NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
1) Hand hygiene and infection control
Scenario / Recognize cues: A postoperative client on the med-
surg unit has a low-grade fever (100.6°F / 38.1°C) and purulent
drainage from the surgical incision. You have glove access and
an alcohol sanitizer at workflow stations.
Which action is the most appropriate immediate step to reduce
cross-contamination when entering and leaving the client’s
room?
A. Use alcohol-based hand rub before entering and after exiting
the room.
B. Wear gloves only when you expect contact with drainage;
perform hand hygiene with soap and water after removing
gloves.
C. Don a gown and gloves before entering the room and
perform hand hygiene only after removing gloves.
D. Use soap and water for handwashing before entering and
after exiting because the client has purulent drainage.
Correct answer: A
Rationale (CJMM):
• Recognize cues: Purulent drainage (possible infection)
increases risk of pathogen transmission; alcohol hand rubs
are available.
, • Analyze: Alcohol-based hand rubs are effective for routine
hand antisepsis and quicker than soap/water; gloves are
indicated when contact with drainage is anticipated, but
hand hygiene is required before and after patient contact.
Evolve
• Decide: Use alcohol hand rub before entering (to avoid
contaminating surfaces) and after exiting (to remove
organisms acquired).
• Act: Apply alcohol rub per WHO technique before and
after patient contact; don gloves when touching drainage.
• Evaluate: Reduction in contamination of hands and
surfaces; compliance with institutional policy.
Why other options are incorrect:
• B: Partially true (gloves + soap/water after removal) but
omits hand antisepsis before patient contact; alcohol rub
before/after is preferred unless hands visibly soiled.
• C: Donning gown/gloves for all entries is unnecessary for
contact precautions unless policy indicates; also hand
hygiene both before donning and after doffing should be
performed.
• D: Soap/water is required when hands are visibly soiled
(e.g., gross contamination), but alcohol rub is acceptable
and recommended when hands are not visibly soiled —
and it’s faster and effective for most organisms.
,2) Standard vs. contact precautions (infection control)
Recognize cues: A client with a leg wound cultured positive for
MRSA is admitted. The nurse must decide precautions.
Which of the following is the best PPE selection when providing
wound care?
A. Standard precautions only (gloves as needed).
B. Contact precautions: gown and gloves.
C. Droplet precautions: surgical mask and gloves.
D. Airborne precautions: N95 respirator and gloves.
Correct answer: B
Rationale (CJMM):
• Recognize cues: MRSA (methicillin-resistant
Staphylococcus aureus) — transmission primarily via direct
contact or contaminated surfaces.
• Analyze: MRSA requires contact precautions during wound
care to prevent spread; gown and gloves protect provider
and limit environmental contamination. Evolve
• Decide: Use gown and gloves (contact precautions) for
wound care.
• Act: Don gown and gloves before entering room and
remove/dispose before exiting; perform hand hygiene.
, • Evaluate: No transmission events; wound site healing
without new MRSA cases.
Why others are incorrect:
• A: Standard precautions alone do not sufficiently prevent
contact transmission of MRSA during wound care.
• C: Droplet precautions (mask) are for pathogens spread by
large droplets (e.g., influenza); mask alone does not
address contact spread.
• D: Airborne precautions (N95) are for small particle
transmission (e.g., TB); not indicated for MRSA wound
care.
3) Patient safety — fall prevention
Recognize cues: A 78-year-old client with history of orthostatic
hypotension and recent dizziness ambulates unassisted to the
bathroom at night and falls.
Which nursing action is the highest priority to reduce future fall
risk?
A. Place the bed in lowest position and leave the call light
within reach.
B. Apply restraints to prevent unsupervised ambulation.
C. Request a consult for physical therapy and schedule daily
exercises.
Single-Best-Answer Questions
1) Hand hygiene and infection control
Scenario / Recognize cues: A postoperative client on the med-
surg unit has a low-grade fever (100.6°F / 38.1°C) and purulent
drainage from the surgical incision. You have glove access and
an alcohol sanitizer at workflow stations.
Which action is the most appropriate immediate step to reduce
cross-contamination when entering and leaving the client’s
room?
A. Use alcohol-based hand rub before entering and after exiting
the room.
B. Wear gloves only when you expect contact with drainage;
perform hand hygiene with soap and water after removing
gloves.
C. Don a gown and gloves before entering the room and
perform hand hygiene only after removing gloves.
D. Use soap and water for handwashing before entering and
after exiting because the client has purulent drainage.
Correct answer: A
Rationale (CJMM):
• Recognize cues: Purulent drainage (possible infection)
increases risk of pathogen transmission; alcohol hand rubs
are available.
, • Analyze: Alcohol-based hand rubs are effective for routine
hand antisepsis and quicker than soap/water; gloves are
indicated when contact with drainage is anticipated, but
hand hygiene is required before and after patient contact.
Evolve
• Decide: Use alcohol hand rub before entering (to avoid
contaminating surfaces) and after exiting (to remove
organisms acquired).
• Act: Apply alcohol rub per WHO technique before and
after patient contact; don gloves when touching drainage.
• Evaluate: Reduction in contamination of hands and
surfaces; compliance with institutional policy.
Why other options are incorrect:
• B: Partially true (gloves + soap/water after removal) but
omits hand antisepsis before patient contact; alcohol rub
before/after is preferred unless hands visibly soiled.
• C: Donning gown/gloves for all entries is unnecessary for
contact precautions unless policy indicates; also hand
hygiene both before donning and after doffing should be
performed.
• D: Soap/water is required when hands are visibly soiled
(e.g., gross contamination), but alcohol rub is acceptable
and recommended when hands are not visibly soiled —
and it’s faster and effective for most organisms.
,2) Standard vs. contact precautions (infection control)
Recognize cues: A client with a leg wound cultured positive for
MRSA is admitted. The nurse must decide precautions.
Which of the following is the best PPE selection when providing
wound care?
A. Standard precautions only (gloves as needed).
B. Contact precautions: gown and gloves.
C. Droplet precautions: surgical mask and gloves.
D. Airborne precautions: N95 respirator and gloves.
Correct answer: B
Rationale (CJMM):
• Recognize cues: MRSA (methicillin-resistant
Staphylococcus aureus) — transmission primarily via direct
contact or contaminated surfaces.
• Analyze: MRSA requires contact precautions during wound
care to prevent spread; gown and gloves protect provider
and limit environmental contamination. Evolve
• Decide: Use gown and gloves (contact precautions) for
wound care.
• Act: Don gown and gloves before entering room and
remove/dispose before exiting; perform hand hygiene.
, • Evaluate: No transmission events; wound site healing
without new MRSA cases.
Why others are incorrect:
• A: Standard precautions alone do not sufficiently prevent
contact transmission of MRSA during wound care.
• C: Droplet precautions (mask) are for pathogens spread by
large droplets (e.g., influenza); mask alone does not
address contact spread.
• D: Airborne precautions (N95) are for small particle
transmission (e.g., TB); not indicated for MRSA wound
care.
3) Patient safety — fall prevention
Recognize cues: A 78-year-old client with history of orthostatic
hypotension and recent dizziness ambulates unassisted to the
bathroom at night and falls.
Which nursing action is the highest priority to reduce future fall
risk?
A. Place the bed in lowest position and leave the call light
within reach.
B. Apply restraints to prevent unsupervised ambulation.
C. Request a consult for physical therapy and schedule daily
exercises.
