Fundamentals of Nursing Practice — High-Yield Review

Highest-Yield Facts by Unit

Unit 1 — Foundations

• High yield: Nursing roles = caregiver, advocate, educator, communicator, manager, collaborator.
• High yield: Scope of practice is defined by each state's Nurse Practice Act.
• QSEN competencies: patient-centered care, teamwork, EBP, quality improvement, safety, informatics.
• Primary (prevent onset) vs secondary (early detection) vs tertiary (reduce complications) prevention.

Unit 2 — Nursing Process

• High yield: ADPIE = Assessment, Diagnosis, Planning, Implementation, Evaluation.
• High yield: Prioritize by ABCs (airway, breathing, circulation), then Maslow, then safety.
• Subjective data = what the client says; objective data = what the nurse observes/measures.
• Nursing diagnosis (PES: Problem, Etiology, Signs/symptoms) ≠ medical diagnosis.
• SMART goals: Specific, Measurable, Attainable, Realistic, Time-bound.
• Interventions are independent, dependent (require orders), or collaborative.

Unit 3 — Communication & Documentation

• High yield: SBAR = Situation, Background, Assessment, Recommendation.
• Therapeutic communication uses open-ended questions, restating, reflecting, silence — avoid "why" questions, false reassurance, and giving advice.
• Documentation must be factual, timely, accurate, complete; incident reports are separate from the health record.

Unit 4 — Assessment & Vital Signs

• High yield: Normal adult VS: temp ~36–38°C, pulse 60–100, respirations 12–20, BP ~120/80.
• PQRST (Provokes, Quality, Region/Radiation, Severity, Timing) and COLDSPA for pain.
• Orthostatic BP = drop on position change; SpO2 target per institutional policy.

Unit 5 — Infection & Safety

• High yield: Standard precautions for ALL clients; contact (MRSA, C. diff), droplet (flu), airborne (TB, measles) are transmission-based add-ons.
• High yield: RACE (Rescue, Alarm, Contain, Extinguish) and PASS (Pull, Aim, Squeeze, Sweep).
• Restraints: least restrictive first, require orders, monitoring, and documentation.

Unit 6 — Hygiene & Mobility

• High yield: Complications of immobility affect every system (DVT, atelectasis, pressure injuries, constipation, muscle atrophy).
• Body mechanics: wide base of support, low center of gravity, lift with legs.

Unit 7 — Skin & Wound

• High yield: Wound-healing phases: hemostasis → inflammatory → proliferative → maturation.
• High yield: Pressure-injury staging 1–4 + unstageable + deep-tissue; prevent via repositioning, support surfaces, nutrition, moisture management.
• REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation); drainage serous/sanguineous/ serosanguineous/purulent.

Unit 8 — Nutrition & Fluid

• High yield: Aspiration precautions for dysphagia (positioning, texture modification).
• Therapeutic diets: clear liquid → full liquid → pureed → mechanical soft → regular.
• I&O: intake (oral/enteral/parenteral) minus output (urine, emesis, drainage, stool, insensible).

Unit 9 — Elimination

• High yield: CAUTI prevention = catheter only when necessary, closed drainage, timely removal.
• Incontinence types: stress, urge, overflow, functional.

Unit 10 — Oxygenation

• High yield: Hypoxemia = low blood O2; hypoxia = low tissue O2. Ventilation ≠ oxygenation ≠ perfusion.
• Oxygen is a medication requiring an order; no open flames.

Unit 11 — Medication

• High yield: Rights of medication administration (client, medication, dose, route, time, documentation, reason, response, refuse) + three checks.
• Pharmacokinetics = ADME (absorption, distribution, metabolism, excretion).
• Insulin mixing: "clear before cloudy."

Unit 12 — Comfort, Sleep, Sensory

• High yield: Pain is always subjective — self-report is the gold standard.
• Multimodal: nonpharmacologic (relaxation, imagery, distraction) + pharmacologic.

Unit 13 — Perioperative

• High yield: Universal Protocol "time-out" = correct client, procedure, site.
• Postop complications: atelectasis, pneumonia, DVT/PE, ileus, retention, infection, hemorrhage.

Unit 14 — End-of-Life

• High yield: Palliative care (any stage, alongside treatment) ≠ hospice (comfort-focused, terminal).
• Kübler-Ross stages are descriptive, not a required linear sequence.

Comparison Tables

Cumulative Self-Check (20 questions)

1. List the five steps of the nursing process.
2. What does each letter of SBAR stand for?
3. Which vital sign is the highest priority per the ABCs, and why?
4. Name the four phases of wound healing in order.
5. Differentiate subjective from objective data with one example each.
6. What are the three types of nursing interventions?
7. Name three examples of transmission-based precautions and one condition for each.
8. What does RACE stand for in fire safety?
9. List the rights of medication administration (at least six).
10. Differentiate hypoxemia from hypoxia.
11. What does the "time-out" in the Universal Protocol verify?
12. Differentiate palliative care from hospice care.
13. Name the four types of urinary incontinence.
14. What are the six links of the chain of infection?
15. What does PES stand for in a nursing diagnosis?
16. Define SMART goals.
17. Name three complications of immobility by body system.
18. Differentiate medical asepsis from surgical asepsis.
19. What is the gold standard for pain assessment, and why?
20. Name three signs of approaching death.

Answers and Rationales

1. Assessment, Diagnosis, Planning, Implementation, Evaluation — ADPIE, the organizing framework.
2. Situation, Background, Assessment, Recommendation — structured handoff/report.
3. Airway — without a patent airway, oxygenation and circulation cannot be maintained.
4. Hemostasis, inflammatory, proliferative, maturation — the standard sequence.
5. Subjective = client-reported (e.g., "I feel nauseated"); objective = observed/measured (e.g., temperature 38.2°C).
6. Independent, dependent, collaborative — nurse-initiated, order-required, interprofessional.
7. Contact (MRSA/C. diff), droplet (influenza), airborne (TB/measles) — added to standard.
8. Rescue, Alarm, Contain, Extinguish — fire-response sequence.
9. Client, medication, dose, route, time, documentation, reason, response, refuse.
10. Hypoxemia = low O2 in blood; hypoxia = low O2 at the tissue level.
11. Correct client, correct procedure, correct site — immediately before incision.
12. Palliative = comfort/symptom management at any stage alongside treatment; hospice = comfort-focused care for terminal illness.
13. Stress, urge, overflow, functional.
14. Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.
15. Problem, Etiology, Signs/symptoms — the nursing-diagnosis statement structure.
16. Specific, Measurable, Attainable, Realistic, Time-bound.
17. Cardiovascular (DVT), respiratory (atelectasis/pneumonia), musculoskeletal (atrophy), integumentary (pressure injury), GI (constipation) — any three.
18. Medical asepsis reduces organisms (clean); surgical asepsis eliminates all organisms (sterile).
19. Client self-report — pain is subjective; the client is the authority on their own pain.
20. Cheyne-Stokes respirations, noisy respiratory secretions, mottling, decreased consciousness — any three.

Last-Minute Review

• Prioritization: ABCs first, then Maslow (physiologic → safety), then urgent vs nonurgent.
• Communication: therapeutic (open-ended, reflection, silence) over nontherapeutic ("why", advice, false reassurance); SBAR for handoffs; read-back for verbal orders.
• Documentation: factual, timely, accurate, complete; incident reports separate; late entries and corrections follow policy.
• Infection prevention: standard precautions always; transmission-based as indicated; hand hygiene is the single most important intervention.
• Medication safety: rights + three checks; independent double-check for high-alert drugs; no real-world dosing or administration from study notes.
• Perioperative: time-out (client/procedure/site); monitor ABCs postop; prevent atelectasis, DVT, infection.
• End-of-life: comfort-focused; palliative ≠ hospice; grief is individual and nonlinear.

Related

• Subject overview
• Topic 06 — Planning, Prioritization, Goals, and Nursing Interventions
• Topic 09 — Interprofessional Communication, Handoffs, and Documentation
• Topic 30 — Medication Safety, Orders, Rights, and Dosage Calculations