Nursing Foundations and Fundamentals of Nursing
This domain tests the bedrock of safe practice: the nursing process, vital-sign interpretation, asepsis and infection control, medication safety, positioning and documentation. ESIC-style items often ask for the first or safest nursing action rather than a diagnosis.
Core rules
- The nursing process is ADPIE: Assessment, Diagnosis (NANDA-I), Planning, Implementation, Evaluation. Assessment precedes every intervention.
- Adult resting norms: heart rate 60–100/min, respiratory rate 12–20/min, blood pressure about 120/80 mmHg, oral temperature 36.5–37.5 °C.
- Medical asepsis reduces pathogen transfer (hand hygiene, clean gloves); surgical asepsis keeps objects sterile (sterile field, sterile gloves).
- The medication rights include right patient, drug, dose, route, time, reason and documentation; many services add right to refuse and right response.
Worked example
A 60-year-old has temperature 39.2 °C, pulse 112/min, BP 100/60 mmHg and confusion. The first action is not simply to give paracetamol. The combination suggests possible sepsis: assess airway, breathing and circulation, obtain cultures if ordered before antibiotics, start prescribed IV fluids, give antipyretic and monitor. Reasoning: ABC and source control take priority over fever control.
Traps
Confusing medical with surgical asepsis; documenting before assessing; omitting the reason or response from medication checks; treating a single abnormal vital sign without trend or context.