ECPI 164 Exam 2 Prep 2026 | 200 Practice Questions with
Answers & Explanations | Study Guide
SECTION A: PATIENT SAFETY & INFECTION CONTROL (Questions 1–40)
1. A nurse is caring for a client with a Clostridioides difficile infection. Which hand hygiene method is
most effective?
A. Wash hands with soap and water for at least 15 seconds
B. Use alcohol-based hand sanitizer before and after contact
C. Wear gloves and wash with alcohol-based rub
D. Use chlorhexidine wipes only
Answer: A
Explanation: Alcohol-based sanitizers do not kill C. diff spores; soap and water mechanically remove
spores.
2. A client is placed on contact precautions. Which personal protective equipment (PPE) must the nurse
wear when entering the room?
A. Gown and gloves
B. N95 respirator and gown
C. Surgical mask and gloves
D. Gloves only
Answer: A
Explanation: Contact precautions require gown and gloves; mask is not needed unless splashes
expected.
3. A nurse is preparing to insert a urinary catheter. Which action demonstrates sterile technique?
A. Open the sterile kit away from the body, keeping the inner surface facing up
B. Place the sterile field on a wet surface to prevent sliding
C. Use non-sterile gloves to handle the catheter
,D. Pour sterile solution onto the field from a height of 12 inches
Answer: A
Explanation: Opening the kit away from the body maintains sterility; wet surfaces contaminate; sterile
gloves required.
4. A client is diagnosed with tuberculosis. Which type of isolation is required?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Protective environment
Answer: A
Explanation: TB requires airborne precautions (negative pressure room, N95 respirator).
5. A nurse is performing hand hygiene. How long should the nurse rub hands together when using
alcohol-based hand sanitizer?
A. Until hands are dry (about 20 seconds)
B. 5 seconds
C. 30 seconds with friction
D. 1 minute
Answer: A
Explanation: Hands should be rubbed until dry, typically 15-20 seconds; alcohol-based sanitizer is not
rinsed.
6. A client with a wound infection is placed on contact precautions. Which instruction should the nurse
give to visitors?
A. Wear a gown and gloves when entering the room
B. No special precautions are needed
C. Wear a surgical mask at all times
D. Wash hands with alcohol-based sanitizer only
Answer: A
,Explanation: Contact precautions require visitors to wear gown and gloves; hand hygiene with soap and
water is preferred.
7. A nurse is caring for a client with a central line. Which action is most important to prevent catheter-
related bloodstream infection?
A. Use maximal sterile barrier precautions during insertion
B. Change the dressing every 7 days
C. Flush the line with 10 mL of sterile water daily
D. Apply topical antibiotic ointment at the insertion site
Answer: A
Explanation: Maximal sterile barriers (cap, mask, sterile gown, gloves, large drape) reduce infection risk
during insertion.
8. A nurse is preparing to administer an intramuscular injection. Which site is preferred for a viscous
medication in an adult?
A. Ventrogluteal
B. Deltoid
C. Vastus lateralis
D. Dorsogluteal
Answer: A
Explanation: Ventrogluteal is preferred for IM injections in adults; it has no major nerves or vessels and
can accommodate larger volumes.
9. A client is on fall precautions. Which intervention is most important?
A. Keep the call light within reach and bed in low position
B. Raise all four side rails
C. Apply wrist restraints at night
D. Keep the room dark to promote sleep
Answer: A
Explanation: Call light accessibility and low bed position reduce fall risk; side rails may increase injury if
patient climbs over.
, 10. A nurse is assessing a client who has a new onset of confusion. Which is the priority action?
A. Check the client’s oxygen saturation and blood glucose
B. Notify the provider immediately
C. Administer a sedative as needed
D. Restrain the client to prevent injury
Answer: A
Explanation: New confusion may be due to hypoxia or hypoglycemia; assess these first before notifying
provider.
11. A nurse is applying a restraint to a client. Which action is correct?
A. Tie the restraint with a quick-release knot to the bed frame
B. Tie the restraint to the side rail
C. Apply the restraint tightly to prevent movement
D. Leave the restraint on for 24 hours before reassessing
Answer: A
Explanation: Restraints must be tied to a non-moving part of the bed frame with a quick-release knot;
never to side rails.
12. A client is receiving a blood transfusion. Which finding indicates a febrile non-hemolytic transfusion
reaction?
A. Temperature rise of 2°F (1°C) and chills within 1 hour of starting transfusion
B. Hypotension and back pain
C. Hives and itching
D. Respiratory distress and wheezing
Answer: A
Explanation: Febrile reaction presents with fever and chills without hemolysis; usually due to antibodies
against donor WBCs.
Answers & Explanations | Study Guide
SECTION A: PATIENT SAFETY & INFECTION CONTROL (Questions 1–40)
1. A nurse is caring for a client with a Clostridioides difficile infection. Which hand hygiene method is
most effective?
A. Wash hands with soap and water for at least 15 seconds
B. Use alcohol-based hand sanitizer before and after contact
C. Wear gloves and wash with alcohol-based rub
D. Use chlorhexidine wipes only
Answer: A
Explanation: Alcohol-based sanitizers do not kill C. diff spores; soap and water mechanically remove
spores.
2. A client is placed on contact precautions. Which personal protective equipment (PPE) must the nurse
wear when entering the room?
A. Gown and gloves
B. N95 respirator and gown
C. Surgical mask and gloves
D. Gloves only
Answer: A
Explanation: Contact precautions require gown and gloves; mask is not needed unless splashes
expected.
3. A nurse is preparing to insert a urinary catheter. Which action demonstrates sterile technique?
A. Open the sterile kit away from the body, keeping the inner surface facing up
B. Place the sterile field on a wet surface to prevent sliding
C. Use non-sterile gloves to handle the catheter
,D. Pour sterile solution onto the field from a height of 12 inches
Answer: A
Explanation: Opening the kit away from the body maintains sterility; wet surfaces contaminate; sterile
gloves required.
4. A client is diagnosed with tuberculosis. Which type of isolation is required?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Protective environment
Answer: A
Explanation: TB requires airborne precautions (negative pressure room, N95 respirator).
5. A nurse is performing hand hygiene. How long should the nurse rub hands together when using
alcohol-based hand sanitizer?
A. Until hands are dry (about 20 seconds)
B. 5 seconds
C. 30 seconds with friction
D. 1 minute
Answer: A
Explanation: Hands should be rubbed until dry, typically 15-20 seconds; alcohol-based sanitizer is not
rinsed.
6. A client with a wound infection is placed on contact precautions. Which instruction should the nurse
give to visitors?
A. Wear a gown and gloves when entering the room
B. No special precautions are needed
C. Wear a surgical mask at all times
D. Wash hands with alcohol-based sanitizer only
Answer: A
,Explanation: Contact precautions require visitors to wear gown and gloves; hand hygiene with soap and
water is preferred.
7. A nurse is caring for a client with a central line. Which action is most important to prevent catheter-
related bloodstream infection?
A. Use maximal sterile barrier precautions during insertion
B. Change the dressing every 7 days
C. Flush the line with 10 mL of sterile water daily
D. Apply topical antibiotic ointment at the insertion site
Answer: A
Explanation: Maximal sterile barriers (cap, mask, sterile gown, gloves, large drape) reduce infection risk
during insertion.
8. A nurse is preparing to administer an intramuscular injection. Which site is preferred for a viscous
medication in an adult?
A. Ventrogluteal
B. Deltoid
C. Vastus lateralis
D. Dorsogluteal
Answer: A
Explanation: Ventrogluteal is preferred for IM injections in adults; it has no major nerves or vessels and
can accommodate larger volumes.
9. A client is on fall precautions. Which intervention is most important?
A. Keep the call light within reach and bed in low position
B. Raise all four side rails
C. Apply wrist restraints at night
D. Keep the room dark to promote sleep
Answer: A
Explanation: Call light accessibility and low bed position reduce fall risk; side rails may increase injury if
patient climbs over.
, 10. A nurse is assessing a client who has a new onset of confusion. Which is the priority action?
A. Check the client’s oxygen saturation and blood glucose
B. Notify the provider immediately
C. Administer a sedative as needed
D. Restrain the client to prevent injury
Answer: A
Explanation: New confusion may be due to hypoxia or hypoglycemia; assess these first before notifying
provider.
11. A nurse is applying a restraint to a client. Which action is correct?
A. Tie the restraint with a quick-release knot to the bed frame
B. Tie the restraint to the side rail
C. Apply the restraint tightly to prevent movement
D. Leave the restraint on for 24 hours before reassessing
Answer: A
Explanation: Restraints must be tied to a non-moving part of the bed frame with a quick-release knot;
never to side rails.
12. A client is receiving a blood transfusion. Which finding indicates a febrile non-hemolytic transfusion
reaction?
A. Temperature rise of 2°F (1°C) and chills within 1 hour of starting transfusion
B. Hypotension and back pain
C. Hives and itching
D. Respiratory distress and wheezing
Answer: A
Explanation: Febrile reaction presents with fever and chills without hemolysis; usually due to antibodies
against donor WBCs.
