Free NCLEX-RN Safety & Infection Control Questions
Free NCLEX-RN safety and infection control practice questions with rationales — precautions, error prevention, and safe equipment use.
A nurse discovers that a client received a dose of insulin intended for the client in the next bed because of similar last names. The client now has a blood glucose of 58 mg/dL and reports feeling shaky. Which actions should the nurse take? Select all that apply.
- A.Assess the client and treat the hypoglycemia per protocol
- B.Notify the provider of the error and the client's status
- C.Complete an incident or occurrence report
- D.Document in the incident report that a medication error occurred and chart it as a near miss in the medical record
- E.Omit the error from the client's chart to avoid alarming the family
Show answer & rationaleHide answer & rationale
Correct answers: A, B, C
After an error, the client comes first, then disclosure, then the safety system. Assess and treat the hypoglycemia immediately because the physiologic threat outranks paperwork. Notify the provider so orders and monitoring follow, and file an incident report so the system can prevent the next mix-up. The incident report stays separate from the chart and is never referenced in it, and you do chart the objective clinical facts and treatment given. Hiding the event endangers the client and is never acceptable.
Why the other options are wrong
- D. This is wrong on two counts: the event was an actual error reaching the client, not a near miss, and you never document that an incident report was filed in the medical record.
- E. Concealing a medication error is unethical and unsafe; the clinical facts and the client's response must be charted.
Key takeaway: After a med error: assess and treat the client, notify the provider, file an incident report kept separate from the chart, and document only objective facts.
A nurse is caring for a client with active pulmonary tuberculosis who is on airborne precautions in a negative-pressure room. The nurse must enter the room to administer medications. Which piece of personal protective equipment is essential to don before entering?
- A.A surgical face mask
- B.A fit-tested N95 respirator
- C.A face shield and gown
- D.Sterile gloves
Show answer & rationaleHide answer & rationale
Correct answer: B
Match the PPE to the route. Tuberculosis spreads on airborne droplet nuclei that stay suspended and pass straight through a loose surgical mask, so airborne precautions require a fit-tested N95 (or higher) respirator that seals to the face and filters those tiny particles. The negative-pressure room contains the air, but it does nothing to protect your airway once you step inside. A fitted N95 is the single item that actually blocks the infectious aerosol.
Why the other options are wrong
- A. A surgical mask blocks large droplets but lets airborne nuclei through, so it is the right choice for droplet precautions, not airborne.
- C. Face shields and gowns address splash and contact, which are not how TB is transmitted.
- D. Sterile gloves protect a sterile field, not your respiratory tract; they have no role in airborne protection.
Key takeaway: Airborne pathogens like TB require a fit-tested N95 respirator, not a surgical mask.
A nurse is preparing to leave the room of a client on contact and droplet precautions. The nurse is wearing gloves, a gown, a surgical mask, and goggles. Which item should the nurse remove first when doffing the personal protective equipment?
- A.The goggles
- B.The surgical mask
- C.The gloves
- D.The gown
Show answer & rationaleHide answer & rationale
Correct answer: C
Take off the dirtiest item first. During care the gloves contact the most contaminated surfaces, so they come off first to keep that bioburden away from your skin and clothing. A common safe doffing order is gloves, goggles, gown, then mask, with the mask last because you remove it outside the room and it has guarded the airway throughout. Removing gloves first prevents transferring pathogens to your hands while you handle the remaining gear.
Why the other options are wrong
- A. Goggles come off after gloves; removing them first means handling eyewear near your face with contaminated gloved hands.
- B. The mask is removed last and outside the room, so it is never first.
- D. The gown is removed after gloves and goggles, not before, to avoid spreading contamination from soiled gloves.
Key takeaway: When doffing PPE, remove the most contaminated item, the gloves, first.
A nurse is assigning rooms for four newly admitted clients during an influenza surge with limited private rooms. Which client most urgently requires placement in the single available private negative-pressure airborne isolation room?
- A.A client with Clostridioides difficile diarrhea
- B.A client with a confirmed measles (rubeola) rash and fever
- C.A client with influenza and a productive cough
- D.A client with a draining MRSA wound infection
Show answer & rationaleHide answer & rationale
Correct answer: B
Reserve the negative-pressure room for true airborne pathogens. Measles, tuberculosis, and varicella spread by droplet nuclei that linger in the air and demand a negative-pressure room plus N95 protection. The other three spread by contact or droplet and are safely managed in standard private or cohorted rooms with the matching precautions. When a single airborne room exists, the airborne client wins it because no lesser room can safely contain that pathogen.
Why the other options are wrong
- A. C. difficile needs contact precautions and soap-and-water hand hygiene, not airborne isolation.
- C. Influenza requires droplet precautions, which a standard private room with a surgical mask can provide.
- D. A draining MRSA wound calls for contact precautions, manageable without negative pressure.
Key takeaway: Negative-pressure airborne rooms are prioritized for airborne pathogens: measles, TB, and varicella.
A client with a history of generalized tonic-clonic seizures is admitted to a medical unit. Which item at the bedside reflects a correct seizure precaution?
- A.A padded oral airway taped to the headboard for quick insertion
- B.Functioning wall suction set up and ready at the bedside
- C.Soft wrist restraints stored in the bedside drawer
- D.A tongue blade wrapped in gauze on the nightstand
Show answer & rationaleHide answer & rationale
Correct answer: B
Seizure precautions protect the airway without forcing anything into the mouth. Suction at the bedside is correct because it clears secretions and prevents aspiration during and after a seizure. You never insert objects into a clenched mouth: doing so can break teeth, obstruct the airway, or injure the rescuer. Padded side rails, oxygen, and removing hazards round out true precautions. Restraints are not used to control seizure activity, and they can worsen injury during convulsions.
Why the other options are wrong
- A. Forcing an airway into a clenched jaw during a seizure causes injury and obstruction.
- C. Restraints do not stop seizures and increase the risk of fracture during convulsions.
- D. Placing a tongue blade in the mouth can break teeth and block the airway.
Key takeaway: Seizure precautions center on suction and a safe environment, never on putting objects in the mouth.
A nurse sustains a needlestick from a hollow-bore needle used on a client with unknown hepatitis and HIV status. After the immediate injury, which action takes priority?
- A.Wash the puncture site with soap and running water
- B.Report the exposure to the supervisor and complete an incident report
- C.Draw the source client's blood for hepatitis and HIV testing
- D.Go to employee health to start post-exposure prophylaxis
Show answer & rationaleHide answer & rationale
Correct answer: A
After any sharps injury, first reduce the pathogen load at the wound: wash the site immediately with soap and running water. This is the very first hands-on step before reporting or prophylaxis. Reporting, source testing, and timely post-exposure prophylaxis all follow and are essential, but decontaminating the wound is the immediate physical action under the nurse's direct control. Do not squeeze or scrub aggressively, and do not delay washing to find a supervisor first.
Why the other options are wrong
- B. Reporting is required but follows wound decontamination, the first physical step.
- C. Source testing guides prophylaxis but comes after cleansing the wound.
- D. Prophylaxis is time-sensitive yet still follows immediate wound washing.
Key takeaway: After a needlestick, wash the site immediately before reporting or seeking prophylaxis.
A nurse is setting up a sterile field on the over-bed table to perform a urinary catheterization. After opening the sterile kit, which action keeps the field sterile?
- A.Consider the outer 1 inch border of the drape sterile and lay supplies there
- B.Hold sterile items above waist level and within your line of sight
- C.Reach across the open field to retrieve forceps on the far side
- D.Turn your back to the field briefly to retrieve extra lubricant
Show answer & rationaleHide answer & rationale
Correct answer: B
A sterile field stays sterile only while you keep it in view and above your waist. Anything below the waist or out of sight is considered contaminated because you cannot verify it. Holding items above waist level and watching the field directly meets that standard. The 1 inch border of any sterile drape is treated as contaminated, reaching across an open field drops skin and microbes onto it, and turning your back removes the field from your line of sight, all of which break asepsis.
Why the other options are wrong
- A. Tempting because the drape looks usable edge to edge, but the outer 1 inch is always contaminated.
- C. Reaching over a sterile field, even without touching, contaminates it with shed particles.
- D. Once the field leaves your sight it is considered contaminated and must be redone.
Key takeaway: A sterile field is sterile only while it stays above your waist and within your direct line of sight.
A nurse is reviewing a state list of nationally notifiable diseases. Which conditions must the nurse report to public health authorities? Select all that apply.
- A.Active pulmonary tuberculosis
- B.Measles (rubeola)
- C.Seasonal allergic rhinitis
- D.Pertussis (whooping cough)
- E.Iron-deficiency anemia
Show answer & rationaleHide answer & rationale
Correct answers: A, B, D
Notifiable diseases share a common thread: they are communicable, pose a population risk, or trigger outbreak control. Tuberculosis, measles, and pertussis all spread person to person and require contact tracing, isolation, or vaccination response, so each is reportable to public health. Allergic rhinitis and iron-deficiency anemia are non-communicable and carry no outbreak risk, so they are not reported. When deciding, ask whether the condition can spread and whether public health action protects others.
Why the other options are wrong
- C. Allergic rhinitis is non-communicable and poses no population risk, so it is not reportable.
- E. Iron-deficiency anemia does not spread and triggers no public health response.
Key takeaway: Reportable diseases are communicable conditions that require public health action to protect the population.
A nurse is admitting a client who reports a latex allergy that causes hives and wheezing. Before the client arrives on the unit, which action best protects them?
- A.Place the client in a private room and stock it with latex-free supplies
- B.Keep latex gloves available but don them only when out of the room
- C.Schedule the client as the last case of the day for any procedures
- D.Post the allergy on the door and continue using standard supplies
Show answer & rationaleHide answer & rationale
Correct answer: A
Prevention for a latex allergy means removing latex from the environment before exposure can occur. A latex-safe room stocked with latex-free gloves, tubing, and supplies eliminates the trigger proactively. Latex proteins also become airborne from powdered gloves, so simply gloving outside the room does not protect a sensitized client. Scheduling reduces residual airborne latex for surgery but is not the unit admission priority, and continuing standard latex supplies leaves the known trigger in place despite a warning sign.
Why the other options are wrong
- B. Latex proteins go airborne, so wearing the gloves nearby still risks a reaction.
- C. Last-case scheduling helps in the OR but does not address the inpatient room environment.
- D. A warning sign without removing latex leaves the trigger in place.
Key takeaway: Latex allergy management starts with a latex-safe environment, not just warning signage.
A nurse is teaching new staff how to dispose of materials after a dressing change on a draining wound. Which items belong in the red biohazard bag rather than regular trash? Select all that apply.
- A.Gauze saturated with wound drainage that would drip if compressed
- B.An intact, unused gauze pad opened but not contaminated
- C.Gloves visibly soiled with blood and exudate
- D.The empty cardboard box the dressing supplies came in
- E.A blood-soaked abdominal pad removed from the wound
Show answer & rationaleHide answer & rationale
Correct answers: A, C, E
Regulated medical (biohazard) waste is defined by the drip-or-flake test: items saturated or caked with blood or body fluids that could release them when handled go in the red bag. Saturated gauze, visibly soiled gloves, and a blood-soaked abdominal pad all meet that standard. An intact unused pad and a clean cardboard box are not contaminated and go in regular trash, which prevents overfilling costly biohazard streams. Lightly soiled items that would not drip also belong in regular waste.
Why the other options are wrong
- B. An unused, uncontaminated pad is not regulated waste and goes in regular trash.
- D. A clean packaging box never contacted body fluids and is ordinary trash.
Key takeaway: Biohazard bags are for items that would drip or release blood or body fluids when handled.
A nurse uses a validated fall risk tool and scores an older adult as high risk after a syncopal episode. Which interventions are appropriate for this client? Select all that apply.
- A.Place the bed in the lowest position with the brakes locked
- B.Ensure a nonslip call light is within the client's reach
- C.Raise all four side rails to keep the client in bed
- D.Provide nonskid footwear before the client ambulates
- E.Place a bed or chair exit alarm and orient the client to it
Show answer & rationaleHide answer & rationale
Correct answers: A, B, D, E
Fall prevention works by shrinking the distance and barriers between a client and safe help. A low locked bed reduces injury if a fall occurs, a reachable call light brings staff before the client self-mobilizes, nonskid footwear improves traction, and an exit alarm signals unassisted movement. All four lower risk without restraining. Raising all four side rails, however, is a restraint that clients can climb over, increasing fall height and injury, so it is not appropriate.
Why the other options are wrong
- C. Four raised side rails act as a restraint clients climb over, raising fall height and injury risk.
Key takeaway: Fall prevention uses low beds, alarms, footwear, and reachable call lights, not full side rails that act as restraints.