Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — PPE sequencing (donning)
A nurse is preparing to enter the room of a client on contact
precautions for a draining wound. What is the correct sequence
for donning PPE before entering the room?
A. Gloves → Gown → Mask → Goggles
B. Mask → Goggles → Gown → Gloves
C. Gown → Mask → Gloves → Goggles
D. Gown → Gloves → Mask → Goggles
Answer: B
Rationale:
Evidence-based standard: donning sequence is typically mask
(or respirator) → goggles/face shield → gown → gloves (CDC).
Correct sequence prevents contaminating inner PPE or skin.
CJMM: Recognize cues (client on contact precautions); Generate
solutions (apply recommended donning sequence); Take action
(don mask first to secure respiratory protection).
,2 — PPE sequencing (doffing)
After providing care to the same client with contact precautions
and returning to the anteroom, which doffing step reduces self-
contamination risk?
A. Remove gloves, then gown, then goggles, then mask.
B. Remove gown, then gloves, then goggles, then mask.
C. Remove gloves, then goggles, then gown, then mask.
D. Remove gown and gloves together, then goggles, then mask.
Answer: D
Rationale:
Best practice: remove the most contaminated items first (gloves
and gown together if possible, rolling them inside out), then
face protection, then mask/respirator last — to avoid
contaminating face/hands (CDC). CJMM: Analyze cues (soiled
PPE); Prioritize hypothesis (prevent self-contamination); Take
action (doff in correct order).
3 — Isolation precautions matching
Which isolation precaution is required for a client with
suspected pulmonary tuberculosis?
A. Contact precautions with gloves and gown.
B. Droplet precautions with surgical mask.
C. Airborne precautions with N95 or higher respirator.
D. Reverse isolation (protective environment).
,Answer: C
Rationale:
Pulmonary TB is transmitted by airborne droplet nuclei;
airborne precautions require a fit-tested N95 (or higher)
respirator and negative-pressure room. CJMM: Recognize cues
(suspected airborne pathogen); Generate solutions (airborne
isolation). Evidence-based fundamentals: CDC airborne
precautions for TB.
4 — Hand hygiene technique
Which action best demonstrates proper hand hygiene when
hands are visibly soiled after caring for a client with diarrhea?
A. Use alcohol-based hand rub for 15 seconds.
B. Wash with soap and water for at least 20 seconds.
C. Wipe hands with a sanitizing wipe.
D. Use alcohol-based hand rub for 5–10 seconds.
Answer: B
Rationale:
When hands are visibly soiled (or after caring for patients with
diarrhea/C. difficile), soap and water for at least 20 seconds is
required because alcohol rubs are less effective against some
spores/soil. CJMM: Recognize cues (visibly soiled); Take action
(soap & water). Evidence-based: WHO/CDC hand hygiene
guidance.
, 5 — Isolation signage and visitors
A client is on droplet precautions for influenza. Which
instruction should the nurse give to visitors?
A. No visitors allowed under any circumstances.
B. Visitors must wear an N95 respirator and gown.
C. Visitors should wear a surgical mask within 3–6 ft of the
client.
D. Visitors must wear gloves only when touching the client.
Answer: C
Rationale:
Droplet precautions require surgical masks when within close
contact (generally within ~3–6 feet). N95 is not routinely
required for droplet pathogens. CJMM: Recognize cues (droplet
pathogen); Generate solutions (visitor mask within proximate
distance). Evidence-based fundamentals: droplet precautions.
6 — Bathing & skin inspection
While giving a bed bath, the nurse finds a reddened area over
the sacrum that does not blanch. Which action is highest
priority?
A. Document the finding and continue the bath.
B. Reposition the client and perform a focused skin assessment.
C. Apply lotion and finish hygiene care.
D. Notify housekeeping to schedule a pressure-relief mattress.
Answer: B
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — PPE sequencing (donning)
A nurse is preparing to enter the room of a client on contact
precautions for a draining wound. What is the correct sequence
for donning PPE before entering the room?
A. Gloves → Gown → Mask → Goggles
B. Mask → Goggles → Gown → Gloves
C. Gown → Mask → Gloves → Goggles
D. Gown → Gloves → Mask → Goggles
Answer: B
Rationale:
Evidence-based standard: donning sequence is typically mask
(or respirator) → goggles/face shield → gown → gloves (CDC).
Correct sequence prevents contaminating inner PPE or skin.
CJMM: Recognize cues (client on contact precautions); Generate
solutions (apply recommended donning sequence); Take action
(don mask first to secure respiratory protection).
,2 — PPE sequencing (doffing)
After providing care to the same client with contact precautions
and returning to the anteroom, which doffing step reduces self-
contamination risk?
A. Remove gloves, then gown, then goggles, then mask.
B. Remove gown, then gloves, then goggles, then mask.
C. Remove gloves, then goggles, then gown, then mask.
D. Remove gown and gloves together, then goggles, then mask.
Answer: D
Rationale:
Best practice: remove the most contaminated items first (gloves
and gown together if possible, rolling them inside out), then
face protection, then mask/respirator last — to avoid
contaminating face/hands (CDC). CJMM: Analyze cues (soiled
PPE); Prioritize hypothesis (prevent self-contamination); Take
action (doff in correct order).
3 — Isolation precautions matching
Which isolation precaution is required for a client with
suspected pulmonary tuberculosis?
A. Contact precautions with gloves and gown.
B. Droplet precautions with surgical mask.
C. Airborne precautions with N95 or higher respirator.
D. Reverse isolation (protective environment).
,Answer: C
Rationale:
Pulmonary TB is transmitted by airborne droplet nuclei;
airborne precautions require a fit-tested N95 (or higher)
respirator and negative-pressure room. CJMM: Recognize cues
(suspected airborne pathogen); Generate solutions (airborne
isolation). Evidence-based fundamentals: CDC airborne
precautions for TB.
4 — Hand hygiene technique
Which action best demonstrates proper hand hygiene when
hands are visibly soiled after caring for a client with diarrhea?
A. Use alcohol-based hand rub for 15 seconds.
B. Wash with soap and water for at least 20 seconds.
C. Wipe hands with a sanitizing wipe.
D. Use alcohol-based hand rub for 5–10 seconds.
Answer: B
Rationale:
When hands are visibly soiled (or after caring for patients with
diarrhea/C. difficile), soap and water for at least 20 seconds is
required because alcohol rubs are less effective against some
spores/soil. CJMM: Recognize cues (visibly soiled); Take action
(soap & water). Evidence-based: WHO/CDC hand hygiene
guidance.
, 5 — Isolation signage and visitors
A client is on droplet precautions for influenza. Which
instruction should the nurse give to visitors?
A. No visitors allowed under any circumstances.
B. Visitors must wear an N95 respirator and gown.
C. Visitors should wear a surgical mask within 3–6 ft of the
client.
D. Visitors must wear gloves only when touching the client.
Answer: C
Rationale:
Droplet precautions require surgical masks when within close
contact (generally within ~3–6 feet). N95 is not routinely
required for droplet pathogens. CJMM: Recognize cues (droplet
pathogen); Generate solutions (visitor mask within proximate
distance). Evidence-based fundamentals: droplet precautions.
6 — Bathing & skin inspection
While giving a bed bath, the nurse finds a reddened area over
the sacrum that does not blanch. Which action is highest
priority?
A. Document the finding and continue the bath.
B. Reposition the client and perform a focused skin assessment.
C. Apply lotion and finish hygiene care.
D. Notify housekeeping to schedule a pressure-relief mattress.
Answer: B
