Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — Multiple choice (PPE sequencing)
A nurse is entering the room of a patient on contact precautions
for MRSA to change a dressing. Which is the correct sequence
for donning PPE?
A. Gown → gloves → mask → eye protection
B. Mask → gown → gloves → eye protection
C. Gown → mask → eye protection → gloves
D. Gown → eye protection → mask → gloves
Correct answer: C
Rationale:
Donning sequence is gown first (to secure coverage of
torso/arms), then mask (if required), then eye protection, then
gloves last (gloves should cover gown cuff). This order
minimizes contamination risk and ensures gloves are donned
last to maintain a barrier. This follows standard precaution
technique used in infection prevention practice.
,2 — Multiple choice (PPE removal)
Which statement shows correct glove removal to reduce
contamination?
A. Peel one glove off, hold it in gloved hand, slide fingers under
the remaining glove cuff and pull off.
B. Pull gloves off together by grabbing at the fingertips of both
gloves.
C. Remove gloves by touching the outside of the glove with
bare hand.
D. Cut gloves off with scissors at the wrist and discard.
Correct answer: A
Rationale:
The glove-off technique where one glove is peeled off and held
in the gloved hand, then fingers are slid under the remaining
glove cuff and the second glove is peeled off over the first
reduces hand contamination. Avoid touching outer glove
surfaces with bare hands. This is consistent with standard
precautions and correct donning/doffing technique.
3 — Multiple choice (isolation precaution selection)
A patient with suspected pulmonary tuberculosis is admitted.
Which isolation precaution is indicated?
,A. Contact precautions (gown + gloves)
B. Droplet precautions (surgical mask within 3 ft)
C. Airborne precautions (negative-pressure room + N95
respirator)
D. Standard precautions only
Correct answer: C
Rationale:
Tuberculosis is transmitted by airborne droplet nuclei; airborne
precautions (negative pressure room, an N95 or higher
respirator) are required to protect staff and other patients.
Using the appropriate isolation level prevents airborne
transmission per established infection control guidance.
4 — Multiple response (oral hygiene)
Which of the following interventions are appropriate when
providing oral care to an unconscious patient? (Select all that
apply.)
A. Position client on their side with head turned
B. Use a toothette or soft toothbrush moistened with water or
prescribed solution
C. Insert fingers into mouth to remove secretions manually
D. Suction oral cavity as needed during care
E. Rinse with large amounts of water and instruct client to spit
Correct answers: A, B, D
, Rationale:
For unconscious patients, position on side to prevent aspiration;
use soft brushes/toottees and small volumes of water; suction
when necessary. Do NOT insert fingers into the mouth (risk of
injury) or rely on the client to spit. These steps follow safe oral
care and aspiration-prevention practices.
5 — Multiple choice (vital signs interpretation)
A client’s vital signs: T 38.4°C (101.1°F), HR 112, RR 22, BP
88/54. Which action is highest priority?
A. Offer antipyretic and reassess later
B. Notify the health care provider immediately — possible
sepsis/hypotension
C. Recheck temperature in 1 hour
D. Encourage oral fluids and rest
Correct answer: B
Rationale:
Fever with tachycardia and hypotension suggests possible
sepsis or hemodynamic instability. Immediate notification and
rapid assessment/intervention are required. Per prioritization
principles, unstable vital signs and signs of shock take
precedence over routine measures.
6 — Multiple choice (urinary elimination & catheter care)
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — Multiple choice (PPE sequencing)
A nurse is entering the room of a patient on contact precautions
for MRSA to change a dressing. Which is the correct sequence
for donning PPE?
A. Gown → gloves → mask → eye protection
B. Mask → gown → gloves → eye protection
C. Gown → mask → eye protection → gloves
D. Gown → eye protection → mask → gloves
Correct answer: C
Rationale:
Donning sequence is gown first (to secure coverage of
torso/arms), then mask (if required), then eye protection, then
gloves last (gloves should cover gown cuff). This order
minimizes contamination risk and ensures gloves are donned
last to maintain a barrier. This follows standard precaution
technique used in infection prevention practice.
,2 — Multiple choice (PPE removal)
Which statement shows correct glove removal to reduce
contamination?
A. Peel one glove off, hold it in gloved hand, slide fingers under
the remaining glove cuff and pull off.
B. Pull gloves off together by grabbing at the fingertips of both
gloves.
C. Remove gloves by touching the outside of the glove with
bare hand.
D. Cut gloves off with scissors at the wrist and discard.
Correct answer: A
Rationale:
The glove-off technique where one glove is peeled off and held
in the gloved hand, then fingers are slid under the remaining
glove cuff and the second glove is peeled off over the first
reduces hand contamination. Avoid touching outer glove
surfaces with bare hands. This is consistent with standard
precautions and correct donning/doffing technique.
3 — Multiple choice (isolation precaution selection)
A patient with suspected pulmonary tuberculosis is admitted.
Which isolation precaution is indicated?
,A. Contact precautions (gown + gloves)
B. Droplet precautions (surgical mask within 3 ft)
C. Airborne precautions (negative-pressure room + N95
respirator)
D. Standard precautions only
Correct answer: C
Rationale:
Tuberculosis is transmitted by airborne droplet nuclei; airborne
precautions (negative pressure room, an N95 or higher
respirator) are required to protect staff and other patients.
Using the appropriate isolation level prevents airborne
transmission per established infection control guidance.
4 — Multiple response (oral hygiene)
Which of the following interventions are appropriate when
providing oral care to an unconscious patient? (Select all that
apply.)
A. Position client on their side with head turned
B. Use a toothette or soft toothbrush moistened with water or
prescribed solution
C. Insert fingers into mouth to remove secretions manually
D. Suction oral cavity as needed during care
E. Rinse with large amounts of water and instruct client to spit
Correct answers: A, B, D
, Rationale:
For unconscious patients, position on side to prevent aspiration;
use soft brushes/toottees and small volumes of water; suction
when necessary. Do NOT insert fingers into the mouth (risk of
injury) or rely on the client to spit. These steps follow safe oral
care and aspiration-prevention practices.
5 — Multiple choice (vital signs interpretation)
A client’s vital signs: T 38.4°C (101.1°F), HR 112, RR 22, BP
88/54. Which action is highest priority?
A. Offer antipyretic and reassess later
B. Notify the health care provider immediately — possible
sepsis/hypotension
C. Recheck temperature in 1 hour
D. Encourage oral fluids and rest
Correct answer: B
Rationale:
Fever with tachycardia and hypotension suggests possible
sepsis or hemodynamic instability. Immediate notification and
rapid assessment/intervention are required. Per prioritization
principles, unstable vital signs and signs of shock take
precedence over routine measures.
6 — Multiple choice (urinary elimination & catheter care)
