Safety and Infection Control — NCLEX-RN Practice
Covers standard and transmission-based precautions, infection control principles, emergency response planning, error and hazard prevention, and safe use of equipment and restraints.
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What you must know about Safety and Infection Control
Standard precautions apply to every client, every time — transmission-based precautions (contact, droplet, airborne) are added on top for specific organisms.
Airborne precautions require a negative-pressure room and N95 respirator — this is the most commonly tested precaution type.
Reporting a hazard or near-miss is a professional obligation, not optional, even if no harm occurred.
Restraints require a time-limited order and regular reassessment — they are a last resort, not a convenience.
NCLEX Exam Tips
How this category appears on the NCLEX-RN exam
If a question describes an organism, identify the transmission route first (airborne/droplet/contact) before choosing the precaution.
Fire safety questions usually test the RACE (rescue, alarm, contain, extinguish) or PASS (pull, aim, squeeze, sweep) sequence.
Needlestick and exposure questions test the immediate first action, then who to report to.
Practice Questions
Test yourself — 10 questions
Practice questions written to the NCSBN NCLEX-RN test plan. The NCSBN does not publish real exam items, so no provider has genuine NCLEX past questions. Every question here comes with a full written rationale.
A 72-year-old patient is admitted to the hospital with pneumonia and a history of COPD. The nurse notices signs of confusion and restlessness. The patient's oxygen saturation is 88% on room air. What is the most appropriate initial intervention by the nurse to ensure patient safety?
Rationale
The patient's low oxygen saturation and symptoms of confusion and restlessness indicate hypoxia. Initiating oxygen therapy is the most immediate and appropriate intervention to address hypoxia and ensure safety. Administering bronchodilators may be necessary but not the first step. Notifying the physician is important but should follow after addressing immediate safety needs. Chest physiotherapy is not an immediate intervention for hypoxia.
A nurse is preparing to insert an indwelling urinary catheter for a female patient. Which action should the nurse take to maintain a sterile field and prevent infection during the procedure?
Rationale
Applying sterile gloves after opening the catheter kit is essential to maintain a sterile field during catheter insertion. Cleaning with soap and water is part of pre-procedure hygiene but does not maintain sterility during the procedure. Using the dominant hand to open the catheter package could compromise sterility. Inflating the catheter balloon before insertion is not recommended as it can compromise the sterility and function of the catheter.
A nurse is caring for a patient with methicillin-resistant Staphylococcus aureus (MRSA) infection. Which precaution should the nurse implement to prevent the spread of infection?
Rationale
Contact precautions, including wearing a gown and gloves, are necessary to prevent the spread of MRSA as it is primarily transmitted through direct contact. A surgical mask, negative air pressure, and droplet precautions are not necessary for MRSA, which does not spread through respiratory droplets or by airborne transmission.
During a disaster drill, a nurse is assigned to triage patients arriving at the emergency department. Which patient should the nurse prioritize for treatment based on the principles of triage?
Rationale
In a disaster scenario, the principles of triage prioritize patients who need immediate care to survive, such as those with severe respiratory distress from a penetrating chest wound. The patient with a fractured arm, contusions, or mild symptoms can wait for treatment as they are not immediately life-threatening.
A nurse is preparing to administer an intramuscular injection to a 5-year-old child who is anxious and uncooperative. What is the best approach to ensure the child’s safety during the procedure?
Rationale
Asking the parent to hold the child securely is the best approach because it ensures the child is safely restrained while reducing anxiety by having a familiar presence. Explaining in detail may not be effective for a 5-year-old and could increase anxiety. Restraining with a blanket may be traumatic and is not a preferred method. Administering the injection quickly without warning is not safe practice as it can cause injury or increase fear.
A nurse is teaching a group of nursing students about proper hand hygiene. Which statement by a student indicates a need for further teaching?
Rationale
Hand hygiene is necessary not only after contact with visibly soiled surfaces but also after touching patients, before procedures, and after exposure to bodily fluids, regardless of visible soil. Options B, C, and D are correct statements reflecting proper hand hygiene practices.
In a hospital setting, which measure is most effective in reducing the transmission of Clostridium difficile?
Rationale
Hand hygiene with soap and water is most effective in reducing the transmission of Clostridium difficile, as alcohol-based rubs are not effective against spores. While wearing gloves and disposable gowns (options B and D) are important, they are not the primary measure. Option A is incorrect as alcohol-based rubs are ineffective against C. difficile.
A patient in an isolation room for tuberculosis is about to be discharged. What should the nurse ensure before the patient leaves the facility?
Rationale
The patient should wear a surgical mask to prevent the spread of tuberculosis to others when leaving the hospital. Option B is irrelevant as tuberculosis treatment involves long-term medications. Room cleaning (option C) is important but not the priority before the patient leaves. Escorting by a staff member (option D) is not necessary for infection control.
A nurse is caring for a patient with MRSA in a wound. Which personal protective equipment (PPE) should the nurse prioritize when changing the wound dressing?
Rationale
A gown and clean gloves are appropriate for contact precautions when dealing with MRSA in a wound. Sterile gloves are not necessary unless performing a sterile procedure. Masks and goggles are not required unless there is a risk of splashes or sprays.
The nurse is preparing to transport a patient with airborne precautions to a diagnostic test. What is the most important action to take?
Rationale
Ensuring the patient wears a surgical mask during transport is crucial to prevent the spread of airborne pathogens. While notifying the team (option C) and disinfecting equipment (option B) are important, they do not directly prevent airborne transmission. Transport timing (option D) is less effective than masking the patient.
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