Fundamentals of Nursing: Safety and Infection Control Practice Questions
Test yourself on Safety and Infection Control with 13 original NCLEX-RN practice questions. Pick an answer to see instant feedback and a full explanation.
Free original practice questions for study purposes. Open Exam Prep is an independent study resource and is not affiliated with, endorsed by, or sponsored by the makers of NCLEX-RN.
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Answer the questions below — you get instant feedback and a full explanation for each.
1. A nurse is caring for a client with active pulmonary tuberculosis. Which type of personal protective equipment is required when entering the room?
Explanation. Tuberculosis requires airborne precautions, which mandate a fit-tested N95 respirator (or higher) plus a negative-pressure (AIIR) room. A standard surgical mask does not filter the small airborne droplet nuclei that transmit TB, so it is inadequate.
2. A nurse is assigning rooms for newly admitted clients. Which client requires a private negative-pressure airborne infection isolation room?
Explanation. Measles is transmitted by the airborne route and requires a negative-pressure room and N95 respirator. C. difficile and MRSA require contact precautions; pertussis requires droplet precautions (private room or cohort with a surgical mask), not airborne isolation.
3. A nurse enters a room to care for a client on contact precautions for C. difficile. Which hand hygiene method is most appropriate before leaving the room?
Explanation. C. difficile spores are NOT killed by alcohol-based hand rubs. Mechanical removal with soap and water is required to physically wash the spores away. Gloves alone do not replace hand hygiene.
4. Which client should the charge nurse place on droplet precautions?
Explanation. Neisseria meningitidis (meningococcal) meningitis requires droplet precautions, including a private room and a surgical mask within 3 feet (or per facility policy). Disseminated zoster requires airborne plus contact; scabies requires contact; hepatitis A is spread fecal-orally with contact precautions.
5. A nurse is removing personal protective equipment after leaving a contact isolation room. Which item should be removed first?
Explanation. The correct doffing sequence removes the most contaminated items first: gloves, then goggles/face shield, then gown, then mask/respirator (removed last, outside the room). Removing gloves first prevents transferring pathogens to the face or clean items.
6. A nurse is preparing a sterile field. Which action breaks sterile technique?
Explanation. Reaching across a sterile field contaminates it because particles or microorganisms can fall onto the field. Keeping items above the waist and in view, and pouring solutions from the proper height, all maintain sterility.
7. During a fire in a client care area, the nurse should follow the RACE acronym. What is the FIRST action?
Explanation. RACE stands for Rescue, Alarm, Contain, Extinguish/Evacuate. The FIRST priority is to Rescue (remove) clients from immediate danger. Pulling the alarm comes next.
8. A confused older adult client is at high risk for falls. Which intervention is the most appropriate first step to promote safety?
Explanation. The least restrictive measures are tried first. Lowering the bed and ensuring the call light is accessible reduce fall risk without restraining the client. Restraints (including four raised side rails, which is considered a restraint) and sedation carry risks and require less-restrictive alternatives first.
9. A nurse must apply a physical restraint to a client at risk of harming themselves. Which nursing action is correct?
Explanation. Restraints must be tied to the non-movable part of the bed frame using a quick-release (slip) knot so they can be removed quickly in an emergency. They must never be attached to side rails. A provider order is required (except in an emergency, with order obtained promptly), and circulation must be maintained.
10. A nurse notes that a medication order reads 'digoxin .25 mg PO daily.' What is the safest nursing action regarding this order?
Explanation. A leading zero should be used (0.25 mg) to prevent the decimal from being misread as 25 mg, a tenfold overdose. The naked decimal '.25' is an error-prone notation, so the nurse should clarify and document the correct order before administering.
11. A client receiving a blood transfusion suddenly develops chills, fever, low back pain, and dark urine. What is the nurse's FIRST action?
Explanation. These signs indicate an acute hemolytic transfusion reaction. The FIRST action is to STOP the transfusion immediately to prevent further harm, then keep the IV line open with normal saline using new tubing, and notify the provider and blood bank.
12. A nurse is caring for several clients. Which finding requires the most immediate safety intervention?
Explanation. Oxygen supports combustion, so an open flame near oxygen tubing poses an immediate fire/explosion hazard and is the priority. The other situations are important but do not present an immediate life-threatening danger.
13. A nurse accidentally sustains a needlestick injury from a contaminated needle while caring for a client. What is the FIRST action the nurse should take?
Explanation. The FIRST step after a needlestick is to immediately wash the area with soap and water (flush mucous membranes with water). After first aid, the nurse reports the exposure, completes documentation, and undergoes evaluation for post-exposure prophylaxis.
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FAQ
How do I remember the different types of transmission-based precautions?
Group by transmission route. Airborne (TB, measles, varicella) needs an N95 and negative-pressure room. Droplet (influenza, pertussis, meningococcal meningitis) needs a surgical mask within 3 feet. Contact (MRSA, C. diff, scabies, VRE) needs gown and gloves. Memorize a few key diseases for each category, and remember C. diff requires soap-and-water handwashing because alcohol does not kill spores.
What's the best way to handle prioritization and safety questions on NCLEX?
Use a framework: protect from immediate physical harm first (fire, oxygen near flames, hemolytic reactions—'stop the transfusion'), then apply ABCs and Maslow. For safety devices like restraints, always choose the least restrictive option first. Read carefully for the word 'FIRST'—it changes which correct-sounding option is the best answer.
Do I need to memorize PPE donning and doffing order?
Yes. Donning order: gown, mask/respirator, goggles/face shield, gloves. Doffing order: gloves, goggles/face shield, gown, then mask/respirator last (removed outside the room). The logic is to remove the dirtiest item (gloves) first and protect your airway by removing the mask last—these sequences are frequently tested.