NCLEX-RN Safety and Infection Control Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Easy

   A nurse is orienting a newly licensed nurse to the care of a hospitalized client on seizure precautions. Which intervention should the nurse emphasize as an essential safety measure?

   1. AA. Maintain the hospital bed in the lowest position with padded side rails
   2. BB. Apply soft wrist restraints loosely during periods of unsupervised sleep
   3. CC. Tape a padded tongue blade to the wall above the head of the bed
   4. DD. Place two firm pillows beneath the client's neck during tonic contractions
   Show answer to question 1

   Answer: A. Maintain the hospital bed in the lowest position with padded side rails

   Maintaining the bed in its lowest position with side rails raised and padded significantly reduces the risk of serious fall-related trauma should a seizure occur while the client is in bed. Padded tongue blades should never be kept or used because inserting anything into the mouth during a seizure is unsafe. Restraints are strictly contraindicated during seizures, and placing multiple pillows under the head can flex the neck and compromise airway patency.

2. Question 2 of 25Easy

   A client admitted with confirmed influenza requires transport to the radiology department for a computed tomography (CT) scan. Which action should the nurse take before moving the client?

   1. AA. Place a standard surgical mask on the client.
   2. BB. Administer a prophylactic oral antimicrobial rinse to the client.
   3. CC. Have the transport technician wear a sterile gown and gloves.
   4. DD. Fit the client with an N95 particulate respirator.
   Show answer to question 2

   Answer: A. Place a standard surgical mask on the client.

   Clients on droplet precautions, such as those with influenza, must wear a standard surgical or procedure mask during transport to minimize the dispersal of respiratory droplets into the environment. An N95 respirator is intended for healthcare personnel caring for clients on airborne precautions, not for client transport. Transport personnel do not need sterile attire, and oral antimicrobial rinses do not mitigate respiratory droplet transmission.

3. Question 3 of 25Easy

   Two nurses are preparing to reposition a client up in bed using a friction-reducing slide sheet. Which ergonomic intervention should the nurses implement?

   1. AA. Keep the client in a high-Fowler position during the repositioning.
   2. BB. Lock knees and lean backward while pulling the slide sheet.
   3. CC. Adjust the bed to the level of the nurses' waists or elbows.
   4. DD. Place the bed in the lowest horizontal position to maintain stability.
   Show answer to question 3

   Answer: C. Adjust the bed to the level of the nurses' waists or elbows.

   Raising the bed to the height of the nurses' waists or elbows avoids trunk flexion and excessive spinal strain during repositioning. Leaving the bed low requires nurses to bend awkwardly, and positioning the client in high-Fowler works against gravity, greatly increasing the required pulling force.

4. Question 4 of 25Medium

   The nurse is preparing to insert an indwelling urinary catheter for a client. When opening the sterile catheter kit on the bedside table, in which direction should the nurse unfold the first flap of the wrapper?

   1. AA. Toward the nurse's non-dominant hand
   2. BB. Toward the nurse's dominant hand
   3. CC. Toward the nurse's body
   4. DD. Away from the nurse's body
   Show answer to question 4

   Answer: D. Away from the nurse's body

   Opening the first (outermost) flap away from the nurse ensures that the nurse will not need to reach across the exposed sterile field when opening the remaining flaps. Opening the flap toward the body first or opening side flaps first increases the likelihood that the nurse's unsterile arms will cross over sterile contents. Flaps are opened away first, followed by the side flaps, and finally the flap closest to the body.

5. Question 5 of 25Medium

   A nurse is providing care to a client who has both an indwelling urinary catheter and a peripheral intravenous (IV) line. Which action by the nurse adheres to standard precautions?

   1. AA. Washing gloved hands with soap and water after completing catheter care before touching the IV line
   2. BB. Applying two pairs of clean gloves initially and discarding the outer pair after emptying the catheter bag
   3. CC. Changing gloves and performing hand hygiene after emptying the catheter bag before assessing the IV site
   4. DD. Wearing the same pair of clean gloves throughout the morning care to conserve medical supplies
   Show answer to question 5

   Answer: C. Changing gloves and performing hand hygiene after emptying the catheter bag before assessing the IV site

   Under standard precautions, gloves must be removed and hand hygiene performed when moving from a contaminated body area to a clean body area on the same client to prevent cross-contamination. Washing gloved hands compromises glove integrity and is contraindicated. Double-gloving is not recommended for routine patient care and does not eliminate the need for hand hygiene between tasks.

6. Question 6 of 25Hard

   A nurse is exposed to blood from a client confirmed to be HIV-positive through a deep needle puncture. Which action aligns with current post-exposure prophylaxis (PEP) guidelines?

   1. AA. Administering a single-dose intramuscular antiretroviral injection within 24 hours
   2. BB. Initiating a multi-drug antiretroviral regimen within 2 hours of exposure
   3. CC. Delaying PEP until the source client's viral load is confirmed by laboratory testing
   4. DD. Waiting for the exposed nurse's initial rapid HIV test results before initiating PEP
   Show answer to question 6

   Answer: B. Initiating a multi-drug antiretroviral regimen within 2 hours of exposure

   Occupational HIV post-exposure prophylaxis is most effective when initiated as soon as possible, ideally within 2 hours of the incident, using a multi-drug antiretroviral regimen for 28 days. Prophylaxis should not be delayed while awaiting source client viral load confirmation or baseline laboratory testing results.

7. Question 7 of 25Easy

   A newborn with a myelomeningocele is admitted to the neonatal intensive care unit before surgical repair. Which intervention should the nurse include in the plan of care from admission?

   1. AA. Place the newborn supine with a rolled towel under the sac
   2. BB. Use latex-free gloves and equipment for all care
   3. CC. Cover the sac with a dry gauze dressing changed daily
   4. DD. Hold the newborn upright for feedings to protect the sac
   Show answer to question 7

   Answer: B. Use latex-free gloves and equipment for all care

   Children with spina bifida are at high risk for latex allergy because of repeated latex exposure during surgeries and procedures, so latex-free care should begin at birth.

   Why the other options are wrong

   • ABefore repair, the newborn is positioned prone to keep pressure off the sac.
   • CThe sac is covered with a sterile, moist, nonadherent dressing to prevent drying and rupture.
   • DHolding the newborn upright can put pressure on the sac; positioning before repair keeps pressure off it.

8. Question 8 of 25Hard

   A 71-year-old client with delirium after hip surgery keeps trying to pull out an indwelling urinary catheter despite repeated redirection. The health care provider writes this prescription: 'Soft wrist restraints as needed for agitation.' Which part of the prescription requires clarification?

   1. AA. The choice of soft wrist restraints rather than a vest restraint
   2. BB. The as-needed wording, which is not permitted for restraint prescriptions
   3. CC. The lack of a sedative prescription to use together with the restraints
   4. DD. The absence of a plan to keep the restraints on overnight while the client sleeps
   Show answer to question 8

   Answer: B. The as-needed wording, which is not permitted for restraint prescriptions

   Federal (CMS) rules prohibit restraint prescriptions written as standing or as-needed (PRN) orders. The nurse asks the health care provider for a time-limited prescription based on a current assessment and keeps using less restrictive alternatives first.

   Why the other options are wrong

   • AWrist restraints are less restrictive than a vest; the type of device is not the problem with this prescription.
   • CA sedative given to control behavior acts as a chemical restraint and does not correct the invalid prescription.
   • DRestraints are removed as soon as they are no longer needed, not kept on through the night by plan.

9. Question 9 of 25Hard

   A nurse is fitting an adult client for axillary crutches prior to ambulation training. Which measurement confirms that the crutches are properly adjusted?

   1. AA. A distance of 1 to 2 inches (2.5 to 5 cm) between the crutch pad and the axilla with elbows flexed at 45 degrees.
   2. BB. The crutch pad resting firmly against the axillary fold with hand grips adjusted to neutral wrist extension.
   3. CC. The crutch tips positioned 12 inches (30 cm) anterolateral to the toes with the client's arms completely straight.
   4. DD. A distance of 1 to 2 inches (2.5 to 5 cm) between the crutch pad and the axilla with elbows flexed at 20 to 30 degrees.
   Show answer to question 9

   Answer: D. A distance of 1 to 2 inches (2.5 to 5 cm) between the crutch pad and the axilla with elbows flexed at 20 to 30 degrees.

   Properly adjusted crutches have a gap of 1 to 2 inches (approximately 2 to 3 fingerbreadths) between the axilla and the crutch pad when the crutch tips are placed roughly 6 inches lateral and 6 inches anterior to the foot, accompanied by 20 to 30 degrees of elbow flexion at the handgrips. If the crutch pads press directly into the axillae, body weight can compress the radial nerve and brachial plexus, causing crutch palsy. An elbow flexion angle of 45 degrees is too deep and indicates handgrips positioned too high.

10. Question 10 of 25Medium

    A charge nurse must evacuate an inpatient surgical unit due to an active, spreading fire in an adjacent service room. Which client should the nurse instruct staff to evacuate first?

    1. AA. A client with an open abdominal incision receiving negative pressure wound therapy.
    2. BB. A client who is 1 day postoperative after a total hip replacement and requires a walker.
    3. CC. A client admitted with cellulitis who is alert and ambulatory without assistance.
    4. DD. A client receiving continuous intravenous vasopressors via a central venous catheter.
    Show answer to question 10

    Answer: C. A client admitted with cellulitis who is alert and ambulatory without assistance.

    During an emergency evacuation, clients who are ambulatory and require minimal or no assistance are evacuated first to clear the unit quickly and safely. Once ambulatory clients are guided to safety, staff can dedicate time and resources to semi-ambulatory clients and finally to non-ambulatory or critically ill individuals. Clients requiring complex medical equipment or extensive mobility assistance are moved after the ambulatory population is evacuated.

11. Question 11 of 25Medium

    A nurse observes an assistive personnel (AP) and a coworker moving a 210-lb (95-kg) client up in bed on a surgical unit. Which action by the AP requires the nurse to intervene?

    1. AA. Places a friction-reducing sheet under the client before the move
    2. BB. Lowers the head of the bed flat before moving the client
    3. CC. Keeps the bed at its lowest height and bends at the waist to pull
    4. DD. Stands with feet apart and shifts weight from the back leg to the front leg
    Show answer to question 11

    Answer: C. Keeps the bed at its lowest height and bends at the waist to pull

    Working with the bed at its lowest height forces the caregiver to bend at the waist, which strains the lower back. The bed should be raised to about waist height so that staff can keep their backs straight and use their leg muscles.

    Why the other options are wrong

    • AA friction-reducing sheet lowers the force needed and protects the client's skin from shear.
    • BLowering the head of the bed flat, if tolerated, lets the client move up without working against gravity.
    • DA wide base of support with a weight shift uses the large leg muscles and protects the back.

12. Question 12 of 25Medium

    A nurse admits a college student presenting with high fever, severe headache, nuchal rigidity, and petechial lesions on the extremities. While diagnostic tests are underway to confirm meningococcal meningitis, which infection control measure should the nurse initiate first?

    1. AA. Don an N95 particulate respirator prior to performing physical assessments.
    2. BB. Transfer the client to a negative-airflow isolation room.
    3. CC. Restrict all visitors until cerebrospinal fluid cultures show no growth for 48 hours.
    4. DD. Place the client on droplet precautions in a private room.
    Show answer to question 12

    Answer: D. Place the client on droplet precautions in a private room.

    Suspected Neisseria meningitidis infection warrants immediate droplet precautions, which require placement in a private room and the use of a surgical mask by staff within close proximity until 24 hours of effective antimicrobial therapy have been completed. Negative-airflow rooms and N95 particulate respirators are indicated for airborne pathogens such as rubeola or Mycobacterium tuberculosis, not droplet-spread meningococcal disease.

13. Question 13 of 25Medium

    A 45-year-old environmental services worker spills a container of concentrated bleach solution on the floor of the hospital corridor. The worker reports skin stinging on both forearms. Which action should the nurse take first?

    1. AA. Apply a barrier cream to the forearms before removing clothing.
    2. BB. Direct the worker to the emergency department for evaluation.
    3. CC. Flush the affected skin with copious amounts of water immediately.
    4. DD. Call the hospital hazardous materials team to contain the spill.
    Show answer to question 13

    Answer: C. Flush the affected skin with copious amounts of water immediately.

    Bleach is a caustic chemical, so the first step is to flush the skin with large amounts of running water, removing any contaminated clothing, to dilute and wash away the chemical. Prompt irrigation limits tissue damage.

    Why the other options are wrong

    • ABarrier cream would trap the chemical against the skin and worsen the injury.
    • BMedical evaluation may follow, but decontamination must start immediately.
    • DThe spill must be contained, but caring for the exposed worker comes first.

14. Question 14 of 25Medium

    A nurse provides education on carbon monoxide poisoning prevention to an older adult client who heats the home with a gas furnace. Which statement by the client indicates an understanding of the teaching?

    1. AA. I can run my portable generator in the basement as long as a window is cracked.
    2. BB. I will mount the carbon monoxide detector inside the furnace closet.
    3. CC. I should install carbon monoxide alarms on every level of my home and near sleeping areas.
    4. DD. I will use my kitchen gas range with the door open to heat the house if the power fails.
    Show answer to question 14

    Answer: C. I should install carbon monoxide alarms on every level of my home and near sleeping areas.

    Carbon monoxide detectors should be installed on each level of the home and in immediate proximity to sleeping areas so occupants are awakened if toxic fumes accumulate. Using unvented combustion appliances like gas ranges for space heating creates an extreme risk of lethal carbon monoxide buildup.

15. Question 15 of 25Medium

    A nurse prepares an incident report after witnessing a visitor suddenly fall in the hallway. Which statement is the most appropriate documentation for the report?

    1. AA. Visitor slid to the floor, was unresponsive for 15 seconds, and vital signs were obtained.
    2. BB. Visitor appeared clumsy and tripped over own feet while hurrying down the corridor.
    3. CC. Visitor fell due to a transient ischemic attack and required an emergency evaluation.
    4. DD. Visitor seemed intoxicated from alcohol and lost balance while carrying personal items.
    Show answer to question 15

    Answer: A. Visitor slid to the floor, was unresponsive for 15 seconds, and vital signs were obtained.

    Documentation in an incident report must be completely objective, precise, and limited to directly observed facts and actions taken. Statements attributing the fall to clumsy behavior, alcohol consumption, or medical diagnoses without diagnostic confirmation are subjective interpretations. Documenting exactly what was observed, the duration of unresponsiveness, and the immediate clinical response ensures legal and clinical accuracy.

16. Question 16 of 25Medium

    A nurse is caring for a client receiving a continuous heparin infusion via a smart infusion pump. The nurse observes that the pump interface is completely frozen, the keys are unresponsive, and the current delivery rate cannot be confirmed. Which action should the nurse take first?

    1. AA. Press and hold the power button to initiate a manual system reboot.
    2. BB. Unplug the pump from the wall outlet to force it onto backup battery power.
    3. CC. Contact the hospital pharmacy to request a new preprogrammed infusion pump.
    4. DD. Close the roller clamp on the intravenous tubing to halt the infusion.
    Show answer to question 16

    Answer: D. Close the roller clamp on the intravenous tubing to halt the infusion.

    When an infusion pump administering a high-alert medication such as heparin malfunctions and freezes, the immediate priority is to close the manual clamp to prevent an uncontrolled free-flow or inaccurate delivery that could cause severe harm. Rebooting or changing power sources on a malfunctioning pump does not eliminate the immediate risk of an unregulated drug bolus while troubleshooting. Requesting replacement equipment occurs only after the flow of medication is safely arrested and client assessment is complete.

17. Question 17 of 25Medium

    A nurse reviews the medication administration record of an older client who was admitted after a syncopal episode. Which medication class requires the nurse to teach the client to pause and sit on the edge of the bed before standing?

    1. AA. Loop diuretics
    2. BB. HMG-CoA reductase inhibitors
    3. CC. Broad-spectrum oral antibiotics
    4. DD. Proton pump inhibitors
    Show answer to question 17

    Answer: A. Loop diuretics

    Loop diuretics promote rapid fluid excretion, predisposing clients to hypovolemia and orthostatic hypotension, which can trigger lightheadedness and falls upon standing. Clients should be taught to transition slowly from supine to sitting, pause before rising, and stand only when steady. Proton pump inhibitors, statins, and antibiotics do not directly impair postural blood pressure regulation.

18. Question 18 of 25Easy

    A nurse is caring for a client with a history of generalized tonic-clonic seizures. Which safety measure should the nurse establish at the bedside to prevent injury during a potential seizure?

    1. AA. Place the bed in the highest position with all four side rails elevated.
    2. BB. Keep a padded tongue depressor within easy reach at the head of the bed.
    3. CC. Fasten soft limb holders to the bed frame to prevent violent movement.
    4. DD. Maintain functioning suction apparatus and supplemental oxygen equipment.
    Show answer to question 18

    Answer: D. Maintain functioning suction apparatus and supplemental oxygen equipment.

    Standard seizure precautions require ready access to working suction equipment and oxygen to manage post-ictal airway compromise, secretions, and hypoxemia. Inserting any object into a seizing client's mouth, such as a padded tongue blade, risks dental trauma, aspiration, and airway obstruction. Physical restraints should never be applied to a seizing client because forceful restraint can cause fractures, dislocations, and severe muscle tears.

19. Question 19 of 25Medium

    A hospital activates its emergency operations plan after a tornado strikes a nearby town. Staff on a medical unit hear that the emergency department is overwhelmed. Which staff action requires follow-up by the charge nurse?

    1. AA. A nurse reviews the unit's clients to identify those who could be discharged early
    2. BB. A nurse leaves the unit to help in the emergency department without being assigned
    3. CC. An off-duty nurse calls to report availability and waits for instructions
    4. DD. An assistive personnel (AP) stocks extra linens and supplies for incoming clients
    Show answer to question 19

    Answer: B. A nurse leaves the unit to help in the emergency department without being assigned

    During an emergency response, staff work within the incident command structure and go where they are assigned, often through a labor pool. A nurse who leaves the unit without an assignment leaves clients uncovered and disrupts coordinated staffing.

    Why the other options are wrong

    • AIdentifying clients who could be discharged supports surge capacity and is an expected role.
    • CReporting availability and waiting for instructions follows the emergency plan.
    • DPreparing supplies for incoming clients is an appropriate unit activity during a surge.

20. Question 20 of 25Hard

    A 79-year-old resident of a skilled nursing facility has an indwelling urinary catheter, and a rectal screening swab is positive for carbapenem-resistant Enterobacterales (CRE). The resident is continent of stool, has no wounds and has no signs of infection. Which plan is consistent with CDC guidance?

    1. AA. Enhanced barrier precautions, with gown and gloves for high-contact care
    2. BB. Contact precautions for every room entry, with the resident kept in the room
    3. CC. Standard precautions only, because the resident is colonized and not infected
    4. DD. Droplet precautions, with the resident excluded from group dining
    Show answer to question 20

    Answer: A. Enhanced barrier precautions, with gown and gloves for high-contact care

    CDC recommends enhanced barrier precautions in nursing homes for residents colonized with a multidrug-resistant organism or who have an indwelling device, when contact precautions do not otherwise apply. Staff wear a gown and gloves for high-contact care such as bathing, transfers, toileting and catheter care, and the resident may still join group activities.

    Why the other options are wrong

    • BContact precautions with room restriction are used for situations such as acute diarrhea or uncontained drainage.
    • CColonization plus an indwelling catheter calls for gown and gloves during high-contact care, not standard precautions alone.
    • DCRE spreads by contact, not by droplets, and excluding the resident from group dining is not required.

21. Question 21 of 25Easy

    A 60-year-old client in a telemetry unit is on a continuous IV infusion of 0.9% sodium chloride at 100 mL/hr via an infusion pump. The nurse enters the room and sees the pump alarming 'occlusion' and the IV tubing is kinked under the client's arm. Which action should the nurse take first?

    1. AA. Remove the IV catheter and restart a new site
    2. BB. Unkink the tubing and press the restart button
    3. CC. Flush the IV line with normal saline
    4. DD. Change the IV tubing and the fluid bag
    Show answer to question 21

    Answer: B. Unkink the tubing and press the restart button

    An occlusion alarm with visibly kinked tubing has an obvious external cause. Straightening the tubing and restarting the pump restores flow, and the nurse can then check the site for patency.

    Why the other options are wrong

    • AThe occlusion is external, so removing a working IV catheter causes needless trauma and a new venipuncture.
    • CFlushing against a kink does not relieve it; the external obstruction must be corrected first.
    • DChanging the tubing and fluid bag is wasteful and unnecessary when a simple kink is the cause.

22. Question 22 of 25Hard

    The nurse is working in the emergency department when a visitor becomes increasingly agitated, shouting at staff and clenching his fists. The visitor has no weapon visible. Which intervention by the nurse is the priority to maintain safety?

    1. AA. Direct the visitor to a quiet waiting area and offer him a beverage to de-escalate the situation
    2. BB. Approach the visitor calmly, maintain a distance of at least two arm lengths, and speak in a low tone
    3. CC. Notify the charge nurse and wait for security to arrive before interacting with the visitor
    4. DD. Ask the visitor to leave the department immediately and call security to escort him out
    Show answer to question 22

    Answer: B. Approach the visitor calmly, maintain a distance of at least two arm lengths, and speak in a low tone

    Calm, nonthreatening communication is the first step in de-escalation. Keeping at least two arm lengths away protects the nurse, while a low, steady voice helps lower the visitor's agitation.

    Why the other options are wrong

    • AMoving him away and offering a beverage does not address his anger and can leave staff alone with an agitated person.
    • CWaiting for security without engaging allows the agitation to escalate.
    • DOrdering him to leave is confrontational and likely to escalate the situation.

23. Question 23 of 25Hard

    A nurse on a telemetry unit is about to label blood specimens just drawn from a 72-year-old client and notices that the printed labels carry the name of another client with the same last name. The nurse prints the correct labels and labels the tubes at the bedside. How should the nurse classify and handle this event?

    1. AA. A near miss that should be reported through the facility's safety event system
    2. BB. An error that needs no report because the wrong labels were not applied
    3. CC. A sentinel event that must be reported to the state board of nursing
    4. DD. An adverse event that should be described in the client's progress note
    Show answer to question 23

    Answer: A. A near miss that should be reported through the facility's safety event system

    An error that is caught before it reaches the client is a near miss. Reporting near misses lets the organization correct system problems, such as similar names and label printing, before someone is harmed.

    Why the other options are wrong

    • BNear misses are reported precisely because they reveal hazards before anyone is harmed.
    • CA sentinel event involves death or serious harm; this event caused no harm and is not a board of nursing matter.
    • DNo harm reached the client, so this is not an adverse event, and the event report does not belong in the progress note.

24. Question 24 of 25Easy

    A nurse is changing the bed linens for a client with an open surgical wound that has purulent drainage. Which action by the nurse represents correct handling of the soiled linens?

    1. AA. Shake the linens gently over the bed to inspect for any personal belongings.
    2. BB. Carry the rolled linens against the uniform to maintain stability while walking to the hamper.
    3. CC. Fold the linens with the soiled side turned inward and hold them away from the uniform.
    4. DD. Place the soiled linens temporarily on a clean bedside chair while making the bed.
    Show answer to question 24

    Answer: C. Fold the linens with the soiled side turned inward and hold them away from the uniform.

    Soiled linens should be rolled with the contaminated surface turned inward to contain microorganisms and carried away from the body to prevent cross-contaminating the nurse's uniform. Shaking linens disperses pathogens into the air, and placing them on the bedside chair contaminates environmental surfaces.

25. Question 25 of 25Hard

    The nurse wearing sterile attire is assisting with a surgical procedure in the operating room. Which area of the nurse's surgical gown is considered sterile?

    1. AA. The entire front surface of the gown extending from the neck to the bottom hem
    2. BB. The sleeves from the fingertips up to the shoulder seams
    3. CC. The back of the gown from the mid-scapular region down to the waist
    4. DD. The front from the chest level down to the level of the sterile field
    Show answer to question 25

    Answer: D. The front from the chest level down to the level of the sterile field

    According to surgical asepsis standards, sterile gowns are considered sterile on the front from the chest level down to the level of the sterile field, and the sleeves from two inches above the elbow to the cuff. The neck, shoulders, axillae, and areas below the field level are considered non-sterile. The back of the gown is also considered unsterile because it cannot be constantly monitored by the wearer.

Email me my score report

The full NCLEX-RN bank has 424 Safety and Infection Control questions. See plans