NCLEX Safety and Infection Control Practice Test

Question 1

The nurse at a family practice is responsible for reviewing home safety issues with all patients. She knows that there is an increased risk of falls in which of these two groups of patients?

Accepted Answer

infants and the elderly. Infants and the elderly both have increased risk of falls. Nurses should educate the parents and/or caregivers of infants about safe places for sleep and play to prevent a fall. In the elderly, nurses must consider age-related factors, both physical and cognitive that can increase the risk of falling.

Note: Even though toddlers (ages 1–4) are more mobile than infants (ages 0–1), statistics show that infants are more susceptible to falling. This may be due to being left in unsafe places (on changing tables, beds, grocery carts, etc.) and the lack of knowledge of and experience with space and their bodies.

Question 2

A nurse is counseling an 87-year-old female patient and her daughter. The patient is obese, has multiple medical problems, including dementia, and takes numerous medications. The patient is preparing to move in with her daughter for full-time care. Which of the following is least important for the nurse to discuss with the patient and her daughter.

Accepted Answer

fire safety and prevention. While fire safety and prevention is certainly a worthwhile topic to discuss, given this patient’s particular set of problems of obesity, polypharmacy, dementia, and advanced age, the other choices should take priority during the review of safety and accident prevention.

Question 3

A nurse on the medical/surgical floor is caring for an elderly, postoperative patient with dementia who is in restraints because she refuses to stay in bed or keep her IVs in. The nurse knows that she will have to provide range of motion exercises and ask if the patient needs to use the restroom how often?

Accepted Answer

every 2 hours. For this patient, the use of restraints is necessary to prevent injury during a fall and to help the patient recuperate from surgery. In addition to frequent monitoring to ensure correct placement of the restraints and the need for continued use, the nurse needs to provide bathroom opportunities and range of motion exercises every 2 hours.

Question 4

A nurse in the emergency room is taking care of a 4-year-old patient who has a suspected case of impetigo. The nurse knows that which of the following precautions is most important to prevent the spread of this infection?

Accepted Answer

contact precautions. Impetigo is an infectious skin condition that is spread via skin to hand contact or indirect contact of the skin and other surfaces. Contact precautions are, therefore, necessary to limit the spread of this skin infection.

Question 5

A nurse is working with a patient who has a contagious condition. In recalling the chain of infection, the nurse knows that an environment favorable for the growth and reproduction of an infectious agent is referred to as ____.

Accepted Answer

a reservoir. The chain of infection has six elements:

a pathogen which is an infectious agent
a reservoir which is any environment that is favorable for the growth and reproduction of an infectious agent
a portal of exit which is a place where an infectious agent gets out of a host
a method of transmission which is the way an infectious organism is transferred from a reservoir to a host
a portal of entry which is the place where an infectious agent enters a host
a susceptible host which is a person who is at risk for infection
A vector is an object which can spread an infection via indirect contact. It is one of the three possible methods of transmission.

Question 6

A nurse is volunteering in an indigent clinic. She is seeing a patient whom she suspects has active tuberculosis. In this disease process, which of the following body systems serves as both the reservoir and portal of entry for this infection?

Accepted Answer

the respiratory system. Tuberculosis (TB) is a bacterial infection that mainly infects the respiratory system caused by the organism Mycobacterium tuberculosis. It is spread via inhalation of droplets that contain the bacteria that are released during coughing, sneezing, etc. There are two forms of TB: latent and active. Patients are contagious only during an active TB infection, and they usually feel sick during this time. Those with latent infection are not infectious and do not feel ill. The respiratory system is where this organism best grows and reproduces (a reservoir) and how one becomes infected with the organism via inhalation (portal of entry).

Question 7

A nurse is preparing a bag of chemotherapy agent for one of the patients. The nurse accidentally pierces a hole through the bag while attempting to spike it. A moderate amount of chemotherapy spills onto the ground. Which of the following actions should the nurse perform first?

Accepted Answer

Cordon off the area and notify housekeeping/facilities of the spill. Chemotherapy is extremely caustic to any persons and environment it contacts. When chemotherapy spills occur, the nurse must immediately secure the area and notify the facility’s designated personnel to have the area appropriately cleaned. The chemotherapy should never be cleaned with inappropriate tools such as paper towels or linens. Since the bag has been compromised, the nurse should no longer prime the tubing or administer the chemotherapy to the patient. The nurse will need to notify the pharmacy to have the chemotherapy redosed, but this is not the priority action.

Question 8

The nurse is admitting a 70-year-old patient for a procedure. The patient has type I diabetes mellitus with significant peripheral neuropathy, atrial fibrillation controlled with antiarrhythmic medications, and osteoarthritis bilaterally in his knees. He is also on anticoagulants with an INR of 3.0. Given that the nurse knows about the individual risk factors that raise the risk of a fall, accident, or injury while hospitalized, which of the following should be identified as the most significant risk factor for this patient?

Accepted Answer

peripheral neuropathy. Sensory deficits such as sight, hearing, proprioception, and neuropathy can all raise the risk of a fall, accident, or injury in a hospitalized patient. These factors should be noted at the time of admission and factored into the care plan to protect the patient during his or her time under medical care. Osteoarthritis may limit the patient’s mobility. This should be discussed upon admission. Atrial fibrillation that is not controlled can increase the risk of stroke, but this patient is controlled with antiarrhythmic medications. Anticoagulant therapy doesn’t raise the risk of a fall, accident, or injury, but it is an important part of the medical history, given that the patient is being admitted for a procedure.

Question 9

A patient with a suspected renal tumor is being admitted for an intravenous pyelogram (IVP). The nurse discusses the procedure with the patient in addition to taking a full medical history. Which of these pieces of information reported in the patient’s history should the nurse report to the physician performing the IVP?

Accepted Answer

iodine allergy. The nurse is responsible for identifying factors in the patient’s medical history that may be contraindicated for the procedure or treatment that is ordered for the patient. Since an IVP involves the use of iodinated contrast dye, the patient’s iodine allergy must be reported to the physician to prevent an allergic reaction. The rest of the patient’s medical history is acceptable and reveals no contraindications to the procedure.

Question 10

A nurse working an overnight hospital shift is administering medications to her patients. Which of these is the most important thing to do prior to giving medications to her patients?

Accepted Answer

Identify the patient by name and date of birth on the patient’s wristband and match it to the medication order. Medication errors are one of the primary areas of medical mistakes. Always identify the patient, preferably using two identifiers, to ensure the right medication is being administered to the right patient. Room and bed numbers are not reliable identifiers and should not be used to identify patients. Always follow the protocols and procedures of your facility for administering medications.

Question 11

A nurse is working in a nursing home when there is a fire in the kitchen and cafeteria area. Which of the following is the first priority for the nurse in this situation?

Accepted Answer

Ensure that all patients are moved out of harm’s way. Each facility will have its own emergency response plan in which the nurse will have a specific role. A nurse’s first priority in the event of a fire is to ensure that all patients are removed from immediate harm. A nurse may then be asked to help extinguish or contain the fire, and then evacuate the building if necessary by triaging the patients and identifying those that must be evacuated by bed or stretcher.

Question 12

A nurse is checking on her patients and notes that one of them has slid down in the bed. The patient states that he is uncomfortable, but that he is unable to reposition himself on his own. The nurse knows that in order to help him and avoid injury to herself, she needs to ____.

Accepted Answer

ask the patient to wait a moment while she finds another nurse to assist her in repositioning him. The nurse must have assistance from another person in order to correctly reposition the patient and avoid injury to herself. While this takes more time and means the patient will have to wait to be moved, it is the best and safest option for both the nurse and patient.

Question 13

Select the appropriate personal protective equipment (PPE) that will be applied prior to entering the room of a patient with influenza.
A. gloves
B. mask
C. gown
D. goggles
E. respirator

Accepted Answer

A, B, and C. Influenza is a virus that requires droplet precautions. The PPE used in droplet precautions includes donning gloves, mask, and gown. Respirators are used with airborne precautions such as tuberculosis and varicella. Goggles are used in the event of concern for splashes of bodily fluids or chemicals and not necessary for droplet precautions.

Question 14

A nurse who works in an outpatient surgical center develops a new respiratory illness. She has atypical symptoms and is not responding to conventional therapies. Her work history includes spending considerable amounts of time in her facility’s central supply and equipment sterilization areas. Her treating physician suspects her illness is linked to a workplace exposure. Where is the best place for the nurse to obtain information regarding her potential workplace exposures?

Accepted Answer

the Safety Data Sheets/SDS (formerly referred to as Material Safety Data Sheets/MSDS) at her facility. Nurses may be exposed to various potentially hazardous materials and chemicals in the workplace. A list of all of the chemical agents found in a particular employment setting can be obtained via a nurse’s Safety Data Sheets/SDS (formerly referred to as Material Safety Data Sheets/MSDS) which, by law, must be kept at the facility. The governing body that mandates the use of SDS is the Occupational Safety and Health Administration (OSHA). OSHA also has guidelines on the safe handling of potentially biohazardous materials that include recommendations from the Centers for Disease Control and Prevention (CDC). Workplace-related illness is not reportable to the CDC. While information about occupational exposures may be derived from an equipment manufacturer, this information should be readily available to an employee via the SDS.

Question 15

Which of these is the correct order of events a nurse should follow when applying personal protective equipment (PPE)?

Accepted Answer

handwashing, gown, mask, eye protection, and gloves. When applying PPE, the nurse should always follow the order of: handwashing, gown, mask, eye protection, and gloves. This should preferably take place outside of the patient’s room.

Question 16

A nurse has just completed a blood draw for a patient with unknown HIV status. Which of the following is the correct way to dispose of the needle?

Accepted Answer

Place the needle in the nearest puncture-resistant container. Regardless of a patient’s blood-borne pathogen status, the same procedure should be followed when disposing of used needles. Always place them in the nearest puncture-resistant container. Never recap a needle, never place a needle into a biohazard container where it may injure or puncture someone else, and never break a needle prior to disposing of it.

Question 17

A nurse inadvertently administers the wrong dose of antibiotic to a patient recovering from surgery. Which of these is the correct course of action for the nurse when documenting this in the patient’s medical record?

Accepted Answer

The nurse should create an incident report and record the facts of the incident in the medical record, but does not have to include an actual copy of the incident report or reference its existence. A nurse who administers the wrong dosage of an ordered drug must create an incident report. Each employment facility will have specific guidelines to follow in doing so. Generally, the facts of the incident should be recorded in the patient’s medical record, but an actual copy of the incident report does not have to go into the record and reference as to its existence does not have to be in the record either.

Question 18

A nurse is caring for a patient receiving intravenous drug therapy via an infusion pump. The pump continues to sound an alarm and the nurse is unsure if it is administering the drug correctly. Which of these is the correct course of action for the nurse to follow?

Accepted Answer

Discontinue the infusion, replace the pump with a functioning one and restart the infusion, and then label the broken pump and place it in a designated area for broken equipment. The nurse is responsible for the safe use of all equipment involved in patient care. In this instance, if the nurse is unsure if the pump is malfunctioning, then it should be replaced, labeled as broken, and removed from the work area to prevent another infusion area with a different patient. Never assume an alarm is in error and do not try to fix malfunctioning equipment if properly functioning ones are available for use. The facility may have specific requirements as to who is to be notified of broken equipment and these should be followed.

Question 19

There has been a mass casualty shooting at a nearby school. A nurse is working in the emergency department and is asked to triage clients as they arrive at the hospital. One of the clients arriving at the emergency department is in a wheelchair speaking to a nurse frantically while clutching his leg around a bloodied bandage and his foot is oddly angled. Based on this information, which of the following tag colors would the triage nurse assign this client?

Accepted Answer

yellow. The client in the question has an injury that would need to be addressed but does not appear to be life-threatening based on the information provided. Clients with life-threatening injuries would be assigned a red tag. Those that are ambulatory with minor injuries would be assigned a green tag. Black tags are reserved for those who are deceased or with injuries that are not compatible with survival.

Question 20

A nurse is setting up and assisting in a sterile surgical procedure. According to the principles of surgical asepsis, the nurse understands that which of these statements is correct?

Accepted Answer

The tray is considered to be unsterile if a blood-soaked gauze from the patient is placed back onto the tray. There are eight principles of surgical asepsis or sterile technique:

Every object used in a sterile field must be sterile.
If a sterile object touches an unsterile object, it is no longer sterile.
A sterile object that is out of view, or below waist level, is considered unsterile.
A sterile object can become unsterile via exposure to airborne microorganisms.
Fluids flow in the direction of gravity.
Capillary action can contaminate a sterile field via moisture passing through a sterile object and drawing microorganisms from unsterile surfaces both above and below.
The edges of a sterile field are unsterile.
The skin cannot be sterilized.
Based on these principles, a blood-soaked gauze that is placed onto a sterile tray will contaminate the tray.

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NCLEX Safety and Infection Control Practice Test

Test Details

What You Practice in Safety and Infection Control

Michele J. McCarthy

Molly W.

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Common Safety and Infection Control Questions with Their Answers

What topics usually fall under Safety and Infection Control on NCLEX?

How do I decide between contact, droplet, and airborne precautions fast?

What is the most common mistake when answering PPE questions?

When should I choose hand hygiene over changing gloves?

How do I approach sterile technique questions without memorizing a hundred rules?

What should I pick when two options both sound safe?

Do these questions include fall prevention and mobility safety?

How do I handle questions about sharps and needle safety?

Are restraint and sitter questions part of this category?

How should I use this practice set for the fastest improvement?

Can I restart the set easily for a second attempt?

Do I have to enter an email to view the results?