce · ID · Explain · Privacy — thumb: KNOCK; index: "Hi, I'm [your name]"; middle: check the ID band; ring: EXPLAIN; pinky: PRIVACY — door, curtain. Then wash hands.

2The closing bookend — the going-away rhyme

"Call bell close, bed down low, wash my hands, report, and go." Contains an instant-fail step — that's why it's a rhyme.

3PPE ON — "Grandma Makes Good Gravy"

Gown → Mask → Goggles → Gloves.

4PPE OFF — "Get Germs Gone, Man"

Gloves → Goggles → Gown → Mask. Dirtiest leaves first.

5Chain of infection — "A Rat Escaped Through Every House"

Agent → Reservoir → portal of Exit → mode of Transmission → portal of Entry → susceptible Host.

6Grief — DABDA

Denial, Anger, Bargaining, Depression, Acceptance.

7Six abuse types — "People Protect; Some Forget; Never Ignore"

Physical, Psychological/verbal, Sexual, Financial, Neglect, Involuntary seclusion.

8Range of motion

ABduction = ABducted, taken away · ADDuction = ADDs it back · Flex = bend · Extend = straighten · DORSiflexion = toes up (dorsal fin on top) · PLANTar = plant the foot, step on the gas — toes down.

9The numbers rap

"60 to 100 beats · 12 to 20 breaths · an ounce is thirty · a cup is 240 · feed at 45 · turn every 2 · restraints: check 15, release 2."

10The tolerance line

"4 beats, 2 breaths, 2 pounds — 25 out, 60 in."

11Weak side

"Weak in first, strong out first."

12Transfers

"Brakes before body." · "Shoes, then stand."

13Catheter

"Bag below the bladder, never on the floor."

14Bed rhythm

"Rail up, roll away · dirty in, clean down · rail up, roll back."

15Feeding

"Sit them up, sit yourself down."

16Direction

"Front to back, clean to dirty." Bathing: "Eyes to toes — no soap on the face, peri comes last."

17Stockings

"No twist, no wrinkle."

18Handwashing

"Fingers down, scrub to 20, towel turns the tap." Exam minimum is 10 seconds.

19Respirations

"Keep your fingers on the wrist." · "Rise plus fall equals one."

20Electronic BP

"Under 200 on the pump; write what the screen says."

21Observation

"Subjective = Said · Objective = Observed." · "When in doubt, report it out."

22Fire

RACE — Rescue, Alarm, Contain, Extinguish · PASS — Pull, Aim, Squeeze, Sweep.

23Temperature ladder

"Rectal runs high, armpit runs low" — about a degree either side of oral. Oral normal 97.6–99.6.

24Fowler's ladder

"30–45–60–90: semi, Fowler's, high. Dinner at 45 or more."

25Manual BP — for the class checkoff

"Squeeze over rest" — systolic is the squeeze (top), diastolic is the rest (bottom). "First sound top, last sound bottom." "Let it fall 2 to 4" mmHg per second — slow is accurate.

The numbers

If a written question hands you a number, it is almost always one of these.

Pulse60–100 / min

Respirations12–20 / min

Temp, oral97.6–99.6 °F

Temp, rectal98.6–100.6 °F

Temp, axillary96.6–98.6 °F

Blood pressure90/60 – 119/79

Report BP at≥ 140/90 or < 90/60

Electronic cuffnever above 200

Pulse tolerance± 4 beats

Respiration tolerance± 2 breaths

Weight tolerance± 2 pounds

Urine output tolerance± 25 cc

Fluid intake tolerance± 60 cc

1 ounce= 30 cc

1 cup / glass= 8 oz = 240 cc

1 kilogram= 2.2 pounds

Feed upright at≥ 45°

Semi-Fowler's30–45°

Fowler's45–60°

High Fowler's60–90°

Reposition every2 hours

Restraints — checkevery 15 min

Restraints — releaseevery 2 hours

Handwash scrub≥ 10 s (aim for 20)

Every instant-fail step, by skill

Miss one of these on the skills exam and the attempt ends, however well the rest of it went. 29 steps in total.

Every skill, alwaysLeave the call bell within reach before leaving · Follow infection control practices throughout · Complete every assigned task · Maintain safety at all times

HandwashingRub hands vigorously for at least 10 seconds · Finish the task without recontaminating your hands

Denture care and mouth careGloves on before care, gloves off after

Dressing a resident with a weak sideDress the weak side first

Emptying a catheter drainage bagGloves on before care, gloves off after · Keep the drainage bag below the level of the bladder · Measure and record output within 25 cc of the evaluator

Range of motion - hip, knee, anklePerform ROM on the correct side

Range of motion - shoulder, elbow, wrist, fingersHandle the body gently · Perform ROM on the correct side

Assisting with a bedpanGloves on before care, gloves off after

Positioning a resident on their sideActually get the resident onto their side

Radial pulse for one minuteRecord a result within 4 beats of the evaluator's count

Counting respirations for one minuteRecord a result within 2 breaths of the evaluator's count

Blood pressure (electronic cuff)Record both the systolic and diastolic readings exactly as the display shows them

Measuring and recording weightDocument within 2 pounds of the evaluator

Calculating fluid intake in ccDocument within 60 cc of the evaluator

Transferring from bed to wheelchairLock the wheelchair brakes

Changing a soaker pad with the resident in bedRaise the side rail on the side opposite where you're working

Making an occupied bedRaise the side rail opposite your working side · Raise the second side rail before turning the resident back

Putting an elastic stocking on a legLeave the stocking with no twists and no wrinkles

Nail careGloves on before, gloves off after

Modified bed bath - face, one arm, one handno instant-fail step — but 4 ordinary errors still fails

Donning and doffing an isolation gown and glovesRoll the gown with the soiled side inward, never letting it touch your uniform

Feeding a dependent residentPosition the resident upright at least 45 degrees

The routine

The Daily 45

15 min	Mine tonight's chapters — objectives, then the Guidelines and Procedure boxes, then key terms. You already sat through the lecture.
20 min	Question sets — tonight's chapters, then weakest area, then misses.
10 min	One skill out loud, bookends included, with someone marking the checklist for you.

Micro-loops: five minutes of flashcards or one set at breakfast, at lunch, in the car.

Countdown to test day

7+ days out: the full routine above.
4–6 days: nothing new. Exam mode and misses on a cycle, a Draw-4 mock every other day, pager every morning.
3 days or fewer: triage. Pager read-through, the instant-fail list, one Draw-4, misses-only questions for half an hour, bookends cold. Nothing new at all.
Night before: pack two IDs, a watch with a second hand, uniform, blue or black pen. Stop studying at nine. A rested 75% beats an exhausted 85%.