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Preparing for the NCLEX Fundamentals section requires more than just memorization. It's about understanding core principles that guide safe, effective, and patient-centered nursing care. At Nurseclex.com, we help you focus on high-yield topics so you walk into your exam with confidence. Here's a breakdown of key content areas you'll encounter.

Safety and Infection Control

Standard Precautions

Apply to ALL patients: Use gloves, wash hands before and after contact, wear mask and eye protection if there's a risk of splash.

Transmission-Based Precautions

Contact Precautions (C. diff, MRSA, VRE)

 Wear gloves and gown  Private room preferred

 Dedicated equipment when possible

Droplet Precautions (Influenza, Pertussis)

 Use surgical mask

 Stay 3+ feet away from patient

 Private room or cohort with same infection

Airborne Precautions (TB, Measles, Varicella)

 Wear N95 respirator mask

 Place patient in negative-pressure room  Limit patient transport

Fall Prevention Strategies

 Ensure call light is within reach  Place bed in lowest position

 Use non-slip socks

  Activate bed alarms for high-risk patients

 Keep pathways clear

 Adequate lighting in room and hallways

Fire Safety

Remember RACE:

  Rescue patients in immediate danger

 Alarm - activate fire alarm system  Contain the fire by closing doors  Extinguish if safe to do so

Fire Extinguisher Use - PASS:

 Pull the pin

 Aim at base of fire

 Squeeze the handle

 Sweep from side to side

Restraint Guidelines

 Should be a last resort only

 Requires physician's order

  Check circulation every 15-30 minutes

 Still meet patient's needs for hydration, toileting, and comfort  Document rationale and patient response

 Remove as soon as safely possible

Basic Care and Comfort Patient Positioning Fowler's Position (45-60°)

 Aids in breathing and eating  Reduces risk of aspiration

 Comfortable for conversation

High Fowler's Position (60-90°)

 Used for procedures like NG tube insertion  Maximum lung expansion

 Reduces cardiac workload

Supine Position

 Lying flat on back

 Used for certain procedures  Monitor for pressure points

Prone Position

 Lying on stomach

 Improves oxygenation in ARDS  Requires careful monitoring

Sims' Position

 Side-lying with top leg bent

 Used for rectal procedures or enemas  Promotes comfort during rest

Sleep Hygiene Support

 Lower noise levels during rest hours  Dim lights appropriately

 Limit caffeine intake, especially evening  Maintain comfortable room temperature

 Cluster care activities to minimize disruption  Provide comfortable bedding and pillows

Pain Management Approaches

Non-Pharmacological Methods:

 Distraction techniques (music, conversation)  Heat and cold therapy

 Massage and positioning

 Relaxation and breathing exercises  Environmental modifications

Pharmacological Methods:

  NSAIDs for inflammation and mild-moderate pain

Acetaminophen for mild pain and fever

Opioids for moderate to severe pain (as prescribed) Adjuvant medications for specific pain types

Vital Signs Assessment

Normal Adult Ranges

Key Assessment Points

 Take vital signs at regular intervals as ordered  Compare to patient's baseline when available

 Note factors that may affect readings (activity, medications, pain)  Report significant changes immediately

  Document accurately with time and any relevant observations

Documentation Excellence

The 5 C's of Documentation

1. Clear - Easy to read and understand
2. Concise - Brief but complete
3. Complete - All necessary information included
4. Correct - Accurate and factual
5. Current - Timely and up-to-date

Documentation Best Practices

 Use only approved abbreviations to prevent errors  Include both subjective and objective data

  Subjective: "Patient reports pain 7/10 in lower back"

  Objective: Vital signs, observable behaviors, measurements

 Avoid vague language - be specific and measurable  Document care as soon as possible after providing it  Never document for someone else

 Use black ink if writing by hand

  Correct errors properly - don't use white-out

Legal Considerations

 Documentation serves as legal evidence of care provided  "If it wasn't documented, it wasn't done"

 Be factual and objective, avoid personal opinions  Include patient's response to interventions

  Document refusal of care and education provided

Patient Education Strategies Effective Teaching Methods Teach-Back Method

 Ask patient to repeat information in their own words

 Example: "Can you tell me how you'll take this medication at home?"  Confirms understanding and identifies knowledge gaps

 Allows for immediate clarification

Adult Learning Principles

  Match explanations to patient's literacy level

  Avoid medical jargon - use everyday language

 Provide written materials to reinforce verbal teaching  Consider cultural and language barriers

  Assess readiness to learn (pain level, anxiety, fatigue)

Essential Teaching Topics

  Medications: Name, purpose, dosage, timing, side effects

  Treatments: How to perform, frequency, when to stop

  Warning Signs: When to call healthcare provider

  Follow-up Care: Appointments, monitoring requirements

  Lifestyle Modifications: Diet, activity, restrictions

Barriers to Learning

 Physical discomfort or pain

 High anxiety or emotional distress  Cognitive impairment or confusion  Language barriers

 Low health literacy

 Sensory impairments (hearing, vision)

Delegation Guidelines Scope of Practice by Role Registered Nurse (RN)

 Can perform: All nursing assessments, patient education, medication administration, care planning, supervision of others

  Responsibilities: Initial patient assessment, developing care plans, evaluating patient outcomes

Licensed Practical Nurse (LPN/LVN)

 Can perform: Vital signs, ambulation, basic wound care, medication administration (except IV push), data collection

  Cannot perform: Initial nursing assessments, patient teaching, care planning, IV push medications

Unlicensed Assistive Personnel (UAP)

  Can perform: Vital signs on stable patients, ambulation, activities of daily living, positioning, feeding

  Cannot perform: Medication administration, sterile procedures, assessments, patient teaching

The Five Rights of Delegation

1. Right Task - Appropriate for delegation
2. Right Person - Qualified and competent
3. Right Circumstances - Patient condition stable
4. Right Direction - Clear, specific instructions
5. Right Supervision - Appropriate monitoring and follow-up

When NOT to Delegate

 Patient is unstable or condition is changing  Task requires nursing judgment

 First time assessment or procedure  Patient or family teaching

 Medication administration (to UAP)  Sterile procedures (to UAP)

Key Nursing Considerations

Priority Setting

 Use ABC's (Airway, Breathing, Circulation) for emergencies  Address safety concerns first

 Consider Maslow's hierarchy of needs  Acute before chronic conditions

 Unstable before stable patients

Critical Thinking Questions

 What is the patient's primary concern?  What are the potential complications?

 What interventions will have the greatest impact?  How will I evaluate effectiveness?

 What does the patient need to know?

Professional Standards

 Maintain patient confidentiality (HIPAA)  Practice within scope of license

 Continue professional development

  Advocate for patient safety and rights

  Collaborate effectively with healthcare team

Remember: The NCLEX tests your ability to think critically and make safe decisions. Focus on understanding the "why" behind nursing actions, not just memorizing facts. Practice applying these principles to patient scenarios to build confidence for exam day.

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