Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — Donning and Doffing PPE (single best answer)
A nurse is preparing to enter the room of a client on contact
precautions for Clostridioides difficile. Which sequence for
donning PPE is correct?
A. Gown → Gloves → Mask → Eye protection
B. Mask → Eye protection → Gown → Gloves
C. Gown → Mask → Eye protection → Gloves
D. Gloves → Gown → Mask → Eye protection
Correct answer: C
Rationale: For contact isolation, the appropriate donning order
is gown → mask (if needed) → eye protection (if splashes likely)
→ gloves so that gloves go over gown cuffs to maintain barrier
integrity. This minimizes contamination of underlying clothing
and ensures eye/respiratory protection is in place before
exposure. (Guiding principles: CDC PPE sequence; donning
order emphasizes gown before gloves; if respirator required,
,the respirator is donned before eye protection.)
CJMM mapping: Recognize cues (patient on contact
precautions) → Analyze (risk for contamination) → Generate
solutions (appropriate PPE) → Take action (don PPE in correct
order).
2 — Doffing PPE with contamination risk (single best answer)
A nurse is leaving the room of a client with active C. difficile
diarrhea. Which item should be removed first to reduce
contamination risk?
A. Mask
B. Goggles
C. Gloves
D. Gown
Correct answer: C
Rationale: Gloves are typically the most contaminated items
and should be removed first, followed by gown (with careful
rolling), then eye protection, then mask (or respirator last).
Hand hygiene should be performed immediately after glove
removal and again after all PPE is removed. This reduces the
spread of spores and organisms. (CDC principles for doffing
PPE.)
CJMM mapping: Recognize contamination → Take action
(remove most contaminated item first).
,3 — Isolation precautions selection (single best answer)
Which precautions are required for a client with known
pulmonary tuberculosis (infectious, newly diagnosed)?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct answer: D
Rationale: Pulmonary TB spreads via airborne droplet nuclei;
airborne precautions (negative-pressure room, N95 or higher-
level respirator for staff, patient masking during transport) are
required to prevent inhalation of smaller particles. Standard
precautions are always used but are not sufficient for airborne
pathogens. (Evidence-based infection control practice: airborne
isolation for TB.)
CJMM mapping: Recognize diagnosis → Analyze transmission
route → Generate airborne precautions → Take action (place in
negative-pressure room, staff wear respirators).
4 — Hand hygiene indications (SATA)
Select all the situations when alcohol-based hand sanitizer is
appropriate:
A. Before palpating a client’s abdomen.
B. After removing gloves contaminated with C. difficile.
C. Before invasive procedures (e.g., catheter insertion).
, D. After touching a client’s intact skin.
E. When hands are visibly soiled with blood
Correct answers: A, C, D
Rationale: Alcohol-based hand sanitizer is effective for most
routine situations (before client contact, before invasive
procedures, after touching intact skin) but is not effective
against C. difficile spores and should not be used after contact
with C. difficile — use soap and water instead. When hands are
visibly soiled or contaminated with blood/body fluids, wash
with soap and water. (CDC hand hygiene guidelines.)
CJMM mapping: Recognize cues (type of exposure) → Analyze
(is sanitizer effective?) → Take action (use sanitizer or
soap/water appropriately).
5 — Bed bath & pressure injury prevention (single best
answer)
While giving a bed bath, the nurse notices a reddened,
nonblanching area over the sacrum on an immobile client. The
nurse’s first action should be:
A. Massage the area to increase circulation.
B. Reposition the client off the sacrum and document.
C. Apply moisturizing lotion and continue bathing.
D. Increase room temperature to improve perfusion.
Correct answer: B
Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
FUNDAMENTALS OF NURSING TEST BANK.
1 — Donning and Doffing PPE (single best answer)
A nurse is preparing to enter the room of a client on contact
precautions for Clostridioides difficile. Which sequence for
donning PPE is correct?
A. Gown → Gloves → Mask → Eye protection
B. Mask → Eye protection → Gown → Gloves
C. Gown → Mask → Eye protection → Gloves
D. Gloves → Gown → Mask → Eye protection
Correct answer: C
Rationale: For contact isolation, the appropriate donning order
is gown → mask (if needed) → eye protection (if splashes likely)
→ gloves so that gloves go over gown cuffs to maintain barrier
integrity. This minimizes contamination of underlying clothing
and ensures eye/respiratory protection is in place before
exposure. (Guiding principles: CDC PPE sequence; donning
order emphasizes gown before gloves; if respirator required,
,the respirator is donned before eye protection.)
CJMM mapping: Recognize cues (patient on contact
precautions) → Analyze (risk for contamination) → Generate
solutions (appropriate PPE) → Take action (don PPE in correct
order).
2 — Doffing PPE with contamination risk (single best answer)
A nurse is leaving the room of a client with active C. difficile
diarrhea. Which item should be removed first to reduce
contamination risk?
A. Mask
B. Goggles
C. Gloves
D. Gown
Correct answer: C
Rationale: Gloves are typically the most contaminated items
and should be removed first, followed by gown (with careful
rolling), then eye protection, then mask (or respirator last).
Hand hygiene should be performed immediately after glove
removal and again after all PPE is removed. This reduces the
spread of spores and organisms. (CDC principles for doffing
PPE.)
CJMM mapping: Recognize contamination → Take action
(remove most contaminated item first).
,3 — Isolation precautions selection (single best answer)
Which precautions are required for a client with known
pulmonary tuberculosis (infectious, newly diagnosed)?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct answer: D
Rationale: Pulmonary TB spreads via airborne droplet nuclei;
airborne precautions (negative-pressure room, N95 or higher-
level respirator for staff, patient masking during transport) are
required to prevent inhalation of smaller particles. Standard
precautions are always used but are not sufficient for airborne
pathogens. (Evidence-based infection control practice: airborne
isolation for TB.)
CJMM mapping: Recognize diagnosis → Analyze transmission
route → Generate airborne precautions → Take action (place in
negative-pressure room, staff wear respirators).
4 — Hand hygiene indications (SATA)
Select all the situations when alcohol-based hand sanitizer is
appropriate:
A. Before palpating a client’s abdomen.
B. After removing gloves contaminated with C. difficile.
C. Before invasive procedures (e.g., catheter insertion).
, D. After touching a client’s intact skin.
E. When hands are visibly soiled with blood
Correct answers: A, C, D
Rationale: Alcohol-based hand sanitizer is effective for most
routine situations (before client contact, before invasive
procedures, after touching intact skin) but is not effective
against C. difficile spores and should not be used after contact
with C. difficile — use soap and water instead. When hands are
visibly soiled or contaminated with blood/body fluids, wash
with soap and water. (CDC hand hygiene guidelines.)
CJMM mapping: Recognize cues (type of exposure) → Analyze
(is sanitizer effective?) → Take action (use sanitizer or
soap/water appropriately).
5 — Bed bath & pressure injury prevention (single best
answer)
While giving a bed bath, the nurse notices a reddened,
nonblanching area over the sacrum on an immobile client. The
nurse’s first action should be:
A. Massage the area to increase circulation.
B. Reposition the client off the sacrum and document.
C. Apply moisturizing lotion and continue bathing.
D. Increase room temperature to improve perfusion.
Correct answer: B
