Highlight text NGN items ask you to mark only the relevant cues in a passage (chart note, nurse report, H&P) that matter for this moment in care.
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How highlight text NGN is scored (fast)
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You earn credit for relevant highlights and avoid penalties by not marking noise.
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Many items allow partial credit: each correct highlight counts; over-highlighting can reduce credit.
Mindset: Treat the passage like a handoff. What would you act on in the next few minutes?
The 4-cue filter (what to highlight)
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Instability signals: hypoxemia, hypotension, neuro change, bleeding.
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Time-sensitive trends: worsening SpO₂/BP/UO on the same device/conditions.
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Action-linked data: cues that would change device, medication, or positioning now.
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Contraindications/risks: allergies, reversal-needed meds, high-alert drugs.
Skip: Old history that does not change today’s decision, routine comfort notes, and vague “feels better/worse” without measurable change.
Worked stem 1 (oxygenation)
Passage (condensed):
71-year-old with COPD, on 2 L nasal cannula. Reports ↑ work of breathing. SpO₂ 88%. Accessory muscles noted. Wife says he missed his inhaler yesterday. Eating well. RR 30. No chest pain.
Correct highlights:
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2 L nasal cannula (device context)
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SpO₂ 88%
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↑ work of breathing / accessory muscles
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RR 30
Why: These cues justify oxygen escalation and positioning now. The missed inhaler is background (may inform treatment later, but doesn’t beat hypoxemia).
Worked stem 2 (anticoagulation)
Passage (condensed):
Client on IV heparin for DVT. aPTT due at 12:00. Notes bleeding gums after brushing. IM B12 scheduled at 14:00. Eating lunch. Vitals stable.
Correct highlights:
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IV heparin (high-alert context)
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aPTT due
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bleeding gums
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IM B12 scheduled
Why: These cues trigger monitoring, bleeding assessment, and avoidance of IM injections. Lunch and stable vitals are not the focus.
Worked stem 3 (neuro)
Passage (condensed):
Fall last night. This morning: new unequal pupils, confusion from baseline, BP 138/86, vomited once, “slept poorly.” On acetaminophen only.
Correct highlights:
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new unequal pupils
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confusion from baseline
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vomited once
Why: Potential intracranial issue—time sensitive. BP and acetaminophen are less actionable now.
Language patterns that usually signal “highlight me”
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Numbers with direction: “UO 50 → 30 → 20 mL/hr,” “SpO₂ 93 → 90 → 88.”
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Device + setting: “on 2 L NC,” “Venturi 35%.”
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Acute change words: “new,” “sudden,” “worsening,” “trend down.”
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Risk markers: anticoagulants, insulin drips, MgSO₄, allergies, recent surgery.
Common traps (and fixes)
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History magnet: Highlighting old diagnoses that don’t change today.
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Fix: Ask: “Does this change my first action?”
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Teaching over safety: Marking education needs while the passage shows instability.
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Fix: Stabilize first.
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Over-highlighting: Selecting entire sentences that mix signal + noise.
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Fix: Highlight only the signal words/phrases.
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Missing device context: Ignoring the same device/setting rule in trend passages.
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Fix: Tie every saturation/trend to its device/flow.
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Quick checklist (print this)
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Mark only cues that change care now
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Include device + setting for O₂ data
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Capture directional trends (same device/conditions)
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Flag high-alert meds and contraindications
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Leave out background and non-actionable detail
Mini-drills (5-second highlights)
A) “SpO₂ 89% on 2 L NC, RR 28, ate breakfast, accessory muscles present.”
→ Highlight: SpO₂ 89% on 2 L NC, RR 28, accessory muscles.
B) “On heparin; aPTT not resulted; new hematuria; asking about discharge time.”
→ Highlight: heparin, aPTT not resulted, new hematuria.
C) “Head injury yesterday; new confusion; vomited twice; pupils unequal; temp 37.2 °C.”
→ Highlight: new confusion, vomited twice, pupils unequal.
Image (hero)
Title: “Highlight Text: Signal vs Noise”
Alt: “Passage with relevant phrases highlighted and background text dimmed for highlight text NGN”
More Resources
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FAQs
Do highlight text items always give partial credit?
Many do, especially when multiple cues exist. Still, avoid over-highlighting.
How much text should I highlight?
Only the actionable phrase(s), not the whole sentence.
What if two cues are related?
Highlight both if each is independently relevant (e.g., SpO₂ 88% on 2 L NC + accessory muscles).
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