Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — PPE donning order (multiple choice)
A nurse preparing to enter the room of a patient on contact
precautions should don PPE in which correct sequence?
A. Mask → Gloves → Gown
B. Gown → Mask (or respirator) → Goggles/face shield →
Gloves
C. Gloves → Gown → Mask → Goggles
D. Gown → Gloves → Mask → Goggles
Answer: B
Rationale: The recommended sequence for putting on PPE is to
don gown first (securely covering torso and arms), then mask or
respirator, then eye protection (goggles/face shield), and finally
gloves to cover the gown cuffs. This order reduces
contamination of exposed clothing/skin and ensures
respiratory/eye protection are in place before hand contact
with the patient environment. Other sequences risk
,contaminating face/eyes or exposing skin during glove removal.
CDC
2 — PPE removal (multiple choice)
Which action is most important when removing gloves after
providing care for an infectious patient?
A. Pull both gloves off at once from the wrist.
B. Remove the first glove by peeling it off over the second glove.
C. Remove gloves with bare hands touching the outside of
gloves.
D. Rub hands together vigorously before performing hand
hygiene.
Answer: B
Rationale: Proper glove removal minimizes hand
contamination. The safe technique is to grasp the outside of
one glove at the wrist and peel it away, turning it inside out and
holding it in the gloved hand; then slide an ungloved finger
under the remaining glove at the wrist and peel it off over the
first glove (inside out). This keeps contaminated surfaces
contained. After glove removal, perform hand hygiene. Options
A and C risk contamination; D is incorrect because hand hygiene
(soap/water or alcohol-based sanitizer) should follow removal,
not rubbing hands while still contaminated. CDC
,3 — Transmission-based precautions type (multiple choice)
A patient is admitted with confirmed Mycobacterium
tuberculosis (pulmonary TB). Which transmission-based
precaution is required?
A. Contact precautions only
B. Droplet precautions only
C. Airborne precautions (airborne infection isolation room and
N95 respirator)
D. Standard precautions only
Answer: C
Rationale: TB is transmitted via small airborne droplet nuclei
and requires airborne precautions: placement in an airborne
infection isolation room (AIIR) and use of an N95 or higher-level
respirator for health care personnel entering the room.
Standard or droplet precautions alone do not prevent airborne
spread. Transmission-based precautions are chosen based on
known or suspected routes of transmission (contact, droplet,
airborne). CDC+1
4 — Hand hygiene timing (multiple choice)
Which situation requires hand hygiene with soap and water
rather than alcohol-based hand rub?
A. Before touching a patient
B. After removing gloves contaminated with blood
, C. After using the restroom or when hands are visibly soiled
D. Before performing a sterile procedure
Answer: C
Rationale: Alcohol-based hand rubs are effective for most
clinical situations, but soap and water are required when hands
are visibly soiled or after known exposure to certain pathogens
(e.g., Clostridioides difficile or norovirus) and after using the
restroom. Options A and D are appropriate for alcohol rub if
hands are not visibly soiled, and B is followed by hand hygiene
but soap and water are specifically indicated when hands are
visibly soiled or after certain pathogens. (CDC guidance
supports these distinctions.) CDC
5 — Isolation signage and precautions (NGN-style:
Recognize/Analyze)
A patient with suspected influenza is coughing and febrile. The
unit has limited private rooms. Which immediate steps should
the nurse take? (Select the best sequence consistent with
infection prevention and the CJMM approach: Recognize cues
→ Analyze cues → Prioritize hypotheses → Generate solutions
→ Take actions → Evaluate outcomes.)
A. Recognize respiratory symptoms; place surgical mask on
patient and implement droplet precautions; arrange private
room when available.
B. Place patient in a hallway bed; advise patient to cough into
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — PPE donning order (multiple choice)
A nurse preparing to enter the room of a patient on contact
precautions should don PPE in which correct sequence?
A. Mask → Gloves → Gown
B. Gown → Mask (or respirator) → Goggles/face shield →
Gloves
C. Gloves → Gown → Mask → Goggles
D. Gown → Gloves → Mask → Goggles
Answer: B
Rationale: The recommended sequence for putting on PPE is to
don gown first (securely covering torso and arms), then mask or
respirator, then eye protection (goggles/face shield), and finally
gloves to cover the gown cuffs. This order reduces
contamination of exposed clothing/skin and ensures
respiratory/eye protection are in place before hand contact
with the patient environment. Other sequences risk
,contaminating face/eyes or exposing skin during glove removal.
CDC
2 — PPE removal (multiple choice)
Which action is most important when removing gloves after
providing care for an infectious patient?
A. Pull both gloves off at once from the wrist.
B. Remove the first glove by peeling it off over the second glove.
C. Remove gloves with bare hands touching the outside of
gloves.
D. Rub hands together vigorously before performing hand
hygiene.
Answer: B
Rationale: Proper glove removal minimizes hand
contamination. The safe technique is to grasp the outside of
one glove at the wrist and peel it away, turning it inside out and
holding it in the gloved hand; then slide an ungloved finger
under the remaining glove at the wrist and peel it off over the
first glove (inside out). This keeps contaminated surfaces
contained. After glove removal, perform hand hygiene. Options
A and C risk contamination; D is incorrect because hand hygiene
(soap/water or alcohol-based sanitizer) should follow removal,
not rubbing hands while still contaminated. CDC
,3 — Transmission-based precautions type (multiple choice)
A patient is admitted with confirmed Mycobacterium
tuberculosis (pulmonary TB). Which transmission-based
precaution is required?
A. Contact precautions only
B. Droplet precautions only
C. Airborne precautions (airborne infection isolation room and
N95 respirator)
D. Standard precautions only
Answer: C
Rationale: TB is transmitted via small airborne droplet nuclei
and requires airborne precautions: placement in an airborne
infection isolation room (AIIR) and use of an N95 or higher-level
respirator for health care personnel entering the room.
Standard or droplet precautions alone do not prevent airborne
spread. Transmission-based precautions are chosen based on
known or suspected routes of transmission (contact, droplet,
airborne). CDC+1
4 — Hand hygiene timing (multiple choice)
Which situation requires hand hygiene with soap and water
rather than alcohol-based hand rub?
A. Before touching a patient
B. After removing gloves contaminated with blood
, C. After using the restroom or when hands are visibly soiled
D. Before performing a sterile procedure
Answer: C
Rationale: Alcohol-based hand rubs are effective for most
clinical situations, but soap and water are required when hands
are visibly soiled or after known exposure to certain pathogens
(e.g., Clostridioides difficile or norovirus) and after using the
restroom. Options A and D are appropriate for alcohol rub if
hands are not visibly soiled, and B is followed by hand hygiene
but soap and water are specifically indicated when hands are
visibly soiled or after certain pathogens. (CDC guidance
supports these distinctions.) CDC
5 — Isolation signage and precautions (NGN-style:
Recognize/Analyze)
A patient with suspected influenza is coughing and febrile. The
unit has limited private rooms. Which immediate steps should
the nurse take? (Select the best sequence consistent with
infection prevention and the CJMM approach: Recognize cues
→ Analyze cues → Prioritize hypotheses → Generate solutions
→ Take actions → Evaluate outcomes.)
A. Recognize respiratory symptoms; place surgical mask on
patient and implement droplet precautions; arrange private
room when available.
B. Place patient in a hallway bed; advise patient to cough into
