Practice Safety & Infection Control questions for the National Council Licensure Examination — RN. Every question includes a full explanation of why the correct answer is right and why the tempting distractors are wrong.
54 questions available · easy difficulty · NCLEX-RN · Free, no registration required
10 example questions with full explanations. Use the interactive practice above to work through the complete set.
Question 1easy
Alcohol-based hand gel is the recommended hand hygiene method when caring for a patient diagnosed with Clostridioides difficile (C. diff) infection.
Correct answer: B
This statement is FALSE. Alcohol-based hand gels are NOT effective against C. difficile spores because alcohol does not kill spores. Soap and water handwashing is required when caring for patients with C. diff because the mechanical scrubbing action physically removes the spores from the hands. This is a critical exception to the general preference for alcohol-based hand rub.
Question 2easy
A nurse caring for a patient on airborne precautions for active tuberculosis (TB) must wear an N95 respirator mask before entering the patient's room.
Correct answer: A
This statement is TRUE. Airborne precautions require the use of a fit-tested N95 respirator (or higher level of respiratory protection) because TB is transmitted by small airborne droplet nuclei that remain suspended in the air. A standard surgical mask is insufficient for airborne precautions. The patient should also be placed in a negative-pressure airborne infection isolation room to prevent infectious particles from escaping into the hallway.
Question 3easy
Used needles and syringes should be recapped by hand and then placed into a sharps disposal container to prevent accidental needlestick injuries.
Correct answer: B
This statement is FALSE. Recapping needles by hand is prohibited under OSHA bloodborne pathogen standards because it is a leading cause of needlestick injuries. Used needles should be disposed of immediately and directly into an approved, puncture-resistant sharps container without recapping. If recapping is absolutely necessary in rare circumstances, a one-handed scoop technique or a mechanical device must be used. Needlestick injuries can transmit bloodborne pathogens such as HIV and hepatitis B and C.
Question 4hard
A nurse is caring for a patient admitted with suspected bacterial meningitis who is placed on droplet precautions. The patient's roommate, who has been in the room for 6 hours, is now being transferred to another unit. Which action by the nurse is most appropriate regarding the roommate?
- A.Administer prophylactic antibiotics to the roommate before transfer per standing nursing protocol.
- B.No action is required because the roommate was never within 3 feet of the infected patient.
- C.Place the roommate on airborne precautions at the receiving unit because bacterial meningitis spreads via the airborne route.
- D.Notify the receiving unit and document potential exposure, as droplet transmission requires close contact but the exposure window is clinically significant.✓
Correct answer: D
Droplet precautions apply within approximately 3 feet of the patient, and a 6-hour shared room exposure represents a clinically significant contact event. The nurse's priority is communication — notifying the receiving unit and documenting the exposure ensures the interdisciplinary team (including the physician) can evaluate the need for prophylaxis (e.g., rifampin or ciprofloxacin for Neisseria meningitidis). Option B is incorrect because sharing a room for hours inherently places patients within close-contact range at various points. Option C is wrong because bacterial meningitis spreads via respiratory droplets, not the airborne route; airborne precautions are not indicated. Option A is incorrect because nurses cannot independently administer prophylactic antibiotics without a physician order; this is outside independent nursing scope.
Question 5hard
A nurse is inserting an indwelling urinary catheter using sterile technique. After opening the sterile field and donning sterile gloves, the nurse accidentally touches the sterile drape with the back of an ungloved wrist while reaching for the catheter. Which action should the nurse take next?
- A.Discard the contaminated drape and supplies, obtain a new catheter kit, perform hand hygiene, and restart the procedure.✓
- B.Apply a sterile glove to the wrist that made contact and proceed with the catheter insertion.
- C.Continue the procedure because the back of the wrist is considered a clean area and did not contaminate the sterile field.
- D.Wipe the sterile drape with a chlorhexidine swab to decontaminate the touched area, then continue the procedure.
Correct answer: A
In surgical asepsis, any sterile item or field that contacts a non-sterile surface — including ungloved skin, regardless of how 'clean' it appears — is considered contaminated and must be discarded. The nurse must obtain a new catheter kit, perform hand hygiene, and begin the procedure again to prevent catheter-associated urinary tract infection (CAUTI). Option C is incorrect because ungloved skin is always considered non-sterile; there is no concept of a 'clean ungloved area' in surgical asepsis. Option B is incorrect because gloves cannot retroactively sterilize a contaminated drape. Option D is incorrect because chlorhexidine swabs do not restore sterility to a field; once contaminated, the entire sterile setup is compromised.
Question 6hard
A nurse is caring for a patient in soft wrist restraints following an attempted self-extubation. It has been 2 hours since the restraints were last assessed. The patient is now calm and cooperative but remains intubated. Which sequence of actions reflects correct restraint management?
- A.Tighten the restraints to prevent further movement, obtain a new physician order, and reassess in 4 hours.
- B.Release one restraint at a time, assess neurovascular status and skin integrity, perform passive range of motion, reapply if clinically indicated, and document findings.✓
- C.Release the restraints and perform active range of motion exercises, then reapply both restraints simultaneously without reassessing the continued need.
- D.Remove the restraints permanently since the patient is now calm, and document the behavior change in the chart.
Correct answer: B
Restraint protocols require release every 2 hours to assess circulation, skin integrity, and comfort, and to provide range of motion exercises (typically passive for an intubated patient). The nurse must also reassess and document the continued clinical need for restraints and ensure a current physician order is in place. Option B is incorrect because the patient remains intubated and at risk for self-extubation; removal requires physician evaluation and a documented change in clinical status, not nursing judgment alone. Option A is incorrect because tightening restraints worsens neurovascular risk, and reassessment intervals must remain every 2 hours, not every 4. Option D is incorrect because active range of motion is inappropriate for an intubated, mechanically ventilated patient, and reapplying without reassessing need violates the least-restraint principle.
Question 7hard
A nurse working in an oncology unit is preparing to administer intravenous cyclophosphamide (a cytotoxic chemotherapy agent) to a patient. The nurse notices a small amount of the drug has leaked onto the IV tubing during priming. Which intervention is the nurse's priority?
- A.Wipe the spill with a standard alcohol wipe, discard the wipe in the regular trash, and proceed with administration.
- B.Notify the pharmacist and wait for instructions before touching any contaminated materials.
- C.Don double chemotherapy gloves, use the cytotoxic spill kit to absorb and decontaminate the spill, dispose of all materials in a hazardous waste container, and obtain new tubing before proceeding.✓
- D.Don single latex gloves and wipe the tubing with a bleach solution, then continue with the primed tubing to avoid wasting the medication.
Correct answer: C
Cytotoxic/hazardous drug spills require use of the facility's cytotoxic spill kit, which contains specialized absorbent materials, double chemotherapy-rated gloves, a gown, eye protection, and hazardous waste disposal bags. All contaminated materials including the tubing must be discarded in clearly labeled hazardous (chemotherapy) waste containers — never regular trash. New tubing must be obtained before administration to protect the patient and staff. Option A is incorrect because alcohol wipes are not appropriate for cytotoxic decontamination and regular trash disposal violates OSHA hazardous material standards. Option D is incorrect because single latex gloves provide insufficient protection against cytotoxic permeation, and the contaminated tubing must be discarded, not reused. Option B is incorrect because while pharmacist consultation may follow, the immediate priority is safe containment of the hazardous spill by the nurse using the spill kit.
Question 8medium
A nurse is caring for a patient with methicillin-resistant Staphylococcus aureus (MRSA) in a wound. After removing gloves and a gown upon leaving the room, the nurse uses an alcohol-based hand sanitizer. This action is appropriate and consistent with contact precaution guidelines.
Correct answer: A
Unlike C. difficile (which requires soap and water because alcohol is ineffective against its spores), MRSA does not form spores, so alcohol-based hand sanitizers are effective and appropriate for hand hygiene after contact precaution care. The nurse correctly removed PPE before exiting the room and followed with hand hygiene using an alcohol-based product, which is consistent with both standard precautions and contact precaution guidelines for MRSA. This question requires integrating knowledge of contact precautions with the specific limitation of alcohol gel — a limitation that applies only to spore-forming organisms like C. diff, not to MRSA.
Question 9medium
A nurse responding to a fire on the medical-surgical unit discovers a small, contained flame in a patient's room. According to the RACE protocol, the nurse's first priority action is to activate the fire alarm before attempting to move the patient.
Correct answer: B
According to the RACE fire safety protocol, the correct sequence is: Rescue (remove patients in immediate danger), Activate the alarm, Contain the fire (close doors and windows), and Extinguish or Evacuate. The nurse's first priority is to Rescue — meaning any patient in immediate danger must be moved to safety before activating the alarm. While activating the alarm is critical and must occur promptly, it is the second step, not the first. This question requires integrating the sequential nature of RACE with the prioritization principle that patient safety comes before procedural steps.
Question 10medium
A pregnant nurse is assigned to care for a patient who received a permanent radioactive seed implant (brachytherapy) for prostate cancer. It is safe for the pregnant nurse to provide routine care to this patient as long as she wears a lead apron during all interactions.
Correct answer: B
Pregnant nurses should not be assigned to care for patients with internal radiation implants (brachytherapy) because the fetus is highly sensitive to ionizing radiation and no level of exposure is considered entirely safe during pregnancy. A lead apron does not provide adequate protection from all angles of radiation emitted by an internal implant, and radiation safety principles emphasize time, distance, and shielding — with reassignment being the safest approach for the pregnant nurse. The three principles of radiation safety (minimize time, maximize distance, use shielding) are all relevant here, but the safest action when pregnant is reassignment rather than relying solely on a lead apron.