Fundamentals of Nursing
Fundamentals of Nursing - what the exam tests
Fundamentals of Nursing (Domain 1) is the backbone paper: it asks about the nursing process, vital signs, asepsis and infection control, positioning and mobility, medication administration, and basic procedures such as bed making, hot and cold applications and specimen collection.
Core rules
- Nursing process is a five-step cycle: assessment (subjective and objective data), nursing diagnosis (the patient's response, not the disease), planning (measurable, time-bound goals), implementation, evaluation.
- Adult vital signs at rest: temperature 36.1–37.2 °C oral; pulse 60–100/min; respiration 12–20/min; blood pressure 120/80 mmHg; SpO₂ 95–100 %.
- Medical asepsis reduces organisms (hand washing, clean gloves); surgical asepsis eliminates them (sterile field, sterile gloves). Never turn your back on a sterile field; items below waist level are contaminated.
- Six rights of medication: right patient, drug, dose, route, time, documentation. The nurse who prepares the drug gives it and records it.
Worked example
A man has BP 100/60 mmHg and pulse 112/min. Calculate mean arterial pressure (MAP) and judge perfusion. MAP = DBP + ⅓(SBP − DBP) = 60 + ⅓(40) = 60 + 13.3 = 73 mmHg. A MAP of 65 mmHg or more generally keeps vital organs perfused, so this is low-normal rather than shock, but the tachycardia is a compensatory warning sign: reassess in 15 minutes and report if it persists.
Traps that cost marks
- Counting the pulse for 15 seconds and multiplying by four in an irregular rhythm - count a full minute.
- Documenting a drug before it is given, or recording it as given when the patient refused.
- Treating 'clean' and 'sterile' as the same thing.
- Writing 'patient comfortable' instead of objective, measurable data.