Patient Care Skills
Core concepts
Master vital signs and their normal ranges: temperature, pulse (rate, rhythm, volume), respirations, blood pressure, and pulse oximetry. Know proper technique for measuring blood pressure (cuff size, patient seated, arm supported at heart level), counting respirations without telling the patient, and documenting accurately. Understand positioning (supine, prone, Fowler's, Sims', lithotomy, Trendelenburg), transfer techniques, and body mechanics. Know the sequence for a general physical exam, how to prepare a patient, and how to assist with procedures. Understand intake/output, specimen collection, and wound care basics. Communication skills - therapeutic communication, active listening, open-ended questions - are frequently tested.
Traps in questions
- Respirations: count for a full 30 or 60 seconds without announcing it; patients alter breathing when they know it is being counted.
- Blood pressure errors: a cuff that is too small falsely elevates the reading; an arm below heart level also raises it.
- Positioning: Fowler's is semi-sitting (head elevated); Trendelenburg is head-down; Sims' is a side-lying position used for enemas.
- Thermometer routes: oral, rectal, axillary, tympanic, and temporal have different accuracy and contraindications (e.g., avoid oral in an uncooperative or mouth-breathing patient).
- Therapeutic communication: avoid 'why' questions and false reassurance; use open-ended prompts and reflection.
Rule of thumb
For any vital sign, follow the sequence: prepare equipment, position the patient correctly, measure, and document. If a reading is abnormal, recheck before reporting - but never delay reporting a critical value.
Worked example
Stem: 'A patient's blood pressure reads 158/94 with a cuff that is too small. What is the likely effect?' An undersized cuff compresses the arm excessively, producing a falsely high reading. Recheck with the correct cuff size before documenting or reporting.