NCLEX-RN
Safe & Effective Care
Environment
Latest Exam Review
2026
(With Solutions)
Multiple Choice (MCQ)
A nurse is managing care for a post-operative patient who
develops a sudden drop in blood pressure and tachycardia. What is
the nurse’s priority action?
a) Administer IV fluids as ordered
b) Call rapid response team immediately
c) Reassess vital signs in 15 minutes
d) Document findings and notify the physician at shift end
Answer: b) Call rapid response team immediately
Rationale: Sudden hypotension and tachycardia can indicate shock
or hemorrhage. Immediate intervention via rapid response is
critical to prevent deterioration.
Which of the following is the most effective method to reduce
healthcare-associated infections (HAIs)?
a) Use of personal protective equipment only when in contact with
bodily fluids
b) Hand hygiene before and after patient contact
c) Isolating only patients with confirmed infections
d) Routine environmental cleaning once daily
Answer: b) Hand hygiene before and after patient contact
,Rationale: Hand hygiene is the single most important practice to
prevent HAIs.
A case manager is prioritizing discharge planning for a patient with
multiple comorbidities. Which factor should be considered first?
a) Patient’s ability to pay for medications
b) Availability of family support at home
c) Patient’s understanding of follow-up care instructions
d) Location of patient’s residence
Answer: c) Patient’s understanding of follow-up care instructions
Rationale: Ensuring patient comprehension of care plans directly
impacts safe transition and prevents readmission.
What is the most appropriate nursing action when entering an
isolation room with a patient diagnosed with Clostridium difficile?
a) Don gloves and gown after room entry
b) Use alcohol-based hand rub on entry and exit
c) Don a gown and gloves before entering the room
d) No special precautions required as long as patient is
symptomatic
Answer: c) Don a gown and gloves before entering the room
Rationale: Contact precautions require donning PPE before
entering to prevent spread of spores.
Which legal document gives a healthcare proxy power to make
healthcare decisions for an incapacitated patient?
a) Living will
b) Durable power of attorney for healthcare
c) Do not resuscitate (DNR) order
d) Informed consent form
Answer: b) Durable power of attorney for healthcare
Rationale: This document designates a person to make healthcare
decisions if the patient is unable.
,True/False
The nurse should always place a physical restraint on a confused
patient to prevent injury.
Answer: False
Rationale: Restraints should be used only as a last resort, following
assessment, and after attempting less restrictive interventions.
Standard precautions should be used for all patients regardless of
infection status.
Answer: True
Rationale: Standard precautions apply to all patient care to
minimize risk from bloodborne pathogens.
Effective communication among interdisciplinary teams reduces
medical errors.
Answer: True
Rationale: Clear communication is crucial in preventing errors and
ensuring patient safety.
Airborne precautions require use of N95 respirators when caring
for patients with tuberculosis.
Answer: True
Rationale: N95 masks protect nurses from inhaling airborne
infectious particles.
Hand hygiene is only necessary after removing gloves.
Answer: False
Rationale: Hand hygiene is required both before and after glove
use to reduce infection risk.
Short Answer
What are two key components of effective case management in
nursing?
Answer: Coordination of care and patient advocacy
Rationale: These components ensure patient needs are met
, through collaboration and support across the care continuum.
Name one major challenge in preventing medication errors during
patient hand-off.
Answer: Miscommunication or lack of complete information
transfer
Rationale: Accurate communication during hand-offs is critical to
prevent medication errors.
Identify one infection control practice appropriate for preventing
ventilator-associated pneumonia (VAP).
Answer: Elevating the head of the bed to 30-45 degrees
Rationale: This position reduces aspiration risk, a leading cause of
VAP.
What is one key element of informed consent in nursing practice?
Answer: Ensuring the patient understands the procedure, risks,
and alternatives
Rationale: Patients must have the information to make voluntary
and informed decisions.
Define the term 'never event' with an example.
Answer: A never event is a serious, preventable patient safety
incident, e.g., surgery on the wrong site.
Rationale: These events should never happen with proper safety
protocols.
Matching
Match the term with the correct definition:
16-20.
Terms Definitions
A) Sentinel Event 1) A plan outlining end-of-life care
preferences
Safe & Effective Care
Environment
Latest Exam Review
2026
(With Solutions)
Multiple Choice (MCQ)
A nurse is managing care for a post-operative patient who
develops a sudden drop in blood pressure and tachycardia. What is
the nurse’s priority action?
a) Administer IV fluids as ordered
b) Call rapid response team immediately
c) Reassess vital signs in 15 minutes
d) Document findings and notify the physician at shift end
Answer: b) Call rapid response team immediately
Rationale: Sudden hypotension and tachycardia can indicate shock
or hemorrhage. Immediate intervention via rapid response is
critical to prevent deterioration.
Which of the following is the most effective method to reduce
healthcare-associated infections (HAIs)?
a) Use of personal protective equipment only when in contact with
bodily fluids
b) Hand hygiene before and after patient contact
c) Isolating only patients with confirmed infections
d) Routine environmental cleaning once daily
Answer: b) Hand hygiene before and after patient contact
,Rationale: Hand hygiene is the single most important practice to
prevent HAIs.
A case manager is prioritizing discharge planning for a patient with
multiple comorbidities. Which factor should be considered first?
a) Patient’s ability to pay for medications
b) Availability of family support at home
c) Patient’s understanding of follow-up care instructions
d) Location of patient’s residence
Answer: c) Patient’s understanding of follow-up care instructions
Rationale: Ensuring patient comprehension of care plans directly
impacts safe transition and prevents readmission.
What is the most appropriate nursing action when entering an
isolation room with a patient diagnosed with Clostridium difficile?
a) Don gloves and gown after room entry
b) Use alcohol-based hand rub on entry and exit
c) Don a gown and gloves before entering the room
d) No special precautions required as long as patient is
symptomatic
Answer: c) Don a gown and gloves before entering the room
Rationale: Contact precautions require donning PPE before
entering to prevent spread of spores.
Which legal document gives a healthcare proxy power to make
healthcare decisions for an incapacitated patient?
a) Living will
b) Durable power of attorney for healthcare
c) Do not resuscitate (DNR) order
d) Informed consent form
Answer: b) Durable power of attorney for healthcare
Rationale: This document designates a person to make healthcare
decisions if the patient is unable.
,True/False
The nurse should always place a physical restraint on a confused
patient to prevent injury.
Answer: False
Rationale: Restraints should be used only as a last resort, following
assessment, and after attempting less restrictive interventions.
Standard precautions should be used for all patients regardless of
infection status.
Answer: True
Rationale: Standard precautions apply to all patient care to
minimize risk from bloodborne pathogens.
Effective communication among interdisciplinary teams reduces
medical errors.
Answer: True
Rationale: Clear communication is crucial in preventing errors and
ensuring patient safety.
Airborne precautions require use of N95 respirators when caring
for patients with tuberculosis.
Answer: True
Rationale: N95 masks protect nurses from inhaling airborne
infectious particles.
Hand hygiene is only necessary after removing gloves.
Answer: False
Rationale: Hand hygiene is required both before and after glove
use to reduce infection risk.
Short Answer
What are two key components of effective case management in
nursing?
Answer: Coordination of care and patient advocacy
Rationale: These components ensure patient needs are met
, through collaboration and support across the care continuum.
Name one major challenge in preventing medication errors during
patient hand-off.
Answer: Miscommunication or lack of complete information
transfer
Rationale: Accurate communication during hand-offs is critical to
prevent medication errors.
Identify one infection control practice appropriate for preventing
ventilator-associated pneumonia (VAP).
Answer: Elevating the head of the bed to 30-45 degrees
Rationale: This position reduces aspiration risk, a leading cause of
VAP.
What is one key element of informed consent in nursing practice?
Answer: Ensuring the patient understands the procedure, risks,
and alternatives
Rationale: Patients must have the information to make voluntary
and informed decisions.
Define the term 'never event' with an example.
Answer: A never event is a serious, preventable patient safety
incident, e.g., surgery on the wrong site.
Rationale: These events should never happen with proper safety
protocols.
Matching
Match the term with the correct definition:
16-20.
Terms Definitions
A) Sentinel Event 1) A plan outlining end-of-life care
preferences
