NCLEX-PN Safety and Infection Control Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Hard

   The nurse is checking four clients in an acute care unit who are in restraints. Which finding should the nurse report to the charge nurse first?

   1. AA. A client in a vest restraint asks when it will be removed
   2. BB. A client has mild wrist redness that fades within minutes after the cuff is loosened
   3. CC. A client in a wrist restraint has cool, pale fingers and a weak radial pulse
   4. DD. A client in a mitt restraint is calm with a heart rate of 88/min
   Show answer to question 1

   Answer: C. A client in a wrist restraint has cool, pale fingers and a weak radial pulse

   Cool, pale fingers and a weak pulse suggest impaired circulation from the restraint and need immediate correction and reporting. Neurovascular compromise can cause permanent injury.

   Why the other options are wrong

   • AAsking about removal is expected and calls for reassurance and reassessment of the need, but it is not an urgent physical finding.
   • BMild redness that quickly fades is a transient pressure response, and the cuff has already been loosened.
   • DA calm client with a normal heart rate shows no sign of harm.

2. Question 2 of 25Medium

   A home health nurse is teaching a 68-year-old woman who has Clostridioides difficile infection after antibiotic therapy. Which client statement shows that teaching about infection control was understood?

   1. AA. "I will wash my hands with soap and water after I use the toilet."
   2. BB. "Alcohol hand rub is enough to clean my hands after I use the bathroom."
   3. CC. "I can clean the bathroom with a regular glass cleaner after I use it."
   4. DD. "I can stop these precautions as soon as my diarrhea starts to slow down."
   Show answer to question 2

   Answer: A. "I will wash my hands with soap and water after I use the toilet."

   C. difficile forms spores that alcohol-based hand rub does not reliably kill. Washing with soap and water physically removes spores from the hands.

   Why the other options are wrong

   • BAlcohol-based rub is not effective against C. difficile spores, so soap and water is needed.
   • CGlass cleaner does not kill spores; a bleach-based or spore-killing disinfectant is needed for bathroom surfaces.
   • DSpores can be shed after diarrhea improves, so precautions continue as directed by the provider.

3. Question 3 of 25Medium

   The mother of an 8-month-old girl tells the nurse at a well-child clinic visit that she plans to turn the infant's car seat to face forward because the infant can now sit without support. Which response by the nurse is best?

   1. AA. "Forward-facing is fine now since she can already sit up without support."
   2. BB. "Keep her rear-facing but move the seat to the front passenger seat."
   3. CC. "Keep her rear-facing in the back seat until she reaches the seat limit."
   4. DD. "Move her to a booster seat with the vehicle's lap and shoulder belt."
   Show answer to question 3

   Answer: C. "Keep her rear-facing in the back seat until she reaches the seat limit."

   Current pediatric safety guidance is to keep a child rear-facing in a harnessed seat in the back seat for as long as possible, until reaching the seat manufacturer's height or weight limit. Rear-facing best supports the head, neck and spine in a crash.

   Why the other options are wrong

   • ASitting without support is not a criterion for turning the seat forward, and doing so early raises the risk of head and spinal injury.
   • BChildren should ride in the back seat because front airbags can seriously injure a rear-facing infant.
   • DBooster seats are for older, larger children who have outgrown a harnessed seat, not for an infant.

4. Question 4 of 25Medium

   A home health nurse is evaluating a client with diabetic peripheral neuropathy who has decreased sensation in both feet. Which client statement shows understanding of how to prevent burns at home?

   1. AA. "I will check the bath water by dipping my feet in first before bathing."
   2. BB. "I will lower my water heater setting and use a bath thermometer."
   3. CC. "I will place a hot water bottle near my feet to keep them warm in bed."
   4. DD. "I will set my heating pad on high to warm my legs while I watch TV."
   Show answer to question 4

   Answer: B. "I will lower my water heater setting and use a bath thermometer."

   Clients with neuropathy cannot reliably sense heat in the feet, so they need a lower water heater setting and a thermometer to confirm a safe bath temperature.

   Why the other options are wrong

   • AFeet with reduced sensation cannot detect dangerously hot water, so testing the bath with them risks a burn.
   • CA hot water bottle near insensitive feet can cause a burn without the client noticing it.
   • DA heating pad on high over legs with reduced sensation can cause a burn before the client feels any pain.

5. Question 5 of 25Easy

   The nurse is preparing to give a scheduled oral medication to a client on a medical-surgical unit. Which action is the best way to verify the client's identity?

   1. AA. Compare the room number on the door with the number on the medication administration record
   2. BB. Ask the client, "Are you Mr. Lopez?" and proceed once the client nods or says yes in reply
   3. CC. Have the client state full name and birth date, then match both to the identification band
   4. DD. Ask the roommate in the next bed to confirm the name of the client receiving the medication
   Show answer to question 5

   Answer: C. Have the client state full name and birth date, then match both to the identification band

   Two client identifiers should be checked at the bedside. Having the client state a name and date of birth and matching them with the identification band is the most reliable method.

   Why the other options are wrong

   • ARoom numbers are not a client identifier, and clients can be moved or beds changed.
   • BA leading yes-or-no question can draw a wrong answer from a confused or hearing-impaired client.
   • DA roommate is not a reliable source, and sharing the client's information raises privacy concerns.

6. Question 6 of 25Hard

   A nurse makes a home visit to a 68-year-old woman who uses oxygen by nasal cannula at 2 L/min. Which finding requires the nurse's immediate intervention?

   1. AA. A backup oxygen cylinder standing upright in a floor stand
   2. BB. The client's husband smoking a cigarette in the same room as the client
   3. CC. The oxygen concentrator placed a few inches away from the wall for airflow
   4. DD. A smoke detector in the hallway that was tested last month
   Show answer to question 6

   Answer: B. The client's husband smoking a cigarette in the same room as the client

   Oxygen supports combustion, so smoking or open flames near oxygen create a serious risk of fire and burns. The smoking must stop at once and the household must be taught about oxygen safety.

   Why the other options are wrong

   • AStoring a cylinder upright in a stand is the recommended way to prevent it from falling.
   • CLeaving space around a concentrator allows airflow and cooling, which is appropriate.
   • DA recently tested smoke detector is a protective measure.

7. Question 7 of 25Medium

   On a postpartum unit, a nurse hears the infant security alarm at the unit exit and sees a visitor hurrying away carrying a bundle. Which action should the nurse take first?

   1. AA. Activate the facility's infant abduction alert according to policy.
   2. BB. Check every client room to confirm that an infant is missing.
   3. CC. Follow the visitor into the stairwell and block the door.
   4. DD. Ask the nearest mother whether she gave her infant to a visitor.
   Show answer to question 7

   Answer: A. Activate the facility's infant abduction alert according to policy.

   A security alarm with a suspicious person is a trigger to start the facility's infant abduction response immediately so exits are monitored and security is alerted.

   Why the other options are wrong

   • BSearching rooms first delays the alert, and the person could leave the building.
   • CConfronting or blocking a possible abductor alone risks harm and is not the nurse's role.
   • DQuestioning one mother delays the alert and does not address the alarm and the visitor.

8. Question 8 of 25Easy

   A home health nurse is visiting an 84-year-old client who has an unsteady gait and lives alone. Which hazard should the nurse tell the client to correct first to reduce the risk of falls?

   1. AA. A night light plugged in along the hallway
   2. BB. Loose throw rugs on the hardwood floor
   3. CC. A sturdy handrail along the basement stairs
   4. DD. A rubber mat placed in the shower stall
   Show answer to question 8

   Answer: B. Loose throw rugs on the hardwood floor

   Loose throw rugs slide and catch feet, which makes them a leading cause of falls in older adults. Removing or securing them is a simple, effective change.

   Why the other options are wrong

   • AA night light in the hallway improves visibility at night and helps prevent falls, so it is protective rather than hazardous.
   • CA sturdy handrail along the stairs gives support during climbing and descending, so it should stay in place.
   • DA rubber mat in the shower stall reduces slipping on wet surfaces and is a recommended safety measure.

9. Question 9 of 25Hard

   A nurse applied soft wrist restraints to a client who kept pulling at a central line after redirection failed. Which documentation entry is the most complete and appropriate?

   1. AA. 1400: Soft wrist restraints applied after redirection failed and client pulled at central line. Order obtained. Skin intact, pulses present.
   2. BB. 1400: Client combative and uncooperative, so restraints were applied to both wrists. Client now sleeping and no further problems are expected tonight.
   3. CC. 1400: Restraints applied per unit routine for all clients with central lines. Family notified. Client tolerated the restraints well and had no complaints.
   4. DD. 1400: Wrist restraints applied for client safety. Restraint checks to be completed hourly as scheduled. Client will remain restrained until discharge.
   Show answer to question 9

   Answer: A. 1400: Soft wrist restraints applied after redirection failed and client pulled at central line. Order obtained. Skin intact, pulses present.

   Complete documentation states the behavior, the alternatives tried, the order, the type of restraint, and the skin and circulation findings.

   Why the other options are wrong

   • BIt uses subjective labels, lacks an order and assessment findings, and predicts future behavior instead of recording facts.
   • CRestraints are never routine for a diagnosis or device, and the entry lacks the order, alternatives tried, and assessment findings.
   • DIt does not describe the behavior, the order, or assessment findings, and restraints must be reassessed and discontinued as soon as possible.

10. Question 10 of 25Hard

    A nurse in a long-term care facility finds a client on the floor beside the bed. After assessing the client and notifying the provider, the nurse documents the event in the client's record. Which entry is most appropriate?

    1. AA. Client fell because the nursing assistant was slow to answer the call light, leaving client unattended for too long
    2. BB. Client was careless and ignored repeated instructions to call for help before getting out of bed alone tonight
    3. CC. Incident report completed and filed in the chart, supervisor notified, and risk management informed of the fall
    4. DD. Found on floor beside bed at 0215, stated "I slipped going to the bathroom," no visible injury, provider notified
    Show answer to question 10

    Answer: D. Found on floor beside bed at 0215, stated "I slipped going to the bathroom," no visible injury, provider notified

    Chart entries should be objective and factual: what was seen, what the client said, assessment findings and who was notified.

    Why the other options are wrong

    • AThis assigns blame and states an unverified cause, which is a conclusion and not an objective observation.
    • BThis is a judgmental opinion about the client and is not a factual description of the event.
    • CIncident reports are not referenced in the client's record, and this entry omits the assessment findings and the client's statement.

11. Question 11 of 25Hard

    A nursing assistant tells the nurse in a long-term care facility that an 82-year-old female client is on her bedroom floor. She is awake and says her hip hurts. Which action should the nurse take first?

    1. AA. Help the client back into bed right away so she is comfortable
    2. BB. Stay with the client and assess for injury and vital signs
    3. CC. Complete the incident report while the details are still fresh
    4. DD. Telephone the client's family to explain what has happened now
    Show answer to question 11

    Answer: B. Stay with the client and assess for injury and vital signs

    The client's condition comes first. The nurse should stay with her and assess for injury and vital signs before moving her, because hip pain suggests a possible fracture.

    Why the other options are wrong

    • AMoving her back to bed before assessment could worsen a possible hip fracture or other injury.
    • CThe incident report is necessary but is completed after the client is assessed and stable.
    • DFamily notification is required but follows client assessment and provider notification, so it is not the first action.

12. Question 12 of 25Medium

    While preparing to give an injection in an acute care client's room, the nurse sees that the wall-mounted sharps container is filled to the top and syringes are sticking out of the opening. Which action should the nurse take?

    1. AA. Press the contents down with a gloved hand to make more room
    2. BB. Remove the top syringes by hand and place them in a new bin
    3. CC. Lock the full container per facility policy and replace it
    4. DD. Place the full container in the regular trash for removal
    Show answer to question 12

    Answer: C. Lock the full container per facility policy and replace it

    Sharps containers should be closed and replaced before they are overfilled, then disposed of through the facility's regulated medical waste process. This prevents needlestick injuries.

    Why the other options are wrong

    • APushing sharps down with a hand risks a needlestick injury, even through gloves.
    • BHandling used needles by hand exposes the nurse to injury and bloodborne pathogens.
    • DSharps containers are regulated medical waste and must never be placed in regular trash.

13. Question 13 of 25Easy

    A practical nurse is preparing to lift a heavy box of medical supplies from the floor to a supply counter. Which action demonstrates proper body mechanics?

    1. AA. Twisting the torso toward the counter while lifting the load
    2. BB. Bending at the waist while keeping the knees straight
    3. CC. Spreading the feet shoulder-width apart and bending the knees
    4. DD. Holding the box at arm's length away from the chest
    Show answer to question 13

    Answer: C. Spreading the feet shoulder-width apart and bending the knees

    Maintaining a wide base of support by spreading the feet shoulder-width apart and bending at the knees lowers the center of gravity and uses the large leg muscles rather than the back. Bending at the waist places excessive strain on the lumbar spine. Holding items close to the body and pivoting rather than twisting prevents spinal torsion and ligament injury.

14. Question 14 of 25Hard

    A home health nurse is teaching the daughter of a 70-year-old client with left-sided weakness after a stroke how to help the client move from the bed to a chair. Which statement by the nurse is most important to include in the teaching?

    1. AA. "Pull on your mother's weak arm to help bring her up to a standing position."
    2. BB. "Put the chair on her strong side, use a gait belt and guard her weak side."
    3. CC. "Lift her under both armpits so that you do most of the work during the move."
    4. DD. "Let her lean her full weight on you while you turn her toward the chair."
    Show answer to question 14

    Answer: B. "Put the chair on her strong side, use a gait belt and guard her weak side."

    The client should move toward the stronger side, and a gait belt gives the caregiver a secure hold. Guarding the weaker side helps prevent a fall.

    Why the other options are wrong

    • APulling on a weak arm can injure a flaccid or weak shoulder and does not support the client safely.
    • CLifting under the armpits can injure the client's shoulder and strains the caregiver's back.
    • DHaving the client lean fully on the caregiver is unsafe, risks a fall and may injure both.

15. Question 15 of 25Medium

    In a clinic, a nurse notices before giving a vaccine that the vial label does not match the provider's order and sets it aside. A coworker says no report is needed because no harm occurred. What is the nurse's best response?

    1. AA. File a report on the near miss in the facility system to reveal weaknesses
    2. BB. Skip the report because the client was never exposed to the medication error
    3. CC. Tell the coworker to relabel the vial so the next nurse is not confused
    4. DD. Mention the event at the next staff meeting instead of filing a formal report
    Show answer to question 15

    Answer: A. File a report on the near miss in the facility system to reveal weaknesses

    Near misses should be reported because they identify system weaknesses and help prevent future errors that could cause harm.

    Why the other options are wrong

    • BAbsence of harm does not remove the need to report, because near misses provide valuable safety information.
    • CRelabeling a vial is unsafe and outside appropriate practice, and the vial should be handled per policy and reported.
    • DAn informal comment at a meeting does not document the event or start a formal review, so it is not an acceptable substitute.

16. Question 16 of 25Medium

    The nurse is working on a postpartum unit. A woman in scrubs with no visible identification badge approaches a mother who is asleep and says she is from the nursery and needs to take the newborn for a routine test. Which action should the nurse take?

    1. AA. Ask the woman which test has been ordered and release the newborn if she answers correctly
    2. BB. Keep the newborn in the room, ask the woman to wait, and notify security and the charge nurse
    3. CC. Allow the woman to take the newborn because she is wearing scrubs and document the time
    4. DD. Wake the mother and ask for verbal permission to let the woman take the newborn
    Show answer to question 16

    Answer: B. Keep the newborn in the room, ask the woman to wait, and notify security and the charge nurse

    Newborns may be released only to staff with visible, verified identification. An unidentified person requesting an infant is a security concern, so the nurse keeps the infant secure and alerts security and the charge nurse per policy.

    Why the other options are wrong

    • AA correct answer about a test does not verify identity; an unidentified person must not receive the infant.
    • CScrubs are not proof of employment, and releasing the newborn puts the infant at risk.
    • DThe mother's permission does not replace staff identification checks, and she may be misled by the same person.

17. Question 17 of 25Easy

    An LPN needs information regarding the correct personal protective equipment and cleanup procedure for an industrial disinfectant spilled in the clean utility room. Which resource should the nurse consult first?

    1. AA. Safety data sheet binder or database
    2. BB. Facility employee health services guidelines
    3. CC. Facility infection prevention control manual
    4. DD. Nursing drug handbook for pharmacology
    Show answer to question 17

    Answer: A. Safety data sheet binder or database

    The safety data sheet provides detailed information on chemical hazards, necessary personal protective equipment, first-aid measures, and safe containment and cleanup methods. The infection control manual outlines isolation and infection transmission precautions rather than chemical hazard containment. A nursing drug handbook contains medication administration details rather than industrial chemical management guidance.

18. Question 18 of 25Easy

    A home health nurse is reinforcing teaching with a client and spouse about a newly delivered oxygen concentrator. Which instruction is correct?

    1. AA. Keep the concentrator away from the gas stove and flames
    2. BB. Apply petroleum jelly inside the nostrils to ease dryness
    3. CC. Run the oxygen tubing under a rug to prevent tripping
    4. DD. Increase the flow rate whenever feeling short of breath
    Show answer to question 18

    Answer: A. Keep the concentrator away from the gas stove and flames

    Oxygen supports combustion, so the equipment must be kept away from open flames and heat sources, and smoking must not occur nearby.

    Why the other options are wrong

    • BPetroleum products are flammable near oxygen, so a water-soluble lubricant should be used instead.
    • CTubing under a rug can be damaged or kinked and creates a fire hazard from friction and heat.
    • DThe flow rate is set by the provider's order and must not be changed by the client.

19. Question 19 of 25Medium

    A nurse is pouring a sterile saline solution into a sterile basin on a sterile field. Which technique should the nurse use to maintain sterility?

    1. AA. Pour the liquid rapidly into the basin to minimize air exposure
    2. BB. Reach across the sterile field to pour from the center outward
    3. CC. Hold the bottle 1 to 2 inches (2.5 to 5 cm) above the basin
    4. DD. Rest the lip of the bottle on the rim of the basin while pouring
    Show answer to question 19

    Answer: C. Hold the bottle 1 to 2 inches (2.5 to 5 cm) above the basin

    The nurse should hold the bottle 1 to 2 inches (2.5 to 5 cm) above the sterile receptacle to avoid contaminating the sterile field or touching the bottle lip to the basin. Resting the bottle lip on the basin directly touches a sterile container with a nonsterile bottle rim, resulting in contamination. Pouring rapidly causes splashing, which can create strike-through contamination through capillary action.

20. Question 20 of 25Easy

    The nurse is preparing a room for a client who has a new order for seizure precautions. Which item should the nurse make sure is at the bedside?

    1. AA. A padded tongue blade to place in the mouth during seizures
    2. BB. Soft wrist restraints to prevent injury from movements
    3. CC. The bed raised to its highest position for easy access
    4. DD. Working suction equipment and oxygen delivery supplies
    Show answer to question 20

    Answer: D. Working suction equipment and oxygen delivery supplies

    Seizure precautions include working suction and oxygen at the bedside, a padded and low bed, and a clear environment so the airway can be protected.

    Why the other options are wrong

    • ANothing should be forced into the mouth during a seizure because a tongue blade can injure the client or block the airway.
    • BSoft wrist restraints increase injury and agitation and are not part of routine seizure precautions.
    • CThe bed should be kept in the lowest position to reduce injury from a fall during a seizure.

21. Question 21 of 25Medium

    The nurse is reinforcing discharge safety instructions for a client with a newly diagnosed seizure disorder. Which statement indicates that the client understands the instructions?

    1. AA. I will sleep face down on a soft feather pillow.
    2. BB. I should take showers instead of soaking in a bathtub.
    3. CC. I must skip my morning medication if I feel dizzy.
    4. DD. I need to lock my bathroom door whenever I am inside.
    Show answer to question 21

    Answer: B. I should take showers instead of soaking in a bathtub.

    Taking showers instead of tub baths significantly reduces the risk of accidental drowning if a seizure occurs while bathing. Sleeping prone on soft pillows increases the risk of suffocation, and bathroom doors should remain unlocked so emergency assistance can be provided quickly.

22. Question 22 of 25Medium

    The nurse checks a client who has a provider's order for soft wrist restraints. Which finding indicates the restraints are applied correctly?

    1. AA. Square knots secure the straps to the side rail and one finger fits under the cuff
    2. BB. Quick-release knots secure the straps to the bed frame and no fingers fit under the cuff
    3. CC. Double knots secure the straps to the bed frame and two fingers fit under the cuff
    4. DD. Quick-release knots secure the straps to the bed frame and two fingers fit under the cuff
    Show answer to question 22

    Answer: D. Quick-release knots secure the straps to the bed frame and two fingers fit under the cuff

    Restraints should be secured to the bed frame with a quick-release knot so they can be removed fast in an emergency. Two fingers should fit under the cuff to protect circulation.

    Why the other options are wrong

    • AA side rail moves and can injure the limb when lowered, a square knot is hard to release quickly, and one finger is too snug.
    • BA cuff with no room for fingers is too tight and can impair circulation and nerve function.
    • CA double knot is difficult to untie and cannot be released quickly in an emergency.

23. Question 23 of 25Hard

    A nurse on a pediatric unit helps review an infant abduction drill. Which finding shows that the security plan needs to be revised?

    1. AA. Staff reached their assigned exits within the expected time frame.
    2. BB. Visitors were stopped and asked for identification at the unit entrance.
    3. CC. Security staff received the alert and arrived at the unit quickly.
    4. DD. Several staff could not state how to activate the alert or their exit.
    Show answer to question 23

    Answer: D. Several staff could not state how to activate the alert or their exit.

    An effective plan depends on every staff member knowing how to start the alert and what role to take. Staff uncertainty exposes a gap that needs retraining or clearer procedures.

    Why the other options are wrong

    • AReaching assigned exits within the expected time shows that this part of the plan works as designed.
    • BChecking visitor identification is a protective measure and shows the plan is being followed.
    • CA fast security response shows effective communication and does not call for revision.

24. Question 24 of 25Medium

    The practical nurse is reinforcing dietary safety teaching with a client who is immunocompromised. Which action indicates an understanding of safe food handling at home?

    1. AA. Washing raw poultry in the kitchen sink before seasoning and cooking
    2. BB. Thawing frozen chicken on the kitchen counter at room temperature
    3. CC. Storing raw ground beef on the top shelf above fresh vegetables
    4. DD. Maintaining the refrigerator temperature at or below 40°F (4.4°C)
    Show answer to question 24

    Answer: D. Maintaining the refrigerator temperature at or below 40°F (4.4°C)

    Keeping refrigerators at or below 40°F (4.4°C) slows bacterial growth and helps prevent foodborne illness, which is vital for immunocompromised clients. Thawing meat at room temperature allows bacteria to multiply rapidly in the danger zone; foods should be thawed in the refrigerator, under cold running water, or in the microwave. Washing raw poultry can aerosolize and splash pathogens onto nearby sink surfaces and utensils.

25. Question 25 of 25Easy

    A nurse is securing a limb restraint on a client in bed. Which method of attaching the restraint is correct?

    1. AA. A square knot tied securely to the raised side rail
    2. BB. A double knot tied firmly to the mattress frame
    3. CC. A tight loop tied snugly to the raised side rail
    4. DD. A quick-release knot tied to the movable bed frame
    Show answer to question 25

    Answer: D. A quick-release knot tied to the movable bed frame

    A quick-release knot allows rapid removal in an emergency. Tying to the movable part of the bed frame prevents tightening or injury when the bed position changes.

    Why the other options are wrong

    • ASquare knots are hard to untie quickly, and side rails can be lowered, which may injure the limb.
    • BA double knot cannot be released quickly in an emergency, and the mattress frame is not an appropriate attachment point.
    • CA tight loop on a side rail can harm the limb when the rail moves and cannot be released quickly.

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