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) — multiple choice
A nurse prepares to enter the room of a client on contact
precautions for MRSA to perform a dressing change. What is
the correct order for donning PPE?
A. Gown → Mask → Gloves → Eye protection
B. Hand hygiene → Gown → Mask or respirator → Eye
protection → Gloves
C. Hand hygiene → Mask → Gloves → Gown → Eye protection
D. Gown → Hand hygiene → Gloves → Mask → Eye protection
Answer: B
Rationale: Correct donning order: perform hand hygiene first,
then gown, then mask/respirator (if required), then eye
protection, then gloves. This sequence reduces contamination
risk by ensuring gown covers clothing before respiratory
protection, and gloves go on last to cover gown cuffs. (Evidence-
based fundamentals align with CDC standard and transmission-
,based precautions.) Other options place gloves or mask too
early or omit hand hygiene first.
2 — PPE sequencing (doffing) — multiple choice
After completing a sterile dressing change in a contact-
precautions room, which step should the nurse perform first
when doffing PPE to avoid self-contamination?
A. Remove gloves
B. Remove gown
C. Perform hand hygiene while still gloved
D. Remove eye protection
Answer: A
Rationale: Gloves are the most contaminated item and should
be removed first (or at least before touching face/other PPE),
then gown (untie carefully), then eye protection, then
mask/respirator, finishing with hand hygiene. Performing hand
hygiene while gloved is not recommended; remove gloves first
and then perform hand hygiene per CDC. This minimizes
transfer of pathogens from gloves to other PPE or hands.
3 — Isolation precautions — SATA (select all that apply)
Which infection-control measures are required for a client with
confirmed pulmonary tuberculosis (active TB)? (Select all that
apply.)
,A. Airborne precautions with N95 or higher respirator for staff
B. Surgical mask for the client when transported outside room
C. Negative-pressure (AIIR) room for the client
D. Contact precautions with gown and gloves only
E. Routine hand hygiene after glove removal
Answer: A, B, C, E
Rationale: Active pulmonary TB requires airborne precautions:
use an airborne infection isolation room (negative pressure) and
N95 (or higher) respirator for staff. When transporting the
client, place a surgical mask on the client to limit droplet
spread. Contact precautions alone (D) are insufficient. Hand
hygiene (E) is always required after glove removal. This reflects
CDC airborne-transmission guidance.
4 — Hand hygiene vs gloves — multiple choice
A client has C. difficile infection. Which of the following is the
most appropriate hand-hygiene practice after removing gloves?
A. Use alcohol-based hand rub only.
B. Wash with soap and water.
C. No hand hygiene required if gloves were used properly.
D. Use antiseptic towelette only.
Answer: B
Rationale: C. difficile spores are resistant to alcohol; CDC
recommends washing hands with soap and water after caring
for patients with C. difficile to mechanically remove spores.
, Alcohol-based hand rubs are effective for many organisms but
not for C. difficile spores. Hand hygiene is required after glove
removal; omission is incorrect.
5 — Basic hygiene — multiple choice
During morning care a client with dementia becomes agitated
when the nurse approaches to assist with a bed bath. Which
approach is best to promote cooperation and safety?
A. Explain the whole bath plan in detail and request
cooperation.
B. Provide the bath quickly while the client is distracted.
C. Offer choice (wash face or hands first), use calm voice, and
allow the client to assist.
D. Tell the client they must comply for infection control reasons.
Answer: C
Rationale: Offering choices and involving the client promotes
autonomy and decreases resistance. A calm voice, simple
instructions, and allowing participation reduce agitation.
Explaining long plans (A) can be confusing for dementia;
coercion (D) increases distress; rushing (B) risks safety. Person-
centered care is evidence-based fundamentals practice for
cognitively impaired clients.
6 — Vital signs interpretation — multiple choice
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — PPE sequencing (donning) — multiple choice
A nurse prepares to enter the room of a client on contact
precautions for MRSA to perform a dressing change. What is
the correct order for donning PPE?
A. Gown → Mask → Gloves → Eye protection
B. Hand hygiene → Gown → Mask or respirator → Eye
protection → Gloves
C. Hand hygiene → Mask → Gloves → Gown → Eye protection
D. Gown → Hand hygiene → Gloves → Mask → Eye protection
Answer: B
Rationale: Correct donning order: perform hand hygiene first,
then gown, then mask/respirator (if required), then eye
protection, then gloves. This sequence reduces contamination
risk by ensuring gown covers clothing before respiratory
protection, and gloves go on last to cover gown cuffs. (Evidence-
based fundamentals align with CDC standard and transmission-
,based precautions.) Other options place gloves or mask too
early or omit hand hygiene first.
2 — PPE sequencing (doffing) — multiple choice
After completing a sterile dressing change in a contact-
precautions room, which step should the nurse perform first
when doffing PPE to avoid self-contamination?
A. Remove gloves
B. Remove gown
C. Perform hand hygiene while still gloved
D. Remove eye protection
Answer: A
Rationale: Gloves are the most contaminated item and should
be removed first (or at least before touching face/other PPE),
then gown (untie carefully), then eye protection, then
mask/respirator, finishing with hand hygiene. Performing hand
hygiene while gloved is not recommended; remove gloves first
and then perform hand hygiene per CDC. This minimizes
transfer of pathogens from gloves to other PPE or hands.
3 — Isolation precautions — SATA (select all that apply)
Which infection-control measures are required for a client with
confirmed pulmonary tuberculosis (active TB)? (Select all that
apply.)
,A. Airborne precautions with N95 or higher respirator for staff
B. Surgical mask for the client when transported outside room
C. Negative-pressure (AIIR) room for the client
D. Contact precautions with gown and gloves only
E. Routine hand hygiene after glove removal
Answer: A, B, C, E
Rationale: Active pulmonary TB requires airborne precautions:
use an airborne infection isolation room (negative pressure) and
N95 (or higher) respirator for staff. When transporting the
client, place a surgical mask on the client to limit droplet
spread. Contact precautions alone (D) are insufficient. Hand
hygiene (E) is always required after glove removal. This reflects
CDC airborne-transmission guidance.
4 — Hand hygiene vs gloves — multiple choice
A client has C. difficile infection. Which of the following is the
most appropriate hand-hygiene practice after removing gloves?
A. Use alcohol-based hand rub only.
B. Wash with soap and water.
C. No hand hygiene required if gloves were used properly.
D. Use antiseptic towelette only.
Answer: B
Rationale: C. difficile spores are resistant to alcohol; CDC
recommends washing hands with soap and water after caring
for patients with C. difficile to mechanically remove spores.
, Alcohol-based hand rubs are effective for many organisms but
not for C. difficile spores. Hand hygiene is required after glove
removal; omission is incorrect.
5 — Basic hygiene — multiple choice
During morning care a client with dementia becomes agitated
when the nurse approaches to assist with a bed bath. Which
approach is best to promote cooperation and safety?
A. Explain the whole bath plan in detail and request
cooperation.
B. Provide the bath quickly while the client is distracted.
C. Offer choice (wash face or hands first), use calm voice, and
allow the client to assist.
D. Tell the client they must comply for infection control reasons.
Answer: C
Rationale: Offering choices and involving the client promotes
autonomy and decreases resistance. A calm voice, simple
instructions, and allowing participation reduce agitation.
Explaining long plans (A) can be confusing for dementia;
coercion (D) increases distress; rushing (B) risks safety. Person-
centered care is evidence-based fundamentals practice for
cognitively impaired clients.
6 — Vital signs interpretation — multiple choice
