NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
Question 1 — Infection control: C. difficile vs general hand
hygiene
Scenario / Recognize cues: A 76-year-old patient on the
medical unit has new watery diarrhea and a positive C. difficile
stool PCR 30 minutes after a bedside wound dressing change.
You have alcohol-based hand rub available and a nearby sink.
Analyze: C. difficile spores resist alcohol; risk of transmission.
Question / Decide: What is the best immediate hand hygiene
action after finishing the dressing change?
A. Use alcohol-based hand rub for 20 seconds.
B. Wash hands with soap and water at the sink.
C. Put on a fresh pair of gloves and continue care.
D. Use hand sanitizer followed by a quick rinse.
E. Wipe hands with an antiseptic towelette.
Correct answer: B
Act: Perform soap-and-water handwashing (20 seconds) at the
sink; follow contact precautions.
Evaluate: Confirm hands are visibly clean, no residue; ensure
transmission risk minimized.
,Rationales:
A — Incorrect. Alcohol sanitizers do not reliably remove C.
difficile spores.
B — Correct. Soap and water physically remove spores;
recommended for C. difficile.
C — Incorrect. Gloves are protective during task but do not
replace handwashing after glove removal.
D — Incorrect. Using sanitizer then rinsing is not evidence-
based for spore removal; soap & water is required.
E — Incorrect. Antiseptic towelettes generally contain alcohol
or chlorhexidine; not sufficient for spores.
Question 2 — Correct doffing sequence to avoid
contamination
Scenario / Recognize cues: You finish caring for a patient on
contact precautions wearing gown, gloves, goggles, and a mask.
You must remove PPE without self-contamination.
Analyze: Doffing sequence matters to limit self-contamination.
Question / Decide: Which is the safest next step to begin PPE
removal?
A. Remove mask first.
B. Remove gown first.
C. Remove goggles first.
D. Remove gloves first.
E. Untie gown and step out, then remove gloves.
,Correct answer: D
Act: Remove gloves first (gloves are most contaminated), then
gown, goggles, mask per facility protocol.
Evaluate: Hands remain uncontaminated; perform hand
hygiene immediately after doffing.
Rationales:
A — Incorrect. Mask removal first risks contaminating face if
hands or gloves are contaminated.
B — Incorrect. Gown is likely contaminated; removing before
gloves risks contaminating hands and forearms.
C — Incorrect. Goggles removal is okay later, but gloves should
be removed first.
D — Correct. Gloves are typically removed first to avoid
touching contaminated surfaces with bare hands.
E — Incorrect. Stepping out with gown untied may drag
contaminants; safe doffing follows a controlled sequence.
Question 3 — Fall-risk prevention (safety priority)
Scenario / Recognize cues: An 82-year-old with mild dementia,
recent orthostatic hypotension, and a history of two falls is
ambulating to the bathroom alone but looks unsteady.
Analyze: High fall risk; immediate safety measures needed.
Question / Decide: Which immediate action best reduces fall
risk?
, A. Apply a waist restraint for short term.
B. Ask the patient to wait while you get a walker and assistance.
C. Tell the patient to hold the bedrail on the way to the
bathroom.
D. Lower the bed and lock the wheels, place non-skid socks on
the patient, and call for assistance.
E. Allow the patient to go unassisted to maintain independence.
Correct answer: D
Act: Make environment safe, provide immediate assistance or a
staff sitter, ensure call light & alarm within reach.
Evaluate: Patient completes transfer without falling; reassess
mobility plan.
Rationales:
A — Incorrect. Restraints are last resort (and often
contraindicated) and require order + frequent monitoring.
B — Partially correct but incomplete. Getting a walker is helpful
but urgent environmental safety and immediate help are higher
priority.
C — Incorrect. Bedrails are not a safe substitute for assistance
during ambulation.
D — Correct. Combining environmental modifications (bed low,
wheels locked), non-skid socks, and prompt assistance reduces
immediate risk.
E — Incorrect. Allowing unassisted ambulation places patient at
high risk for fall.
Single-Best-Answer Questions
Question 1 — Infection control: C. difficile vs general hand
hygiene
Scenario / Recognize cues: A 76-year-old patient on the
medical unit has new watery diarrhea and a positive C. difficile
stool PCR 30 minutes after a bedside wound dressing change.
You have alcohol-based hand rub available and a nearby sink.
Analyze: C. difficile spores resist alcohol; risk of transmission.
Question / Decide: What is the best immediate hand hygiene
action after finishing the dressing change?
A. Use alcohol-based hand rub for 20 seconds.
B. Wash hands with soap and water at the sink.
C. Put on a fresh pair of gloves and continue care.
D. Use hand sanitizer followed by a quick rinse.
E. Wipe hands with an antiseptic towelette.
Correct answer: B
Act: Perform soap-and-water handwashing (20 seconds) at the
sink; follow contact precautions.
Evaluate: Confirm hands are visibly clean, no residue; ensure
transmission risk minimized.
,Rationales:
A — Incorrect. Alcohol sanitizers do not reliably remove C.
difficile spores.
B — Correct. Soap and water physically remove spores;
recommended for C. difficile.
C — Incorrect. Gloves are protective during task but do not
replace handwashing after glove removal.
D — Incorrect. Using sanitizer then rinsing is not evidence-
based for spore removal; soap & water is required.
E — Incorrect. Antiseptic towelettes generally contain alcohol
or chlorhexidine; not sufficient for spores.
Question 2 — Correct doffing sequence to avoid
contamination
Scenario / Recognize cues: You finish caring for a patient on
contact precautions wearing gown, gloves, goggles, and a mask.
You must remove PPE without self-contamination.
Analyze: Doffing sequence matters to limit self-contamination.
Question / Decide: Which is the safest next step to begin PPE
removal?
A. Remove mask first.
B. Remove gown first.
C. Remove goggles first.
D. Remove gloves first.
E. Untie gown and step out, then remove gloves.
,Correct answer: D
Act: Remove gloves first (gloves are most contaminated), then
gown, goggles, mask per facility protocol.
Evaluate: Hands remain uncontaminated; perform hand
hygiene immediately after doffing.
Rationales:
A — Incorrect. Mask removal first risks contaminating face if
hands or gloves are contaminated.
B — Incorrect. Gown is likely contaminated; removing before
gloves risks contaminating hands and forearms.
C — Incorrect. Goggles removal is okay later, but gloves should
be removed first.
D — Correct. Gloves are typically removed first to avoid
touching contaminated surfaces with bare hands.
E — Incorrect. Stepping out with gown untied may drag
contaminants; safe doffing follows a controlled sequence.
Question 3 — Fall-risk prevention (safety priority)
Scenario / Recognize cues: An 82-year-old with mild dementia,
recent orthostatic hypotension, and a history of two falls is
ambulating to the bathroom alone but looks unsteady.
Analyze: High fall risk; immediate safety measures needed.
Question / Decide: Which immediate action best reduces fall
risk?
, A. Apply a waist restraint for short term.
B. Ask the patient to wait while you get a walker and assistance.
C. Tell the patient to hold the bedrail on the way to the
bathroom.
D. Lower the bed and lock the wheels, place non-skid socks on
the patient, and call for assistance.
E. Allow the patient to go unassisted to maintain independence.
Correct answer: D
Act: Make environment safe, provide immediate assistance or a
staff sitter, ensure call light & alarm within reach.
Evaluate: Patient completes transfer without falling; reassess
mobility plan.
Rationales:
A — Incorrect. Restraints are last resort (and often
contraindicated) and require order + frequent monitoring.
B — Partially correct but incomplete. Getting a walker is helpful
but urgent environmental safety and immediate help are higher
priority.
C — Incorrect. Bedrails are not a safe substitute for assistance
during ambulation.
D — Correct. Combining environmental modifications (bed low,
wheels locked), non-skid socks, and prompt assistance reduces
immediate risk.
E — Incorrect. Allowing unassisted ambulation places patient at
high risk for fall.
