CJE BENCHMARK EXAM 1 PATIENT CARE FUNDAMENTALS TEST BANK 2026/2027
NCLEX-RN COMPREHENSIVE REVIEW QUESTIONS WITH VERIFIED ANSWERS AND
DETAILED RATIONALES
SECTION A: SAFETY AND INFECTION CONTROL (QUESTIONS 1-30)
1. A nurse is caring for a patient with Clostridium difficile infection. Which infection
control precaution is most appropriate?
A. Standard precautions only
B. Droplet precautions
C. Contact precautions
D. Airborne precautions
Answer: C
Rationale: Contact precautions are required for C. difficile due to spore transmission via
contaminated surfaces and hands. Standard precautions alone are insufficient, and
alcohol-based hand sanitizers are ineffective against C. difficile spores, requiring soap and
water hand hygiene.
2. A patient is placed in isolation for active pulmonary tuberculosis. Which personal
protective equipment is essential during aerosol-generating procedures?
A. Surgical mask
B. N95 respirator
C. Face shield
D. Gown and gloves
Answer: B
Rationale: N95 respirator provides filtration of airborne particles (1-5 microns) containing
M. tuberculosis. Surgical masks do not provide adequate seal or filtration for airborne
pathogens. Aerosol-generating procedures increase transmission risk significantly.
,3. A nurse is preparing to administer medications through a patient's nasogastric tube.
Which action demonstrates proper enteral medication administration safety?
A. Crushing all medications regardless of formulation
B. Mixing all medications together in one syringe
C. Flushing tube with 30 mL of water between each medication
D. Administering medications using gravity flow only
Answer: C
Rationale: Flushing with 30 mL water between each medication prevents drug interactions
and tube occlusion. Enteric-coated or sustained-release medications should not be
crushed. Medications should be given separately and water pressure should be
appropriate for tube type.
4. A patient falls while attempting to get out of bed without assistance. What is the
nurse's priority action immediately after ensuring patient safety?
A. Complete an incident report
B. Notify the healthcare provider
C. Assess for injury and vital signs
D. Restrain the patient to prevent future falls
Answer: C
Rationale: Assessment of injury and vital signs is the priority to identify life-threatening
injuries. Incident reports and provider notification follow assessment. Restraints require
provider order and are not appropriate fall prevention.
5. A surgical patient develops a fever of 101.5°F on postoperative day 3 with purulent
wound drainage. Which infection control action should the nurse implement first?
A. Obtain wound culture
B. Administer prescribed antibiotics
C. Implement wound precautions
D. Notify infection control
Answer: A
Rationale: Wound culture identifies causative organism and guides antibiotic selection.
Empirical antibiotics may be started but culture is essential first. Wound precautions are
necessary but not the first priority before diagnostic testing.
6. A nurse is preparing to insert a urinary catheter. Which technique maintains sterile
field integrity?
A. Placing sterile items 2 inches from the field edge
B. Using sterile gloves and clean drapes
C. Opening sterile packages facing away from the body
,D. Changing sterile gloves if they touch the clean drape
Answer: A
Rationale: Sterile items must be kept 1-2 inches from the field edge to maintain sterility.
Both gloves and drapes must be sterile. Sterile packages should be opened away from the
body to prevent contamination from clothing.
7. A nurse is caring for a patient with neutropenia. Which dietary practice is most
important to prevent infection?
A. Serving fresh fruits and vegetables
B. Providing raw seafood
C. Avoiding uncooked foods and fresh produce
D. Offering unpasteurized dairy products
Answer: C
Rationale: Neutropenic patients require low-microbial diets avoiding raw foods. Fresh
produce may harbor pathogens. All foods should be thoroughly cooked and pasteurized
products should be used.
8. A nurse is removing personal protective equipment after caring for a patient in
contact isolation. Which item should be removed first?
A. Gloves
B. Gown
C. Face shield
D. Mask
Answer: A
Rationale: Gloves are most contaminated and should be removed first to prevent
contamination of other PPE and skin. Gown is removed next, followed by face shield and
mask as the cleanest items.
9. A patient on a medical-surgical unit has a pressure injury on the coccyx. Which
preventive measure should the nurse implement?
A. Massage the area around the pressure injury
B. Position patient directly on the injury site
C. Use supportive surfaces and reposition every 2 hours
D. Cleanse the wound with hydrogen peroxide
Answer: C
Rationale: Pressure redistribution surfaces and regular repositioning reduce pressure and
prevent further tissue damage. Massage can cause tissue trauma. Hydrogen peroxide is
cytotoxic to healing tissue.
, 10. A nurse is administering blood products to a patient. Which action is essential
during the infusion?
A. Complete the transfusion within 2 hours
B. Use a blood warmer for all transfusions
C. Remain with the patient for the first 15 minutes
D. Administer through a 22-gauge peripheral IV
Answer: C
Rationale: The first 15 minutes of transfusion carry the highest risk of acute hemolytic
reaction; the nurse must remain present. A 4-hour completion time is standard. Blood
warmer is only for large-volume or rapid transfusions.
11. A patient is receiving continuous tube feeding through a nasogastric tube. Which
intervention minimizes aspiration risk?
A. Elevate head of bed to 15 degrees
B. Check gastric residual volume every 8 hours
C. Maintain head of bed elevation at 30-45 degrees
D. Position patient in supine position during feeding
Answer: C
Rationale: 30-45 degree head elevation reduces aspiration risk in tube-fed patients.
Residual checks vary by facility policy and should be performed as indicated. Supine
position increases reflux and aspiration risk.
12. A nurse observes a colleague performing hand hygiene with alcohol-based
sanitizer. Which action indicates improper technique?
A. Rubbing hands until completely dry
B. Using sanitizer when hands are visibly soiled
C. Applying adequate amount to cover all surfaces
D. Rubbing for 20-30 seconds
Answer: B
Rationale: Alcohol-based sanitizer is ineffective on visibly soiled hands; soap and water
must be used. The other options represent proper technique including appropriate drying
time and application.
13. A patient requires airborne precautions for suspected measles. Which room
assignment is appropriate?
A. Standard private room
B. Negative pressure isolation room
C. Positive pressure room with HEPA filtration
D. Cohort with another measles patient
NCLEX-RN COMPREHENSIVE REVIEW QUESTIONS WITH VERIFIED ANSWERS AND
DETAILED RATIONALES
SECTION A: SAFETY AND INFECTION CONTROL (QUESTIONS 1-30)
1. A nurse is caring for a patient with Clostridium difficile infection. Which infection
control precaution is most appropriate?
A. Standard precautions only
B. Droplet precautions
C. Contact precautions
D. Airborne precautions
Answer: C
Rationale: Contact precautions are required for C. difficile due to spore transmission via
contaminated surfaces and hands. Standard precautions alone are insufficient, and
alcohol-based hand sanitizers are ineffective against C. difficile spores, requiring soap and
water hand hygiene.
2. A patient is placed in isolation for active pulmonary tuberculosis. Which personal
protective equipment is essential during aerosol-generating procedures?
A. Surgical mask
B. N95 respirator
C. Face shield
D. Gown and gloves
Answer: B
Rationale: N95 respirator provides filtration of airborne particles (1-5 microns) containing
M. tuberculosis. Surgical masks do not provide adequate seal or filtration for airborne
pathogens. Aerosol-generating procedures increase transmission risk significantly.
,3. A nurse is preparing to administer medications through a patient's nasogastric tube.
Which action demonstrates proper enteral medication administration safety?
A. Crushing all medications regardless of formulation
B. Mixing all medications together in one syringe
C. Flushing tube with 30 mL of water between each medication
D. Administering medications using gravity flow only
Answer: C
Rationale: Flushing with 30 mL water between each medication prevents drug interactions
and tube occlusion. Enteric-coated or sustained-release medications should not be
crushed. Medications should be given separately and water pressure should be
appropriate for tube type.
4. A patient falls while attempting to get out of bed without assistance. What is the
nurse's priority action immediately after ensuring patient safety?
A. Complete an incident report
B. Notify the healthcare provider
C. Assess for injury and vital signs
D. Restrain the patient to prevent future falls
Answer: C
Rationale: Assessment of injury and vital signs is the priority to identify life-threatening
injuries. Incident reports and provider notification follow assessment. Restraints require
provider order and are not appropriate fall prevention.
5. A surgical patient develops a fever of 101.5°F on postoperative day 3 with purulent
wound drainage. Which infection control action should the nurse implement first?
A. Obtain wound culture
B. Administer prescribed antibiotics
C. Implement wound precautions
D. Notify infection control
Answer: A
Rationale: Wound culture identifies causative organism and guides antibiotic selection.
Empirical antibiotics may be started but culture is essential first. Wound precautions are
necessary but not the first priority before diagnostic testing.
6. A nurse is preparing to insert a urinary catheter. Which technique maintains sterile
field integrity?
A. Placing sterile items 2 inches from the field edge
B. Using sterile gloves and clean drapes
C. Opening sterile packages facing away from the body
,D. Changing sterile gloves if they touch the clean drape
Answer: A
Rationale: Sterile items must be kept 1-2 inches from the field edge to maintain sterility.
Both gloves and drapes must be sterile. Sterile packages should be opened away from the
body to prevent contamination from clothing.
7. A nurse is caring for a patient with neutropenia. Which dietary practice is most
important to prevent infection?
A. Serving fresh fruits and vegetables
B. Providing raw seafood
C. Avoiding uncooked foods and fresh produce
D. Offering unpasteurized dairy products
Answer: C
Rationale: Neutropenic patients require low-microbial diets avoiding raw foods. Fresh
produce may harbor pathogens. All foods should be thoroughly cooked and pasteurized
products should be used.
8. A nurse is removing personal protective equipment after caring for a patient in
contact isolation. Which item should be removed first?
A. Gloves
B. Gown
C. Face shield
D. Mask
Answer: A
Rationale: Gloves are most contaminated and should be removed first to prevent
contamination of other PPE and skin. Gown is removed next, followed by face shield and
mask as the cleanest items.
9. A patient on a medical-surgical unit has a pressure injury on the coccyx. Which
preventive measure should the nurse implement?
A. Massage the area around the pressure injury
B. Position patient directly on the injury site
C. Use supportive surfaces and reposition every 2 hours
D. Cleanse the wound with hydrogen peroxide
Answer: C
Rationale: Pressure redistribution surfaces and regular repositioning reduce pressure and
prevent further tissue damage. Massage can cause tissue trauma. Hydrogen peroxide is
cytotoxic to healing tissue.
, 10. A nurse is administering blood products to a patient. Which action is essential
during the infusion?
A. Complete the transfusion within 2 hours
B. Use a blood warmer for all transfusions
C. Remain with the patient for the first 15 minutes
D. Administer through a 22-gauge peripheral IV
Answer: C
Rationale: The first 15 minutes of transfusion carry the highest risk of acute hemolytic
reaction; the nurse must remain present. A 4-hour completion time is standard. Blood
warmer is only for large-volume or rapid transfusions.
11. A patient is receiving continuous tube feeding through a nasogastric tube. Which
intervention minimizes aspiration risk?
A. Elevate head of bed to 15 degrees
B. Check gastric residual volume every 8 hours
C. Maintain head of bed elevation at 30-45 degrees
D. Position patient in supine position during feeding
Answer: C
Rationale: 30-45 degree head elevation reduces aspiration risk in tube-fed patients.
Residual checks vary by facility policy and should be performed as indicated. Supine
position increases reflux and aspiration risk.
12. A nurse observes a colleague performing hand hygiene with alcohol-based
sanitizer. Which action indicates improper technique?
A. Rubbing hands until completely dry
B. Using sanitizer when hands are visibly soiled
C. Applying adequate amount to cover all surfaces
D. Rubbing for 20-30 seconds
Answer: B
Rationale: Alcohol-based sanitizer is ineffective on visibly soiled hands; soap and water
must be used. The other options represent proper technique including appropriate drying
time and application.
13. A patient requires airborne precautions for suspected measles. Which room
assignment is appropriate?
A. Standard private room
B. Negative pressure isolation room
C. Positive pressure room with HEPA filtration
D. Cohort with another measles patient
