Fundamentals of Nursing and Nursing Practice Foundations
This domain tests the nursing process, patient safety, infection control, vital-sign interpretation, documentation and foundational care skills. Questions usually ask for the first action, the priority patient, or the correct technique rather than simple recall.
Core rules and concepts
- Nursing process (ADPIE): Assessment, Diagnosis, Planning, Implementation, Evaluation. Reassess before every intervention and evaluate after it. Nursing diagnoses describe human responses, not medical disease.
- Prioritisation: Airway, breathing and circulation come before Maslow needs; unstable physiological needs outrank psychosocial needs.
- Adult vital signs: heart rate 60–100/min, respiratory rate 12–20/min, blood pressure below 120/80 mmHg, SpO2 95% or more on room air, temperature 36.1–37.8°C.
- Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host. Hand hygiene is the single most effective interruption.
- Asepsis: medical asepsis is clean technique (bedmaking, routine care); surgical asepsis is sterile technique (catheterisation, wound packing, IV insertion).
- Documentation: objective, factual and timely. Correct an error with a single line, date, time and signature - never erase or overwrite.
Worked example
A patient on postoperative day one has RR 28/min, SpO2 91% on room air, HR 112/min and BP 102/64 mmHg, and is anxious. The first action is to raise the head of the bed, apply oxygen as prescribed and reassess, because breathing is the priority under ABC. Anxiety is addressed once oxygenation is stable, and the surgeon is notified with the measured data.
Traps that cost marks
- Choosing comfort measures before airway or breathing.
- Confusing medical and surgical asepsis.
- Skipping evaluation after an intervention.
- Writing “patient seemed fine” instead of measurable findings.