NCLEX Safety and Infection Control — Questions and Answers
Question 1: A client is admitted with suspected active pulmonary tuberculosis. Which room placement and personal protective equipment is most appropriate?
- Private room with positive pressure and a surgical mask
- Private negative-pressure airflow room; the nurse wears a fit-tested N95 respirator (Correct answer)
- Semi-private room with a client who has no respiratory illness; the nurse wears a surgical mask
- Private room with standard door open; the nurse wears gown and gloves
Correct answer: Private negative-pressure airflow room; the nurse wears a fit-tested N95 respirator
Tuberculosis spreads by airborne transmission. The client needs a negative-pressure airborne infection isolation room, and staff need a fit-tested N95 or higher respirator. Surgical masks do not filter airborne droplet nuclei, and positive pressure would push contaminated air out of the room.
Question 2: Which client should the nurse place on contact precautions?
- A client with influenza
- A client with Clostridioides difficile infection (Correct answer)
- A client with bacterial meningitis caused by Neisseria meningitidis
- A client with measles
Correct answer: A client with Clostridioides difficile infection
C. difficile spreads by direct and indirect contact and its spores survive alcohol-based sanitizers. The client needs contact precautions (gown and gloves) and soap-and-water hand hygiene. Influenza and meningococcal meningitis need droplet precautions, and measles needs airborne precautions.
Question 3: In which order should the nurse remove personal protective equipment after caring for a client on contact and droplet precautions?
- Mask, gown, gloves, goggles
- Gloves, goggles, gown, mask (Correct answer)
- Gown, gloves, mask, goggles
- Goggles, mask, gloves, gown
Correct answer: Gloves, goggles, gown, mask
Remove the most contaminated items first. The usual sequence is gloves, goggles or face shield, gown, then mask or respirator, followed by hand hygiene. Removing the mask before the gown and gloves risks contaminating the face and hands.
Question 4: A fire starts in a client's room. After the nurse rescues the client and activates the alarm, which action should the nurse take next, following RACE?
- Extinguish the fire (Correct answer)
- Confine the fire by closing doors and windows
- Evacuate the remaining clients on the unit
- Call the operator to report the fire location
Correct answer: Extinguish the fire
RACE stands for Rescue, Alarm, Contain (confine), and Extinguish/Evacuate. After rescue and alarm, the nurse confines the fire by closing doors and windows to limit its spread and the oxygen supply, and then extinguishes it if it is small and safe to do so. In this item, confinement is the next step.
Question 5: A nurse is caring for a client in seclusion who is calm and cooperative. Which statement reflects correct practice regarding restraints?
- Restraints can be applied by nursing judgment and a prescriber order is needed only within 24 hours
- Restraints are used only when less restrictive measures have failed, and they require a prescriber order with frequent monitoring (Correct answer)
- Restraints can be left on indefinitely if the client is sleeping
- Restraints are acceptable as a substitute for staffing shortages
Correct answer: Restraints are used only when less restrictive measures have failed, and they require a prescriber order with frequent monitoring
Restraints are a last resort. They require an order, a documented reason, frequent monitoring and assessment of circulation, skin, and needs, and prompt removal once the reason no longer applies. In an emergency the nurse may apply them and obtain the order immediately afterward. Restraints cannot be used for staff convenience.
Question 6: A nurse is teaching a client who will be discharged with home oxygen. Which statement shows the client understands oxygen safety?
- I will keep the oxygen tank near the gas stove so it stays warm
- I will place a no smoking sign on the door and keep the tank at least 5 to 10 feet from open flames (Correct answer)
- I will use petroleum-based lip balm to prevent dry lips
- I will store the tank lying flat under my bed
Correct answer: I will place a no smoking sign on the door and keep the tank at least 5 to 10 feet from open flames
Oxygen supports combustion, so open flames, smoking, and heat sources must be kept away, and no-smoking signs should be posted. Petroleum-based products are flammable in oxygen-enriched settings, so water-based lubricants should be used. Tanks should be secured upright.
