FUND · Study guide
Fundamentals study guide
Fundamentals is where nursing exams begin and where many points are won or lost, because the same core principles — safety, infection control, asepsis, mobility, and accurate assessment — recur inside every other topic. Master them and the rest of the exam gets easier.
This guide organizes the bedrock: which isolation precaution a diagnosis requires, how to protect a patient from falls and pressure injury, and what a vital-sign trend means. Practice applying them in the fundamentals quiz, where the challenge is doing the basics in the right order and for the right reason.
High-yield concepts
Standard precautions apply to everyone
Standard precautions — hand hygiene, gloves, and appropriate barriers whenever contact with blood or body fluids is possible — are used for every patient regardless of diagnosis. They are the foundation on top of which transmission-based precautions are added. Hand hygiene is the single most effective action to prevent health-care–associated infection.
Transmission-based precautions by route
Contact precautions (gown and gloves) apply to organisms spread by touch, such as C. difficile and MRSA. Droplet precautions (surgical mask) apply to influenza, pertussis, and meningococcal disease. Airborne precautions (N95 or respirator plus a negative-pressure room) apply to tuberculosis, measles, and varicella. Matching the disease to the route is a frequent exam task.
Sterile vs. clean technique
Surgical asepsis (sterile technique) prevents all microorganisms and is required for procedures that enter sterile body areas, such as catheter insertion and dressing a central line. Once a sterile field is contaminated — by moisture, an item passing below waist level, or turning your back on it — it is no longer sterile. Recognizing a break in sterile technique is a classic item type.
Fall prevention is proactive
Falls are among the most common adverse events, so the priority is to identify at-risk patients and remove hazards before a fall happens: bed in low position, call light within reach, clear pathways, appropriate footwear, and scheduled toileting. Restraints are not a fall-prevention tool and carry their own risks.
Positioning has clinical logic
Position follows the goal. Elevating the head of bed eases breathing and reduces aspiration risk; side-lying with suction ready protects the airway of an unconscious or seizing patient; and specific positions support specific procedures and post-operative states. When a stem asks for positioning, choose the one that protects airway, circulation, or the surgical site.
Prevent pressure injuries by repositioning
Pressure injuries develop where soft tissue is compressed over a bony prominence for too long. The core prevention is regular repositioning, keeping skin clean and dry, managing moisture and nutrition, and inspecting the skin. The sacrum and heels are high-risk sites; early redness that does not blanch is a warning to act.
Vital signs are trends, not snapshots
A single reading matters less than the pattern. A rising heart rate with a falling blood pressure suggests deteriorating perfusion; a widening or narrowing pulse pressure has meaning; and pain, temperature, and respiratory rate shift together in many conditions. Always compare against the patient’s baseline and report significant trends.
Common NCLEX-style traps
- Add transmission-based precautions on top of standard precautions — do not treat them as replacements.
- For C. difficile, use soap and water for hand hygiene; alcohol-based gel does not kill the spores.
- Any moisture, item below waist level, or turning your back breaks a sterile field — watch for the subtle contamination in the stem.
- Restraints are not fall prevention; the safe answer is environmental and proactive, not restrictive.
- Prioritize airway and safety in positioning items — comfort is secondary to protecting the airway of an at-risk patient.
Put it into practice
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Sources
- Potter PA, et al. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
- Centers for Disease Control and Prevention. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Updated 2023.
- European Pressure Ulcer Advisory Panel, NPIAP, PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. 3rd ed. 2019.
This study guide is original content written for practice and study only — it is not medical advice and is not a substitute for clinical judgment, institutional policy, or the guidance of a licensed provider. Reference ranges and drug information vary by source and change over time; always confirm against current, authoritative references and your facility's policies. NCLEX® is a registered trademark of NCSBN, which does not endorse or sponsor this site.