Safe and Effective Care Environment (10 items)
This category covers Management of Care and
Safety/Infection Control, emphasizing prioritization,
delegation, legal/ethical issues, and standard precautions.
(NCSBN)
1. A nurse is delegating tasks to unlicensed
assistive personnel (UAP). Which task is
appropriate to assign?
A. Administering a prescribed subcutaneous injection
B. Performing a head‐to‐toe assessment on a newly
admitted client
C. Assisting a stable postoperative client to ambulate
D. Developing a plan of care for a client with heart
failure
o Answer: C
o Rationale: UAP may assist with activities of daily
living and ambulation for stable clients.
Medication administration and assessments are
beyond their scope (NCSBN).
2. A client with Clostridioides difficile infection is on
contact precautions. Which PPE must the nurse
don?
A. Gown, gloves, and N95 mask
B. Gown, gloves, and surgical mask
, C. Gown and gloves only
D. Gloves and goggles only
o Answer: C
o Rationale: Contact precautions require gown
and gloves. Masks and eye protection aren’t
needed unless splashing is anticipated (NCSBN).
3. Which intervention demonstrates adherence to
“just culture” principles when a nurse makes a
medication error?
A. Documenting the error in the client’s record and
informing the provider
B. Reporting the error through facility’s incident
reporting system
C. Discussing the error only with the nursing
supervisor
D. Ignoring the error since no client harm occurred
o Answer: B
o Rationale: A just culture encourages transparent
reporting of near misses and errors to improve
systems (NCLEX).
4. A client is scheduled for MRI with gadolinium
contrast. Which lab result requires follow-up?
A. Serum creatinine 0.8 mg/dL
B. BUN 14 mg/dL
C. eGFR 50 mL/min/1.73 m²
D. eGFR 25 mL/min/1.73 m²
, o Answer: D
o Rationale: Gadolinium is contraindicated if eGFR
< 30 mL/min/1.73 m² due to risk of nephrogenic
systemic fibrosis (NCLEX).
5. Which action best reflects the nurse’s role in risk
management?
A. Completing thorough shift hand‐off reports
B. Implementing an experimental protocol without
consent
C. Charting opinions about a provider
D. Ignoring a near miss since no harm occurred
o Answer: A
o Rationale: Clear hand‐offs reduce
miscommunication and adverse events (NCLEX).
6. A client admitted with MRSA pneumonia has been
on contact precautions for 3 days. Which criterion
indicates it’s safe to discontinue precautions?
A. Afebrile for 24 hours
B. Two negative nasal swabs 24 hours apart
C. Completed course of IV vancomycin
D. No productive cough for 48 hours
o Answer: B
o Rationale: Two negative surveillance cultures
confirm eradication (NCSBN).
7. Which statement about informed consent is
correct?
This category covers Management of Care and
Safety/Infection Control, emphasizing prioritization,
delegation, legal/ethical issues, and standard precautions.
(NCSBN)
1. A nurse is delegating tasks to unlicensed
assistive personnel (UAP). Which task is
appropriate to assign?
A. Administering a prescribed subcutaneous injection
B. Performing a head‐to‐toe assessment on a newly
admitted client
C. Assisting a stable postoperative client to ambulate
D. Developing a plan of care for a client with heart
failure
o Answer: C
o Rationale: UAP may assist with activities of daily
living and ambulation for stable clients.
Medication administration and assessments are
beyond their scope (NCSBN).
2. A client with Clostridioides difficile infection is on
contact precautions. Which PPE must the nurse
don?
A. Gown, gloves, and N95 mask
B. Gown, gloves, and surgical mask
, C. Gown and gloves only
D. Gloves and goggles only
o Answer: C
o Rationale: Contact precautions require gown
and gloves. Masks and eye protection aren’t
needed unless splashing is anticipated (NCSBN).
3. Which intervention demonstrates adherence to
“just culture” principles when a nurse makes a
medication error?
A. Documenting the error in the client’s record and
informing the provider
B. Reporting the error through facility’s incident
reporting system
C. Discussing the error only with the nursing
supervisor
D. Ignoring the error since no client harm occurred
o Answer: B
o Rationale: A just culture encourages transparent
reporting of near misses and errors to improve
systems (NCLEX).
4. A client is scheduled for MRI with gadolinium
contrast. Which lab result requires follow-up?
A. Serum creatinine 0.8 mg/dL
B. BUN 14 mg/dL
C. eGFR 50 mL/min/1.73 m²
D. eGFR 25 mL/min/1.73 m²
, o Answer: D
o Rationale: Gadolinium is contraindicated if eGFR
< 30 mL/min/1.73 m² due to risk of nephrogenic
systemic fibrosis (NCLEX).
5. Which action best reflects the nurse’s role in risk
management?
A. Completing thorough shift hand‐off reports
B. Implementing an experimental protocol without
consent
C. Charting opinions about a provider
D. Ignoring a near miss since no harm occurred
o Answer: A
o Rationale: Clear hand‐offs reduce
miscommunication and adverse events (NCLEX).
6. A client admitted with MRSA pneumonia has been
on contact precautions for 3 days. Which criterion
indicates it’s safe to discontinue precautions?
A. Afebrile for 24 hours
B. Two negative nasal swabs 24 hours apart
C. Completed course of IV vancomycin
D. No productive cough for 48 hours
o Answer: B
o Rationale: Two negative surveillance cultures
confirm eradication (NCSBN).
7. Which statement about informed consent is
correct?
