NCLEX RN Safety & Infection Control
Practice Exam 3 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
A client with a suspected Clostridioides difficile infection is admitted to the
medical surgical unit. Which isolation precaution should the nurse implement
first?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
Rationale: Clostridioides difficile is transmitted via the fecal-oral route through
contact with contaminated surfaces or spores. Contact precautions, which
include the use of gloves and gowns for all patient contact, are essential to
prevent the spread of spores to other patients and the environment. Standard
precautions are insufficient for C. difficile because alcohol-based hand sanitizers
are not effective against spores; soap and water handwashing is required.
Droplet and airborne precautions are not indicated as this organism is not
transmitted through respiratory droplets or aerosolization.
The nurse is preparing to irrigate a wound using sterile technique. Which action
would compromise the sterile field?
A. Holding the sterile solution bottle with the cap facing downward while pouring
B. Placing the sterile drape so that a 1 inch margin around the periphery is not
,considered sterile
C. Pouring the solution from a height of 6 inches into the sterile basin
D. Keeping the sterile forceps tips pointed downward while holding them
Answer: A. Holding the sterile solution bottle with the cap facing downward
while pouring
Rationale: When pouring sterile solutions, the bottle cap should be placed with
the inside surface facing upward on a sterile surface, and the bottle must be held
so that the cap does not become contaminated. Holding the cap facing
downward allows the inside of the cap to come into contact with the nurse's
fingers or the unsterile environment, contaminating the inside of the cap and
thus the solution. The 1 inch border of a sterile drape is considered unsterile (a
safe practice). Pouring from a height of 6 inches is acceptable because it allows
the solution to flow without splashing back into the bottle, and keeping forceps
tips pointed downward prevents fluid from traveling up the instrument to the
unsterile handle and then back down by gravity.
A nurse accidentally sticks themselves with a needle after administering an
intramuscular injection to a patient with a known history of hepatitis B. What is
the priority action by the nurse?
A. Complete an incident report and return to patient care
B. Wash the puncture site with soap and water and immediately report to the
occupational health department
C. Apply a sterile dressing to the puncture site and continue with the shift
D. Squeeze the puncture site vigorously to express blood
Answer: B. Wash the puncture site with soap and water and immediately report
to the occupational health department
Rationale: Following a percutaneous exposure, the immediate priority is to wash
the exposed area with soap and water (or an antiseptic solution) to reduce the
risk of pathogen transmission. The nurse must then report the exposure to
occupational health or employee health services within 1 to 2 hours for
evaluation and potential post-exposure prophylaxis (e.g., hepatitis B immune
,globulin and vaccine). Squeezing the site is contraindicated because it can cause
further tissue trauma and may increase viral entry. Completing an incident
report is important but not the immediate priority; reporting the exposure for
medical follow-up takes precedence.
The nurse is caring for a patient on airborne precautions for active pulmonary
tuberculosis. Which personal protective equipment (PPE) must the nurse wear
when entering the room?
A. Surgical mask, gloves, and gown
B. N95 respirator, gloves, and gown
C. Face shield and surgical mask
D. N95 respirator alone
Answer: B. N95 respirator, gloves, and gown
Rationale: For airborne precautions, the nurse must wear an N95 respirator (or a
powered air-purifying respirator) that is fit-tested to ensure a proper seal.
Gloves and a gown are also required if there is potential for contact with bodily
fluids or contaminated surfaces, which is standard when providing direct patient
care. A surgical mask is not adequate because it does not filter small airborne
particles (less than 5 microns). While the N95 is critical, the nurse must also
wear a gown and gloves for contact with the patient and the environment, as
full barrier protection is indicated for routine care.
A patient is receiving continuous intravenous fluids via an infusion pump. The
nurse notices that the intravenous tubing has become disconnected from the
catheter hub, and blood is leaking onto the floor. What is the nurse’s priority
action?
A. Reconnect the tubing and tighten the connections
B. Apply a sterile gauze to the site and call the provider
C. Stop the pump, clamp the tubing, and apply pressure to the site
D. Clean the blood with a disinfectant wipe and continue monitoring
Answer: C. Stop the pump, clamp the tubing, and apply pressure to the site
, Rationale: The priority action is to stop the infusion immediately to prevent
further fluid or blood loss and to eliminate the risk of air embolism. The nurse
must clamp the tubing to stop the flow of fluid and blood. Applying pressure to
the site helps control bleeding and prevents hematoma formation. Reconnecting
the tubing without first addressing the bleeding and contamination is unsafe;
the connection should be replaced with a new sterile tubing set after bleeding is
controlled. Cleaning the blood without first stopping the leak is inappropriate
and neglects the immediate safety risk.
The nurse is teaching a patient about home fire safety. Which statement by the
patient indicates a need for further teaching?
A. "I will place a fire extinguisher in the kitchen near the stove."
B. "I will check the smoke detectors every month to see if they are working."
C. "I will keep a flashlight and cell phone next to my bed in case of a fire."
D. "I will pour water on a grease fire immediately to put it out."
Answer: D. "I will pour water on a grease fire immediately to put it out."
Rationale: Water should never be used on a grease fire because it will cause the
grease to splatter and spread the fire, potentially causing severe burns. Instead,
the patient should use a fire extinguisher (Class K), baking soda, or smother the
fire with a lid. Placing a fire extinguisher in the kitchen is appropriate, checking
smoke detectors monthly is recommended, and keeping a flashlight and phone
near the bed is a safe escape plan. This response reflects a critical
misunderstanding of fire safety.
During a surgical procedure, the nurse notices that the sterile drape on the back
table has a small tear approximately 1 inch in length. What is the appropriate
nursing action?
A. Cover the tear with a sterile towel and continue the procedure
B. Remove the drape and discard the entire sterile field
C. Tape the tear closed using sterile tape
D. Continue the procedure as long as the tear is not directly over the instruments
Answer: B. Remove the drape and discard the entire sterile field
Practice Exam 3 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
A client with a suspected Clostridioides difficile infection is admitted to the
medical surgical unit. Which isolation precaution should the nurse implement
first?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
Rationale: Clostridioides difficile is transmitted via the fecal-oral route through
contact with contaminated surfaces or spores. Contact precautions, which
include the use of gloves and gowns for all patient contact, are essential to
prevent the spread of spores to other patients and the environment. Standard
precautions are insufficient for C. difficile because alcohol-based hand sanitizers
are not effective against spores; soap and water handwashing is required.
Droplet and airborne precautions are not indicated as this organism is not
transmitted through respiratory droplets or aerosolization.
The nurse is preparing to irrigate a wound using sterile technique. Which action
would compromise the sterile field?
A. Holding the sterile solution bottle with the cap facing downward while pouring
B. Placing the sterile drape so that a 1 inch margin around the periphery is not
,considered sterile
C. Pouring the solution from a height of 6 inches into the sterile basin
D. Keeping the sterile forceps tips pointed downward while holding them
Answer: A. Holding the sterile solution bottle with the cap facing downward
while pouring
Rationale: When pouring sterile solutions, the bottle cap should be placed with
the inside surface facing upward on a sterile surface, and the bottle must be held
so that the cap does not become contaminated. Holding the cap facing
downward allows the inside of the cap to come into contact with the nurse's
fingers or the unsterile environment, contaminating the inside of the cap and
thus the solution. The 1 inch border of a sterile drape is considered unsterile (a
safe practice). Pouring from a height of 6 inches is acceptable because it allows
the solution to flow without splashing back into the bottle, and keeping forceps
tips pointed downward prevents fluid from traveling up the instrument to the
unsterile handle and then back down by gravity.
A nurse accidentally sticks themselves with a needle after administering an
intramuscular injection to a patient with a known history of hepatitis B. What is
the priority action by the nurse?
A. Complete an incident report and return to patient care
B. Wash the puncture site with soap and water and immediately report to the
occupational health department
C. Apply a sterile dressing to the puncture site and continue with the shift
D. Squeeze the puncture site vigorously to express blood
Answer: B. Wash the puncture site with soap and water and immediately report
to the occupational health department
Rationale: Following a percutaneous exposure, the immediate priority is to wash
the exposed area with soap and water (or an antiseptic solution) to reduce the
risk of pathogen transmission. The nurse must then report the exposure to
occupational health or employee health services within 1 to 2 hours for
evaluation and potential post-exposure prophylaxis (e.g., hepatitis B immune
,globulin and vaccine). Squeezing the site is contraindicated because it can cause
further tissue trauma and may increase viral entry. Completing an incident
report is important but not the immediate priority; reporting the exposure for
medical follow-up takes precedence.
The nurse is caring for a patient on airborne precautions for active pulmonary
tuberculosis. Which personal protective equipment (PPE) must the nurse wear
when entering the room?
A. Surgical mask, gloves, and gown
B. N95 respirator, gloves, and gown
C. Face shield and surgical mask
D. N95 respirator alone
Answer: B. N95 respirator, gloves, and gown
Rationale: For airborne precautions, the nurse must wear an N95 respirator (or a
powered air-purifying respirator) that is fit-tested to ensure a proper seal.
Gloves and a gown are also required if there is potential for contact with bodily
fluids or contaminated surfaces, which is standard when providing direct patient
care. A surgical mask is not adequate because it does not filter small airborne
particles (less than 5 microns). While the N95 is critical, the nurse must also
wear a gown and gloves for contact with the patient and the environment, as
full barrier protection is indicated for routine care.
A patient is receiving continuous intravenous fluids via an infusion pump. The
nurse notices that the intravenous tubing has become disconnected from the
catheter hub, and blood is leaking onto the floor. What is the nurse’s priority
action?
A. Reconnect the tubing and tighten the connections
B. Apply a sterile gauze to the site and call the provider
C. Stop the pump, clamp the tubing, and apply pressure to the site
D. Clean the blood with a disinfectant wipe and continue monitoring
Answer: C. Stop the pump, clamp the tubing, and apply pressure to the site
, Rationale: The priority action is to stop the infusion immediately to prevent
further fluid or blood loss and to eliminate the risk of air embolism. The nurse
must clamp the tubing to stop the flow of fluid and blood. Applying pressure to
the site helps control bleeding and prevents hematoma formation. Reconnecting
the tubing without first addressing the bleeding and contamination is unsafe;
the connection should be replaced with a new sterile tubing set after bleeding is
controlled. Cleaning the blood without first stopping the leak is inappropriate
and neglects the immediate safety risk.
The nurse is teaching a patient about home fire safety. Which statement by the
patient indicates a need for further teaching?
A. "I will place a fire extinguisher in the kitchen near the stove."
B. "I will check the smoke detectors every month to see if they are working."
C. "I will keep a flashlight and cell phone next to my bed in case of a fire."
D. "I will pour water on a grease fire immediately to put it out."
Answer: D. "I will pour water on a grease fire immediately to put it out."
Rationale: Water should never be used on a grease fire because it will cause the
grease to splatter and spread the fire, potentially causing severe burns. Instead,
the patient should use a fire extinguisher (Class K), baking soda, or smother the
fire with a lid. Placing a fire extinguisher in the kitchen is appropriate, checking
smoke detectors monthly is recommended, and keeping a flashlight and phone
near the bed is a safe escape plan. This response reflects a critical
misunderstanding of fire safety.
During a surgical procedure, the nurse notices that the sterile drape on the back
table has a small tear approximately 1 inch in length. What is the appropriate
nursing action?
A. Cover the tear with a sterile towel and continue the procedure
B. Remove the drape and discard the entire sterile field
C. Tape the tear closed using sterile tape
D. Continue the procedure as long as the tear is not directly over the instruments
Answer: B. Remove the drape and discard the entire sterile field
