NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
1 — Hand hygiene: choosing the correct technique
Stem: A nurse is caring for three patients. Before moving from
patient A (receiving enteral tube feeding) to patient B (IV site
dressing change), which action is best to prevent cross-
contamination?
A. Use an alcohol-based hand rub for 15 seconds between
patients.
B. Don nonsterile gloves and skip hand hygiene since gloves are
worn.
C. Perform soap-and-water handwashing for at least 20 seconds
before patient B’s IV dressing change.
D. Wipe hands with a disinfectant wipe between patient
contacts.
Correct answer: C
Rationales
• A (alcohol rub 15 s) — Incorrect.
o Recognize cues: moving from potential enteral
feeding contamination to IV dressing.
, o Analyze: Alcohol rubs are effective in most situations
but not for removal of visible soil or fecal/enteric
pathogens; 15 seconds may be insufficient (CDC
recommends ~20–30 s technique).
o Decide: Not best because enteral contamination may
require soap-and-water.
o Act/Evaluate: Soap-and-water reduces organisms and
organic debris; evaluate by no signs of local infection
at IV site and proper technique observed.
• B (gloves only, skip hand hygiene) — Incorrect.
o Recognize cues: gloves are not a substitute for hand
hygiene; contamination can occur when
donning/doffing.
o Analyze: Skipping hand hygiene increases risk of
transferring organisms from glove cuff or hands to
clean site.
o Decide: Unacceptable practice.
o Act/Evaluate: Correct action: perform hand hygiene
then don gloves; evaluate by observing decreased
contamination risk.
• C (soap-and-water 20 s first) — Correct.
o Recognize cues: potential enteric contamination from
enteral feeding.
, o Analyze: Soap-and-water is indicated when hands are
visibly soiled or after caring for patients with known
enteric pathogens; it removes organic matter and
spores better than alcohol rub.
o Decide (best action): Wash 20+ seconds, dry, then
proceed to IV dressing with new gloves.
o Act/Evaluate: Action: handwash then glove and
perform dressing change; evaluate by absence of
cross-contamination incidents.
• D (disinfectant wipe) — Incorrect.
o Recognize cues: wipes are surface disinfectants, not
intended for routine hand antisepsis.
o Analyze: Hand wipes may not be as effective as soap-
and-water for visible soil and are not standard for
preprocedure hand hygiene.
o Decide: Not appropriate for this transition.
o Act/Evaluate: Use soap-and-water; evaluate by
observing reduced contamination risk.
2 — Transmission-based precautions (airborne)
Stem: A client is admitted with suspected pulmonary
tuberculosis. Which PPE is required for the nurse before
entering the client’s room?
, A. Surgical mask.
B. N95 (or higher) respirator that is fit-tested.
C. Gloves and gown only.
D. Face shield only.
Correct answer: B
Rationales
• A (surgical mask) — Incorrect.
o Recognize cues: suspected airborne pathogen (TB).
o Analyze: Surgical masks protect against droplets, not
airborne spores/aerosols.
o Decide: Not adequate for airborne precautions.
o Act/Evaluate: Use N95; evaluate staff protection and
adherence to airborne isolation.
• B (N95 respirator fit-tested) — Correct.
o Recognize cues: airborne transmission risk.
o Analyze: CDC recommends a fitted N95 or higher
respirator for airborne pathogens during patient
contact.
o Decide (best action): Don fit-tested respirator before
entry, place patient in airborne infection isolation
room.
Single-Best-Answer Questions
1 — Hand hygiene: choosing the correct technique
Stem: A nurse is caring for three patients. Before moving from
patient A (receiving enteral tube feeding) to patient B (IV site
dressing change), which action is best to prevent cross-
contamination?
A. Use an alcohol-based hand rub for 15 seconds between
patients.
B. Don nonsterile gloves and skip hand hygiene since gloves are
worn.
C. Perform soap-and-water handwashing for at least 20 seconds
before patient B’s IV dressing change.
D. Wipe hands with a disinfectant wipe between patient
contacts.
Correct answer: C
Rationales
• A (alcohol rub 15 s) — Incorrect.
o Recognize cues: moving from potential enteral
feeding contamination to IV dressing.
, o Analyze: Alcohol rubs are effective in most situations
but not for removal of visible soil or fecal/enteric
pathogens; 15 seconds may be insufficient (CDC
recommends ~20–30 s technique).
o Decide: Not best because enteral contamination may
require soap-and-water.
o Act/Evaluate: Soap-and-water reduces organisms and
organic debris; evaluate by no signs of local infection
at IV site and proper technique observed.
• B (gloves only, skip hand hygiene) — Incorrect.
o Recognize cues: gloves are not a substitute for hand
hygiene; contamination can occur when
donning/doffing.
o Analyze: Skipping hand hygiene increases risk of
transferring organisms from glove cuff or hands to
clean site.
o Decide: Unacceptable practice.
o Act/Evaluate: Correct action: perform hand hygiene
then don gloves; evaluate by observing decreased
contamination risk.
• C (soap-and-water 20 s first) — Correct.
o Recognize cues: potential enteric contamination from
enteral feeding.
, o Analyze: Soap-and-water is indicated when hands are
visibly soiled or after caring for patients with known
enteric pathogens; it removes organic matter and
spores better than alcohol rub.
o Decide (best action): Wash 20+ seconds, dry, then
proceed to IV dressing with new gloves.
o Act/Evaluate: Action: handwash then glove and
perform dressing change; evaluate by absence of
cross-contamination incidents.
• D (disinfectant wipe) — Incorrect.
o Recognize cues: wipes are surface disinfectants, not
intended for routine hand antisepsis.
o Analyze: Hand wipes may not be as effective as soap-
and-water for visible soil and are not standard for
preprocedure hand hygiene.
o Decide: Not appropriate for this transition.
o Act/Evaluate: Use soap-and-water; evaluate by
observing reduced contamination risk.
2 — Transmission-based precautions (airborne)
Stem: A client is admitted with suspected pulmonary
tuberculosis. Which PPE is required for the nurse before
entering the client’s room?
, A. Surgical mask.
B. N95 (or higher) respirator that is fit-tested.
C. Gloves and gown only.
D. Face shield only.
Correct answer: B
Rationales
• A (surgical mask) — Incorrect.
o Recognize cues: suspected airborne pathogen (TB).
o Analyze: Surgical masks protect against droplets, not
airborne spores/aerosols.
o Decide: Not adequate for airborne precautions.
o Act/Evaluate: Use N95; evaluate staff protection and
adherence to airborne isolation.
• B (N95 respirator fit-tested) — Correct.
o Recognize cues: airborne transmission risk.
o Analyze: CDC recommends a fitted N95 or higher
respirator for airborne pathogens during patient
contact.
o Decide (best action): Don fit-tested respirator before
entry, place patient in airborne infection isolation
room.
