Nursing Fundamentals and Principles of Nursing
RRB Staff Nurse questions in Nursing Fundamentals test the nursing process, baseline assessment, vital signs, asepsis, medication safety and documentation. The paper favours situational stems: what to do first, what to delegate, which finding is abnormal.
The nursing process
Assessment collects subjective and objective data; diagnosis is a NANDA-I nursing diagnosis, not a medical one; planning sets measurable goals; implementation carries out orders and independent nursing actions; evaluation compares outcomes with goals. It is cyclic, not linear.
Baseline adult values
Oral temperature 36.5–37.5 °C; radial pulse 60–100/min; respirations 12–20/min; BP under 120/80 mmHg; SpO2 95% or above on room air. Hypertension is confirmed at 140/90 mmHg or higher on repeated readings.
Asepsis and medication safety
Medical asepsis covers hand hygiene, gloves and clean technique; surgical asepsis covers sterile gloves, sterile field and sterile solutions. The six rights are patient, drug, dose, route, time and documentation; many services add reason and response. Hand hygiene is the single most effective infection-control measure.
Worked example
Order: 1000 mL 0.9% saline over 8 hours, drop factor 15 gtt/mL. mL/hour = 1000 ÷ 8 = 125 mL/h. gtt/min = (125 × 15) ÷ 60 = 31.25, so 31 gtt/min. Check: 31 × 60 ÷ 15 = 124 mL/h, within rounding.
Traps
A cuff that is too small reads falsely high. In irregular rhythms count the pulse for a full minute. Do not substitute medical asepsis for surgical asepsis in wound care. In first-action items, assess and ensure safety before calling or documenting.