Fundamentals of Nursing and Basic Nursing Skills
Core concepts
The fundamentals domain tests whether you can think in a disciplined sequence: assess before you act, prioritize by threat to life, and protect safety (infection control, falls, pressure injury, medication rights) while meeting basic needs. Know the nursing process (ADPIE), Maslow-based prioritization, standard precautions and transmission-based precautions, the chain of infection, vital sign norms and the earliest signs of deterioration, asepsis (medical vs surgical), wound care and staging basics, positioning and mobility, intake/output and fluid balance, and documentation principles.
Traps candidates fall for
- Choosing an intervention when the stem asks for the first action; assessment usually comes first unless the patient is unstable.
- Confusing medical asepsis (clean technique) with surgical asepsis (sterile technique).
- Forgetting that hand hygiene is the single most effective infection-control measure and that gloves never replace it.
- Mixing up isolation types: airborne (measles, varicella, TB) needs a negative-pressure room and N95; droplet (influenza, pertussis, meningococcal) needs a mask and private room; contact (MRSA, C. difficile, scabies) needs gown and gloves, with soap-and-water handwashing for C. difficile.
- Answering the disease instead of the patient: a stable patient with a high fever may rank below an unstable patient with a subtle change.
Rule of thumb
When two answers both seem right, ask: Does this option gather information or act on it, and does it address the greatest immediate threat? Assessment and safety outrank comfort and teaching in an unstable patient.
Worked example
A postoperative patient has a new onset of confusion and a respiratory rate of 28. Options: reorient the patient, document, take full vital signs and assess oxygenation, or notify the family. New confusion plus tachypnea suggests hypoxia or another physiologic cause; the nurse should first complete a focused assessment (vitals, oxygen saturation, lung sounds) and then escalate. Reorientation and documentation are correct later, but not first.