High-Yield Topics for the SNB RN Licensure Exam, Ranked

How we chose these topics

Two things make a topic worth extra time. It appears in many categories, so one skill earns marks across several questions. And it is a point where nurses trained elsewhere often choose a sensible but wrong answer. The five official sample questions give some guide: they cover opioid analgesia in cancer pain, quality improvement, evidence-based management of stress urinary incontinence, prioritising injuries in multiple trauma, and therapeutic communication. None of those is rare, and each needs judgement more than recall.

The ten topics in order

1. Medication safety and calculations

The test plan has a category for medication administration and pharmacology, and medication also appears in emergencies, mental health, diabetes and palliative care. Be able to do the following without hesitation.

• Apply the rights of medication administration and the checks before giving a high-alert drug.
• Work out doses, volumes and infusion rates, entering the sum correctly in the on-screen calculator.
• Name the monitoring for insulin, anticoagulants, opioids, digoxin, lithium and potassium.
• Recognise anaphylaxis and a transfusion reaction and know the first action.

See the medication domain.

2. Prioritisation: what to do first

Many stems give several patients or several tasks. The best answer is the one that protects life and airway first, then stable but at-risk patients, then routine care. Practise reading for the word first or priority, and use ABC (airway, breathing, circulation) as the default order. The multiple trauma sample question belongs here.

3. Delegation and supervision

Know what can be delegated to enrolled nurses and healthcare assistants and what cannot. The RN remains accountable. Assessment, interpretation, planning, education and unstable patients stay with the RN. See the collaboration domain.

4. Infection prevention and control

Standard precautions apply to everyone. Contact, droplet and airborne precautions add to them. Know the order of putting on and removing protective equipment, the WHO five moments for hand hygiene, sterile technique for urinary catheters and central lines, and sharps handling. See the quality and infection control domain.

5. Legal and ethical practice in Singapore

This is a named content area on its own. Learn consent, refusal of treatment, confidentiality, capacity, advance care planning and the duty to report. Do not answer from home-country habit. The legal and ethical domain has the checklist.

6. Recognising deterioration and emergencies

Sepsis, anaphylaxis, myocardial infarction, stroke, seizures and cardiac arrest. For each, know the first three actions and the escalation call using SBAR. See the emergencies domain.

7. Fluids, electrolytes and acid-base balance

Sodium, potassium, calcium and magnesium disorders, intravenous fluid choices and blood gas interpretation. Learn the signs, the risk groups and the nursing action. See the nutrition and fluids domain.

8. Perioperative and wound care

Post-operative monitoring, recognising complications such as haemorrhage and infection, drains and stomas, and choosing wound care by wound type. See the assessment and wound care domain.

9. Therapeutic communication and mental health

Open questions, reflection, silence and empathy beat reassurance, advice or changing the subject. The same logic applies to de-escalation. Learn the Mental Health (Care and Treatment) Act at a principle level. See the mental health domain.

10. Elder care and palliative care

Singapore has an ageing population, and several categories (elder care, end-of-life care, falls, continence) belong to this theme. Know atypical presentations in older people, delirium versus dementia, and symptom control at the end of life. See the elder and palliative care domain.

Rules of thumb behind the top three topics

Prioritisation

Use this order unless the stem gives a reason to change it.

1. Immediate threats to airway, breathing or circulation.
2. Acute changes in a patient who was stable, such as new confusion or new pain.
3. Unstable chronic conditions, such as uncontrolled blood glucose.
4. Safety and comfort needs.
5. Routine care, teaching and documentation.

Look for the patient whose problem will cause harm soonest if you do nothing. That is usually not the loudest patient.

Delegation

A useful test: could the task be done by following a clear routine, with a predictable result, in a stable patient? If yes, it may be delegated, with instructions and follow-up. If it needs assessment, judgement, teaching or interpretation, or if the patient is unstable, it stays with the RN. Delegation never removes accountability. Be ready to name what you check afterwards.

Medication safety

Before giving any medicine, confirm the patient's identity, the order, the drug, the dose, the route, the time and the allergy status, and document after giving. For high-alert medicines, expect an independent double check as local policy requires. If a dose looks wrong, stop and clarify. The best answer is rarely "give it and monitor closely".

Singapore-specific facts worth knowing cold

The first three points are verified on the CDA vaccinations page, checked on 25 October 2026. Ages of administration are shown in tables we have not reproduced, so check the national schedules for ages. The fourth point is general background on a national programme.

• The National Childhood Immunisation Schedule covers 15 diseases: tuberculosis, hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, measles, mumps, rubella, varicella, pneumococcal disease, HPV, influenza and COVID-19.
• The National Adult Immunisation Schedule covers 13 diseases for people aged 18 and above: influenza, pneumococcal disease, HPV, tetanus, diphtheria, pertussis, measles, mumps, rubella, hepatitis B, varicella, shingles and COVID-19.
• Measles and diphtheria vaccination are compulsory for children under the Infectious Diseases Act.
• The Healthier SG national programme focuses on preventive care and chronic disease management in the community.

A ranking table for planning

Lower-yield temptations

Some topics feel useful but give little return per hour.

• Rare conditions. The test plan describes generalist RN practice. Spend time on common conditions and their nursing care first.
• Memorising long drug lists. Learn classes, high-alert agents, monitoring and the main adverse effects.
• Perfecting one favourite area. If you are a theatre nurse, do not spend three more weeks on perioperative care.
• Collecting recalled questions. They may be wrong, are not official and can teach the wrong rule. Use the SNB samples and original practice questions.

Turning the ranking into a plan

Combine the table with your own ratings. If you rated yourself 2 out of 5 on medication, medication goes to the top of the schedule. If you rated yourself 5 out of 5 on perioperative care, you still need one timed set to prove it. The study plan shows how to place each topic by week. The test plan explained shows where each topic sits among the SNB categories.

For a visual overview of all ten domains and their estimated weights, return to the exam hub.

Quick self-test: can you do these without notes?

1. Name the steps you take before giving an intravenous high-alert medication.
2. State the first action in suspected anaphylaxis and the escalation route.
3. Place three trauma injuries in order of priority and explain why.
4. Say which tasks you can delegate to a healthcare assistant after morning rounds.
5. Describe what changes if a patient refuses treatment and has capacity, and what changes if capacity is lost.
6. List the signs of hypokalaemia and the nursing monitoring.
7. Reflect a patient's statement back to them in a therapeutic way.

If you cannot do two or more, go back to that domain page before you do another mock set.

How to review a high-yield topic

For each of the ten topics, use the same four steps.

1. State the rule in one sentence.
2. Name the check that keeps the patient safe.
3. List the common wrong turn you have made in practice.
4. Write the question you would ask yourself when you see it in a stem.

For example, in delegation, the rule is that tasks may be delegated but accountability stays. The check is whether the patient is stable and the task routine. The wrong turn is passing on assessment. The question to ask is, "What does the RN have to do herself or himself here?"