Nursing Fundamentals and Clinical Practice
Core concepts
Fundamentals questions test whether you can apply the nursing process (assessment, diagnosis, planning, implementation, evaluation) and prioritize using frameworks like Maslow's hierarchy and the ABCs (airway, breathing, circulation). Know infection control (standard precautions apply to all clients; transmission-based precautions add gloves/gown for contact, droplet precautions for large-particle respiratory droplets, airborne precautions with N95 and negative-pressure rooms for TB, measles, varicella). Understand vital sign norms, safe medication administration (rights of medication, three checks), documentation (objective, timely, never charted in advance), and mobility/safety (fall precautions, restraints as last resort with frequent assessment).
Traps
Questions often ask what to do first or next. The safest first action is usually to assess the client before intervening, unless the client is in immediate danger (then rescue). Do not confuse independent nursing actions with those requiring an order. Watch wording like "priority" versus "initial."
Rule of thumb
When a client's condition is deteriorating, assess and intervene for physiologic stability first, then notify the provider. If the client is stable and the question asks what to do first on a new finding, assess.
Worked example
A client on airborne precautions for suspected TB: which action is priority? Answer: place the client in a negative-pressure room and wear an N95 - airborne precautions come before routine care tasks.