MINDPLUG SOLUTIONS™ | A+ VERIFIED EXAM PREP
D439 FOUNDATIONS OF NURSING – COMPLETE
STUDY GUIDE & EXAM PREP (2026 A+ GRADED)
SBAR Format
-model for effective communication identifying Situation, Background, Assessment, and
Recommendation
-there are two types of ways that communication tools are used to communicate a patients
change in condition: CUS tool (Concerned, Uncomfortable, Safety) and SBAR
-note to always maintain pt privacy and confidentiality
SBAR EXAMPLE :
Case Study: You administered 1 tablet of oxycodone HCl 5 mg/ibuprofen 400 mg PO to a
patient 30 minutes ago for postsurgical pain. You return to the patient's room to evaluate
the effectiveness of the medication 30 minutes later. The patient rates his pain as an 8 on a
scale of 0-10. You use SBAR to contact the patient's health care provider.
Situation: The patient is rating his pain as an 8 on a scale of 0-10. He had his pain
medication 30 minutes ago.
Background: The patient had a knee replacement and returned from the postanesthesia
care unit 6 hours ago. He has 1 tablet of oxycodone HCl 5 mg/ibuprofen 400 mg PO ordered
every 6 hours. This is the first pain medication he has taken since being admitted to the
unit.
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Assessment: His current medication order is not sufficiently managing the patient's pain.
He does not want to sit up or move because of the pain he is experiencing.
Recommendation: It might be helpful to change the pain medication order for the patient.
guided imagery
-mind/body intervention
-Concentrating on an image or series of images to treat pathological conditions
Maslow's Hierarchy of Needs
-where (1) physiological needs are PRIORITY then (2) safety and security, (3) love and
belonging needs. (4) self esteem needs, and FINALLY (5) self actualization needs
The nurse planning care for a client experiencing dystocia determines that the priority is
which action?
1. Position changes and providing comfort measures
2. Explanations to the client about what is happening
3. Monitoring for changes in the condition of the birthing parent and fetus
4. Encouraging the use of breathing techniques learned in childbirth preparatory classes
Answer: 3
Test-Taking Strategy: Note the strategic word, priority, and use Maslow's Hierarchy of Needs
theory to prioritize, remembering that physiological needs come first. The nurse needs to
have knowledge of the client's priority needs and generate solutions. All the options are
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correct and would be implemented during the care of a client with dystocia. Also note that
the correct option is the only one that addresses both the birthing parent and the fetus.
Remember to use Maslow's Hierarchy of Needs theory to help prioritize and generate
solutions!
EHR system and limitations
-EHR AND EMR are different from eachother
-A health care agency often relies on the nursing history model included in the electronic
health record (EHR) as the organizing framework for an assessment. However, EHR
frameworks are often medically driven. Frameworks developed from nursing theories are
more holistic and patient-centered, providing a more comprehensive patient review.
-When it comes to the EMR freezing it's best to notify IT or when the computer system shuts
down during data entry. The nurse should follow established protocols and prepare to re-
enter data as a late entry when the system is operational. Also never attempt to reboot or
fix the EMR system which may prolong the complication.
It's also not recommended to print EMR from a backup server without proper authorization
and ensuring data privacy and security.
-patient outcome data; and use clinical decision support systems. The electronic health
record (EHR) is an efficient method for documenting and managing patient health care
information (see Chapter 26.) Computerized physician/provider order entry (CPOE),
allowing health care providers to directly enter medical orders, is a critical patient safety
initiative especially in the area of medication ordering and administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are ways to keep all health
care providers and patients informed
Hand Hygeine
-hand washing does not kill microorganisms but reduces the amount of them present
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-four techniques: hand washing, antiseptic hand wash, antiseptic hand rub, surgical hand
antisepsis
-4 elements of hand washing: water, friction, soap , and time
Dosage Calculation (ml, tbsp->ml)
VITAL SIGNS
-what to do if reassessment is needed
-know the pt usual range of vital signs (baseline)
-assess respiratory
Factors affecting vital signs of older adults:
MOBILITY: How do you use crutches?
TYPES OF GAITS:
-2-point: 2 points (crutch or foot) on the ground: pt moves right crutch and left foot
together, left crutch and right foot together
-4 point gait:
-3 point gait: moving both crutches and the injured leg at the same time
-weight is on both hands
support weight at the hand grips, with elbow flexed at 30 degrees, position crutches on the
unaffected side when sitting or raising from the chair
© 2026 MindPlug Solutions™
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Success Starts with Smart Preparation
D439 FOUNDATIONS OF NURSING – COMPLETE
STUDY GUIDE & EXAM PREP (2026 A+ GRADED)
SBAR Format
-model for effective communication identifying Situation, Background, Assessment, and
Recommendation
-there are two types of ways that communication tools are used to communicate a patients
change in condition: CUS tool (Concerned, Uncomfortable, Safety) and SBAR
-note to always maintain pt privacy and confidentiality
SBAR EXAMPLE :
Case Study: You administered 1 tablet of oxycodone HCl 5 mg/ibuprofen 400 mg PO to a
patient 30 minutes ago for postsurgical pain. You return to the patient's room to evaluate
the effectiveness of the medication 30 minutes later. The patient rates his pain as an 8 on a
scale of 0-10. You use SBAR to contact the patient's health care provider.
Situation: The patient is rating his pain as an 8 on a scale of 0-10. He had his pain
medication 30 minutes ago.
Background: The patient had a knee replacement and returned from the postanesthesia
care unit 6 hours ago. He has 1 tablet of oxycodone HCl 5 mg/ibuprofen 400 mg PO ordered
every 6 hours. This is the first pain medication he has taken since being admitted to the
unit.
© 2026 MindPlug Solutions™
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Success Starts with Smart Preparation
,MINDPLUG SOLUTIONS™ | A+ VERIFIED EXAM PREP
Assessment: His current medication order is not sufficiently managing the patient's pain.
He does not want to sit up or move because of the pain he is experiencing.
Recommendation: It might be helpful to change the pain medication order for the patient.
guided imagery
-mind/body intervention
-Concentrating on an image or series of images to treat pathological conditions
Maslow's Hierarchy of Needs
-where (1) physiological needs are PRIORITY then (2) safety and security, (3) love and
belonging needs. (4) self esteem needs, and FINALLY (5) self actualization needs
The nurse planning care for a client experiencing dystocia determines that the priority is
which action?
1. Position changes and providing comfort measures
2. Explanations to the client about what is happening
3. Monitoring for changes in the condition of the birthing parent and fetus
4. Encouraging the use of breathing techniques learned in childbirth preparatory classes
Answer: 3
Test-Taking Strategy: Note the strategic word, priority, and use Maslow's Hierarchy of Needs
theory to prioritize, remembering that physiological needs come first. The nurse needs to
have knowledge of the client's priority needs and generate solutions. All the options are
© 2026 MindPlug Solutions™
If this resource helped you, explore more top-rated study guides on our profile.
Success Starts with Smart Preparation
,MINDPLUG SOLUTIONS™ | A+ VERIFIED EXAM PREP
correct and would be implemented during the care of a client with dystocia. Also note that
the correct option is the only one that addresses both the birthing parent and the fetus.
Remember to use Maslow's Hierarchy of Needs theory to help prioritize and generate
solutions!
EHR system and limitations
-EHR AND EMR are different from eachother
-A health care agency often relies on the nursing history model included in the electronic
health record (EHR) as the organizing framework for an assessment. However, EHR
frameworks are often medically driven. Frameworks developed from nursing theories are
more holistic and patient-centered, providing a more comprehensive patient review.
-When it comes to the EMR freezing it's best to notify IT or when the computer system shuts
down during data entry. The nurse should follow established protocols and prepare to re-
enter data as a late entry when the system is operational. Also never attempt to reboot or
fix the EMR system which may prolong the complication.
It's also not recommended to print EMR from a backup server without proper authorization
and ensuring data privacy and security.
-patient outcome data; and use clinical decision support systems. The electronic health
record (EHR) is an efficient method for documenting and managing patient health care
information (see Chapter 26.) Computerized physician/provider order entry (CPOE),
allowing health care providers to directly enter medical orders, is a critical patient safety
initiative especially in the area of medication ordering and administration
-Change-of-shift, hand-off reporting, and hourly bedside rounds are ways to keep all health
care providers and patients informed
Hand Hygeine
-hand washing does not kill microorganisms but reduces the amount of them present
© 2026 MindPlug Solutions™
If this resource helped you, explore more top-rated study guides on our profile.
Success Starts with Smart Preparation
, MINDPLUG SOLUTIONS™ | A+ VERIFIED EXAM PREP
-four techniques: hand washing, antiseptic hand wash, antiseptic hand rub, surgical hand
antisepsis
-4 elements of hand washing: water, friction, soap , and time
Dosage Calculation (ml, tbsp->ml)
VITAL SIGNS
-what to do if reassessment is needed
-know the pt usual range of vital signs (baseline)
-assess respiratory
Factors affecting vital signs of older adults:
MOBILITY: How do you use crutches?
TYPES OF GAITS:
-2-point: 2 points (crutch or foot) on the ground: pt moves right crutch and left foot
together, left crutch and right foot together
-4 point gait:
-3 point gait: moving both crutches and the injured leg at the same time
-weight is on both hands
support weight at the hand grips, with elbow flexed at 30 degrees, position crutches on the
unaffected side when sitting or raising from the chair
© 2026 MindPlug Solutions™
If this resource helped you, explore more top-rated study guides on our profile.
Success Starts with Smart Preparation
