Basic Nursing Skills: Measuring, Observing, and Reporting
What this domain actually tests
Basic nursing skills is the measurement-and-monitoring domain: vital signs, intake and output, weight, specimen collection, range of motion, positioning, transfers, catheter care, and oxygen safety. The exam seldom asks you to diagnose. It asks what a nurse aide observes, records, and reports.
Concepts to know cold
Temperature (oral, axillary, tympanic, temporal, rectal), pulse (rate, rhythm, volume), respirations, blood pressure, pulse oximetry, and pain. Know which route is safe for which resident, and that an oral temperature should wait about 15-20 minutes after a hot or cold drink or a cigarette. Intake and output are recorded in milliliters and totaled each shift. Range of motion may be active or passive; you never force a joint past resistance or to the point of pain.
Traps
- Counting respirations while the resident watches - count 30 seconds and double if regular, a full minute if irregular.
- Taking a blood pressure on an arm with an IV, a dialysis fistula, or on the side of a mastectomy or lymphedema.
- Using a cuff that is too small, which falsely raises the reading.
- Confusing pulse deficit (apical minus radial) with an irregular pulse.
- Treating an abnormal reading as something for you to fix rather than something to report.
Rule of thumb
Normal adult resting values: oral temperature 97.6-99.6 degrees F, pulse 60-100, respirations 12-20, blood pressure below 120/80, oxygen saturation 95-100 percent. Recheck anything outside those ranges and report it; you do not adjust treatment yourself.