Fundamentals of Nursing and Basic Nursing Skills
What this domain tests
Fundamentals of Nursing and Basic Nursing Skills tests whether you can apply the nursing process, perform safe core skills, and recognize when a stable patient is deteriorating. Questions often present a scenario with four plausible actions and ask for the first or priority action.
Core rules
- The nursing process is cyclic: Assessment, Diagnosis (NANDA-I), Planning, Implementation, Evaluation. Reassess before and after every intervention.
- ABCs plus level of consciousness outrank comfort, education, and documentation. Oxygenation and perfusion come before temperature.
- Normal adult ranges: HR 60-100, RR 12-20, BP under 120/80, SpO2 94-100% on room air, oral temperature 36.5-37.5 C.
- Use medical asepsis for routine care and surgical asepsis for invasive procedures. Clean to dirty, sterile to sterile.
- Position to match the problem: high Fowler for dyspnea, side-lying for aspiration risk, supine with legs elevated for hypovolemia.
- Document what you did and the response, contemporaneously; never chart an intervention before performing it.
Worked example
A 72-year-old is day 2 after hip replacement. RR 28, SpO2 91% on room air, HR 112, temperature 38.2 C, BP 104/62. What is first? Reasoning: new hypoxia with tachypnea and tachycardia signals deterioration, probably atelectasis or pulmonary embolism. Airway and breathing come first. Sit the patient upright, coach deep breathing, apply oxygen per protocol, auscultate lungs, reassess vital signs, then notify the provider. Treating the fever first delays oxygenation.
Traps
- Chasing a single abnormal number instead of the trend and the work of breathing.
- Taking a blood pressure immediately after ambulation or through an IV line.
- Rectal temperatures in diarrhea, neutropenia, or recent rectal surgery.
- Calling a patient stable without documenting objective reassessment.