Fundamentals of Nursing and Basic Nursing Skills
The Fundamentals of Nursing and Basic Nursing Skills domain tests whether you can apply the nursing process, perform core psychomotor skills safely and document to Egyptian Ministry of Health and Population (MOHP) standards. Items are scenario-based: you receive a patient cue and must choose the next action, the priority, or the correct technique. Memorised lists are not enough; you must show clinical judgement.
The nursing process in exam form
Assessment → Diagnosis (NANDA-I) → Planning (SMART outcomes) → Implementation → Evaluation. In questions, the first action is almost always assessment unless the patient is deteriorating - then airway, breathing and circulation come first. Reassess after every intervention; evaluation closes the loop.
Vital signs and normal ranges (adult)
- Temperature 36.5–37.5 °C oral; axillary about 0.5 °C lower, rectal 0.5 °C higher.
- Pulse 60–100/min and regular; count 30 s ×2 if regular, a full 60 s if irregular.
- Respirations 12–20/min; count unobtrusively for 30 s ×2.
- Blood pressure under 120/80 optimal; hypotension under 90/60; hypertension from 140/90 in clinic.
- SpO2 95–100% on room air.
- Pain on a 0–10 scale; reassess 30–60 minutes after analgesia.
Asepsis and core skills
Hand hygiene is the single most effective infection-prevention action; apply the WHO 5 Moments. Use sterile technique for urinary catheterisation, dressing of exposed tissue and IV insertion; clean technique for chronic granulating wounds. Confirm two patient identifiers before any procedure and follow the rights of medication administration.
Worked example
A 68-year-old postoperative patient has BP 88/54 mmHg, pulse 118/min, urine output 15 mL/h for three hours and is drowsy. What is your first action? Reasoning: the cues cluster into hypovolaemic shock - tachycardia, hypotension, oliguria and altered mentation. First action is to assess airway, breathing and circulation, call for help, lay the patient flat with legs elevated, give oxygen per protocol and prepare an IV fluid bolus as prescribed. Documentation and family notification follow stabilisation. The distractor 'recheck BP in 30 minutes' is wrong because the patient is symptomatic.
Traps that cost marks
- Choosing 'document' or 'notify' before acting on deterioration.
- Confusing sterile with clean technique.
- Reporting one abnormal vital sign without trending it.
- Counting respirations while telling the patient you are doing so.