Fundamentals and Basic Nursing Practice
What this domain tests
Fundamentals and Basic Nursing Practice covers infection prevention, safe care, vital signs, mobility, wound care, documentation, and delegation. Items often test the first action and the correct sequence of a procedure.
Core rules
- Hand hygiene is the single most effective way to prevent healthcare-associated infection; perform it before and after client contact and after glove removal.
- Sterile field: keep it above waist level, do not turn your back, and consider any contact with unsterile objects contamination. Pour sterile solution away from the field.
- Wound care: clean from least contaminated to most contaminated; use sterile technique for surgical wounds.
- Fall prevention: bed low, call light within reach, nonskid footwear, hourly rounding; do not use restraints for convenience.
- Delegation: the RN assesses, teaches, and evaluates; UAP may perform hygiene, vital signs, and ambulation for stable clients. The PN/LPN can perform focused assessment and medications per scope.
- SBAR: Situation, Background, Assessment, Recommendation, used for handoff.
Worked example
While setting up a sterile dressing tray, the nurse's sleeve touches the sterile drape. What should the nurse do? Stop, discard the contaminated drape and supplies, and set up a new sterile field. Reasoning: the sleeve is unsterile; anything it touches is contaminated. Do not work around it or apply the dressing.
Traps
- Reaching over the sterile field or turning away from it.
- Documenting a dressing change before it is completed.
- Delegating client teaching or the initial assessment to UAP.
- Performing a clean procedure when sterile technique is required.