Question 1

During cannulation, the nurse touches the cleaned site with gloves. What should the nurse do?

Accepted Answer

Answer reason: Touching a prepped/cannulation site after it has been cleaned contaminates the antiseptic field, even if gloves are worn. To reduce the risk of introducing microorganisms into the access site and causing local or bloodstream infection, the site must be cleansed again using proper aseptic technique and allowed to dry as indicated for the antiseptic. Continuing without re-prepping or simply wiping with dry gauze does not restore antisepsis. There is no need to ask another nurse to insert; correcting the break in aseptic technique is sufficient.
Category reason: The question tests the nurse’s response to a break in aseptic technique during cannulation to prevent infection, which falls under Safety and Infection Control—Infection Control.

Question 2

What is the most common nosocomial infection?

Accepted Answer

Answer reason: The most common healthcare-associated (nosocomial) infection is a urinary tract infection, largely due to the frequent use of indwelling urinary catheters (CAUTI). Catheter insertion and prolonged catheterization provide a direct pathway for bacterial entry and biofilm formation. Pneumonia, surgical site infection, and septicemia also occur in hospitals but are generally less common overall than catheter-associated UTIs.
Category reason: This question tests knowledge about prevention and epidemiology of healthcare-associated infections, which is central to nursing safety practices and infection control measures in clinical settings.

Question 3

In managing iatrogenic infections, most critical action:

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to prevent transmission of healthcare-associated (iatrogenic) infections because contaminated hands are the most common vector for spread between patients and surfaces. Correct hand washing or alcohol-based hand rub before and after patient contact reduces pathogen transfer more reliably than environmental cleaning alone. Masks are only critical for specific transmission routes (e.g., droplet/airborne) and are not universally required for all care. Avoiding patient contact is not an appropriate infection-control strategy and would compromise necessary care.
Category reason: This question asks for the most critical nursing action to prevent healthcare-associated infection, which is a core patient-safety and infection prevention responsibility in clinical care, fitting the NCLEX Safety and Infection Control category (Infection Control).

Question 4

A nurse notices a central line dressing is wet and coming loose. What is the priority action?

Accepted Answer

Answer reason: A wet and loose central line dressing compromises the sterile barrier and significantly increases the risk of catheter-related bloodstream infection. The priority nursing action is to restore an intact, occlusive dressing using sterile technique per facility policy. Reinforcing with tape does not correct contamination or moisture, and simply documenting/monitoring delays needed infection prevention. Provider notification is not the first step unless there are complications (e.g., signs of infection, catheter dislodgement, or bleeding) after securing the site.
Category reason: This item tests immediate nursing action to prevent infection related to a central venous catheter, which is a core Safety and Infection Control priority.

Question 5

A client in the emergency department has an open leg fracture. What is the nurse’s first action?

Accepted Answer

Answer reason: With an open fracture, the immediate nursing priority is to reduce contamination and infection risk by covering the exposed wound with a sterile dressing. Manipulating the limb to assess mobility can worsen tissue damage and bleeding. Pain assessment is important but does not supersede initial protection of the open wound. IV antibiotics are typically ordered urgently, but the nurse’s first independent action is sterile coverage while preparing for further emergency management.
Category reason: This is a priority nursing action in an emergency situation aimed at preventing contamination and infection in an open fracture, which fits Safety and Infection Control—Infection Control.

Question 6

A child with nephrotic syndrome is receiving corticosteroids. Which finding should the nurse report immediately?

Accepted Answer

Answer reason: Corticosteroids are immunosuppressive and can mask typical signs of infection, so any fever in a child on steroids must be reported promptly for evaluation and treatment. A temperature of 101°F (38.3°C) suggests possible infection, which can quickly become serious in an immunocompromised patient. The other findings (increased appetite, morning periorbital edema, modest short-term weight gain) can occur with nephrotic syndrome and/or steroid therapy and are generally not as urgent as potential infection.
Category reason: The question asks what nursing finding requires immediate reporting for safety while a child is receiving an immunosuppressive medication, emphasizing recognition of infection risk and timely escalation of care, which aligns with Infection Control under Safety and Infection Control.

Question 7

Which finding is most concerning in a client in skeletal traction?

Accepted Answer

Answer reason: Drainage at a skeletal traction pin site is most concerning because it can indicate a developing pin-tract infection and risk progression to osteomyelitis or systemic infection. Pin sites should be monitored closely for increasing redness, warmth, swelling, pain, purulent drainage, or foul odor. In contrast, mild dependent ankle swelling can occur with immobility, palpable distal pulses indicate maintained perfusion, and pain controlled by medication suggests adequate comfort management rather than an urgent complication.
Category reason: This question tests nursing surveillance for complications of an invasive orthopedic device (skeletal traction) and identifying an infection risk requiring prompt intervention, which fits Safety and Infection Control.

Question 8

Which postpartum finding requires immediate intervention?

Accepted Answer

Answer reason: Foul-smelling lochia is an abnormal postpartum finding suggestive of uterine infection/endometritis and requires prompt assessment and intervention to prevent progression to sepsis. Normal lochia rubra can be moderate on postpartum day 1, and a firm, midline fundus indicates appropriate uterine involution. Breast tenderness/engorgement around day 3 is common with milk coming in and is typically managed with supportive measures unless accompanied by fever or localized signs of mastitis.
Category reason: This item tests recognition of a potentially serious postpartum complication and the need for urgent nursing action related to infection surveillance and prevention, which fits Infection Control within Safety and Infection Control.

Question 9

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?

Accepted Answer

Answer reason: Enteral feeding equipment and formula are potential sources of bacterial contamination, so changing feeding solution and tubing at least every 24 hours is a key infection-prevention intervention. A 15-degree head-of-bed elevation is insufficient; aspiration prevention generally requires keeping the HOB elevated about 30–45 degrees during feedings and for a period afterward. Tube placement/position should be assessed more frequently than every 2 days (per policy) to reduce risk of malposition and aspiration. Bed rest is not required during tube feedings; positioning and aspiration precautions are more relevant.
Category reason: The item asks for a nursing intervention to safely administer gastrostomy tube feedings, emphasizing prevention of contamination and complications, which fits Infection Control under Safety and Infection Control.

Question 10

Most common cause of hosp. acquired Infection would be?

Accepted Answer

Answer reason: Catheter-associated urinary tract infection (CAUTI) is one of the most frequent hospital-acquired infections because indwelling urinary catheters provide a direct route for bacteria and allow biofilm formation. The longer a catheter remains in place, the higher the infection risk, making device-associated infection a major driver of HAIs. While IV lines can also cause bloodstream infections, urinary catheters are a more common overall source in typical inpatient settings. Respiratory droplets and dust are less common primary causes compared with device-associated infections.
Category reason: The question tests prevention/recognition of common hospital-acquired infection sources (device-associated infection risk), which is a core Infection Control concept in nursing practice.

Question 11

Dog 🐕 Bites Immediate first aid Treatment ??

Accepted Answer

Answer reason: The immediate first aid for an animal (dog) bite is thorough irrigation and washing with soap and running water for about 15 minutes to mechanically remove saliva, debris, and reduce viral/bacterial load (including rabies risk). Covering with a dressing can be done after cleaning, but it is not the first and most important step. Suturing is generally avoided initially in contaminated bite wounds unless specifically indicated, because it can increase infection risk. Applying antiseptic may be used after washing, but it does not replace prolonged flushing/irrigation.
Category reason: This item tests an immediate nursing first-aid action to reduce infection transmission risk after a bite, which is primarily an infection control/safety intervention rather than foundational science knowledge.

Question 12

This Hepatitis virus is highly contagious and is contracted from ingestion of the virus, primarily through contaminated food, drink, and feces (Fecal-Oral Route). Which hepatitis is it?

Accepted Answer

Answer reason: Hepatitis A is transmitted primarily via the fecal–oral route, commonly through contaminated food or water, and is highly contagious in settings with poor sanitation or close contact. This contrasts with hepatitis B, C, and D, which are predominantly spread through blood and body fluids (e.g., percutaneous exposure, sexual contact, perinatal transmission). Therefore, a fecal–oral transmission description most directly indicates hepatitis A. Infection control teaching emphasizes hand hygiene and safe food/water practices to prevent HAV spread.
Category reason: The stem focuses on mode of transmission and infection control precautions/teaching (fecal–oral spread via food/water), which aligns with preventing transmission in clinical and community settings.

Question 13

Donning PPE Hauwa sets up an area for donning (putting on) PPE outside of the entrance of the room. She also reminds the staff of the proper sequence of steps when donning this PPE, which is...?

Accepted Answer

Answer reason: The correct donning sequence begins with hand hygiene to reduce transmission of microorganisms before touching clean PPE and the face. After hand hygiene, the gown is applied first to cover clothing and skin, followed by mask/respirator, then eye protection, and gloves last to cover the gown cuffs and provide the final barrier. This order helps prevent contaminating PPE during placement and ensures maximum protection at the point of patient contact.
Category reason: This question tests the correct sequence for putting on personal protective equipment to prevent infection transmission in a clinical setting, which is a core Infection Control competency.

Question 14

What is the most appropriate nursing action when caring for a newborn with an unrepaired myelomeningocele?

Accepted Answer

Answer reason: With an unrepaired myelomeningocele, the priority is protecting exposed neural tissue by preventing drying and minimizing infection risk. A sterile saline-soaked (moist) nonadherent dressing helps keep the sac moist and reduces the chance of tissue breakdown and contamination. Dry gauze can adhere and promote drying, increasing injury risk. The newborn is typically positioned prone (not supine) to avoid pressure on the sac, and feeding is not routinely delayed solely due to the defect unless otherwise clinically indicated.  
Category reason: This question tests a priority nursing intervention to prevent infection and protect exposed tissue in a newborn with a congenital defect, which is a patient safety and infection-control nursing care decision.

Question 15

Your assigned client has a leg ulcer that has a dressing on. During your assessment, you find that the dressing is wet. The client admits to showering with the dressing. What action would you do as part?

Accepted Answer

Answer reason: A wet dressing from showering is considered contaminated and can promote bacterial growth and impair wound healing. The safest nursing action is to remove the wet dressing and apply a clean, dry dressing (or per wound care orders/protocol) to reduce infection risk and protect the ulcer. Reinforcing, blow-drying, or air-drying does not restore sterility and may trap moisture against the wound, increasing maceration and infection risk. Client teaching should include keeping the dressing dry or using appropriate waterproof protection during bathing.  
Category reason: This item focuses on preventing wound contamination and infection through appropriate dressing management, which is a nursing safety/infection-control intervention rather than a medical diagnosis or pharmacology question.

Question 16

Period of isolation of the child with mumps at home is:

Accepted Answer

Answer reason: Mumps is transmitted via respiratory droplets, and infectivity is highest from just before to several days after onset of parotitis. Standard guidance is isolation/exclusion for 5 days after the onset of parotid swelling; among the choices provided, 7 days is the best match and provides a practical margin of safety to reduce transmission. Longer periods (10–21 days) are not routinely required for mumps home isolation and would be unnecessarily restrictive.  
Category reason: The question addresses how long to isolate a contagious child to prevent spread to others, which is a direct infection-control measure (transmission-based precautions/containment) rather than health promotion or pathophysiology.

Question 17

INSTRUMENTS in the hospitals are boiled to make them?

Accepted Answer

Answer reason: Boiling is a form of thermal disinfection that kills many vegetative bacteria, viruses, and fungi and is used to reduce microbial load to prevent transmission of infection. However, boiling does not reliably destroy bacterial spores (e.g., Clostridioides spores), so it does not meet the standard definition of sterilization. “Clean for use” is insufficient because cleaning removes visible soil but does not necessarily kill microorganisms. “Immunized” applies to people, and “pasteurized” refers to a controlled heat process used primarily for food/liquids, not instrument processing. Therefore, “disinfected” is the most accurate choice for boiling.  
Category reason: The item tests understanding of decontamination methods used on equipment to prevent healthcare-associated infections, specifically distinguishing disinfection from sterilization—an essential Infection Control concept.

Question 18

The color of bag in which the infectious solid wastes are disposed?

Accepted Answer

Answer reason: Infectious (soiled) waste contaminated with blood/body fluids is segregated into yellow bags in standard biomedical waste color-coding systems. Correct segregation reduces exposure risk to staff and the public and ensures appropriate treatment/disposal (e.g., incineration or other regulated processing). Red is commonly used for contaminated recyclable plastics (after appropriate processing), blue for certain glass/metal waste, and black for general/non-infectious waste (where used). Therefore, yellow is the best answer.  
Category reason: This question assesses safe handling and disposal of infectious waste to prevent pathogen transmission in healthcare settings, which is a core Infection Control responsibility.

Question 19

The best way to break the chain of infection is?

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to interrupt transmission of microorganisms and prevent healthcare-associated infections. It reduces transient flora on the hands that commonly spread pathogens via contact with patients, surfaces, and equipment. While PPE and decontamination are important, they do not replace consistent handwashing/hand rub before and after patient contact. Therefore, handwashing best breaks the chain of infection across multiple transmission routes.
Category reason: The question asks for the best nursing infection-prevention measure to interrupt transmission, which is a core Safety and Infection Control concept on NCLEX.

Question 20

What is the first step in preventing ventilator-associated pneumonia (VAP)?

Accepted Answer

Answer reason: Elevating the head of the bed to 30–45 degrees is a primary, evidence-based intervention to reduce aspiration of oropharyngeal and gastric secretions, which is the leading mechanism in ventilator-associated pneumonia. Antibiotics are not used prophylactically, increasing FiO₂ does not prevent infection, and sedatives may increase VAP risk by suppressing protective airway reflexes.
Category reason: This question focuses on preventing a healthcare-associated infection through standard preventive measures, which directly aligns with Infection Control.

Question 21

The primary purpose of hand hygiene is to?

Accepted Answer

Answer reason:  b. Reduce infection risk Hand hygiene is the single most effective measure to prevent transmission of microorganisms and reduce healthcare-associated infections. It removes transient flora acquired from patients, surfaces, and equipment, interrupting the chain of infection. While it may secondarily help skin cleanliness, its primary goal is infection prevention rather than falls, circulation, or skin condition.
Category reason: This item tests a core patient-safety intervention aimed at preventing pathogen transmission in clinical settings, which aligns directly with Infection Control under Safety and Infection Control.

Question 22

Which infection is commonly acquired in hospitals due to poor hygiene?

Accepted Answer

Answer reason: Nosocomial infection Nosocomial infections are infections acquired in a hospital or healthcare setting and are strongly associated with poor hygiene and inadequate infection-control practices (especially poor hand hygiene). These infections commonly include healthcare-associated UTIs, surgical site infections, pneumonia, and bloodstream infections. The other options are specific diseases with different typical transmission contexts and are not defined by being acquired in hospitals.
Category reason: This question tests knowledge of infections acquired in healthcare settings and emphasizes hygiene and prevention measures, which aligns with Infection Control in the NCLEX Safety and Infection Control category.

Question 23

Which of the following is the MOST crucial step in preventing healthcare-associated infections (HAIs)?

Accepted Answer

Answer reason: Meticulous hand hygiene Hand hygiene is the single most effective intervention to prevent transmission of pathogens in healthcare settings and reduces cross-contamination between patients, staff, and surfaces. Sterile gloves are only required for sterile procedures; routine care typically uses clean gloves and hand hygiene. Isolation and contact precautions are applied based on specific organisms and transmission risk, not universally for all patients. Therefore, meticulous hand hygiene is the most crucial step for preventing HAIs.
Category reason: This item tests a core nursing infection-prevention intervention (hand hygiene) used to reduce healthcare-associated infections, which falls under Safety and Infection Control—Infection Control.

Question 24

A nurse notes redness, warmth, and pain at an IV site. What’s the most appropriate action?

Accepted Answer

Answer reason: Remove the IV and restart in a new location Redness, warmth, and pain at an IV site are classic findings of phlebitis and may indicate local inflammation with risk for progression and complications if the infusion continues. The priority nursing action is to stop the infusion and remove the catheter to prevent further vessel irritation and potential infection or infiltration. Restarting the IV at a different site maintains prescribed therapy while addressing the source of harm. Flushing or continuing the infusion (even with warm compress) can worsen tissue/vessel injury, and observation alone delays needed intervention.
Category reason: This item tests a nurse’s immediate safety action in response to signs of IV site complication (phlebitis), which is a patient-care and infection-prevention decision within Safety and Infection Control.

Question 25

Sterile Techniques is also called..?

Accepted Answer

Answer reason: Surgical asepsis Sterile technique refers to practices used to eliminate all microorganisms and spores to prevent contamination of a sterile field, which is termed surgical asepsis. Medical asepsis refers to clean technique that reduces (but does not eliminate) microorganisms. Autoclaving is one method of sterilization, not a synonym for sterile technique, and disinfection does not reliably destroy bacterial spores.
Category reason: This question tests infection-prevention terminology used in patient care (distinguishing sterile/surgical asepsis from clean/medical asepsis), which aligns with Safety and Infection Control.

Question 26

A new scrub nurse is shadowing and accidentally contaminates the sterile field. What should the circulating nurse do?

Accepted Answer

Answer reason: Acknowledge the breach, replace sterile items, and use it as a teaching moment A break in sterile technique must be addressed immediately to prevent surgical site infection and patient harm. The circulating nurse should clearly call out the contamination so the team can correct it and maintain a sterile field. Replacing the contaminated items restores sterility, and debriefing/teaching supports safe practice and prevents recurrence. Ignoring, delaying reporting, or replacing items without acknowledgment risks ongoing contamination and undermines safety culture.
Category reason: This question centers on an intraoperative nursing action to respond to a sterile field contamination, prioritizing prevention of infection and maintaining aseptic technique, which fits Safety and Infection Control → Infection Control.

Question 27

True or False PPE should always be removed inside the patient's room.?

Accepted Answer

Answer reason: True In transmission-based precautions, most PPE is removed before exiting the patient’s room to prevent carrying contaminants into the hallway and other patient care areas. The usual sequence is to remove gloves and gown in the room, then perform hand hygiene; eye protection and mask/respirator may be removed after leaving the room in specific situations (e.g., airborne precautions for respirator removal per protocol). Because the statement uses “always,” it can be interpreted as the general principle that PPE removal occurs at the point of exit and not in common areas, making “True” the best answer among the given options.
Category reason: This question tests proper PPE doffing location to prevent cross-contamination, which is a core Infection Control topic under NCLEX Safety and Infection Control.

Question 28

The nurse is reviewing orders on a patient admitted for preterm premature rupture of membranes. Which physician order will the nurse question?

Accepted Answer

Answer reason: Perform a vaginal exam every shift With PPROM, frequent digital vaginal examinations increase the risk of ascending infection (chorioamnionitis) and can shorten latency by stimulating labor. Vaginal exams are generally avoided unless delivery is imminent; if evaluation is needed, a sterile speculum exam is preferred. The other orders support monitoring for infection (maternal temperature), fetal well-being (FHR monitoring), and infection prophylaxis/latency antibiotics (ampicillin).
Category reason: This item tests nursing safety judgment about preventing infection in a patient-care scenario (PPROM) and identifying an unsafe order, which aligns with Infection Control.

Question 29

A nurse is finished with patient care. How would the nurse remove PPE when leaving room?

Accepted Answer

Answer reason: Remove gloves, perform hand hygiene, than remove gown, mask and goggles Gloves are the most contaminated PPE item and should be removed first to prevent transferring microorganisms to other PPE or the environment. Performing hand hygiene immediately after glove removal reduces contamination risk if hands were exposed during doffing. After that, the remaining PPE can be removed without contaminating the wearer, and this sequence best matches standard infection-control principles compared with the other options.
Category reason: This item tests safe removal of personal protective equipment to prevent transmission of infection, which is a core Safety and Infection Control nursing responsibility.

Question 30

A postpartum patient has developed endometritis. The mother is concerned about spreading the infection to the infant. Which of the following will the nurse reinforce to the mother?

Accepted Answer

Answer reason: Careful hand washing prior to caring for the infant Postpartum endometritis is a uterine infection and is not typically spread to the newborn through casual contact; standard hygiene is the key prevention strategy. Meticulous hand hygiene before infant care reduces transmission of common pathogens and is the most evidence-based, universally recommended infection-control measure. Wearing a mask is not indicated unless there is a respiratory infection, and restricting all visitors from holding the baby is unnecessary with routine precautions. Avoiding handling the infant is inappropriate and can interfere with bonding and breastfeeding when the mother is otherwise stable.
Category reason: This item tests nursing infection-prevention teaching for a postpartum patient to protect a newborn, which is a patient-safety intervention within Safety and Infection Control.

Question 31

Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?

Accepted Answer

Answer reason: Proper hand washing and infection avoidance Clients with sickle cell disease are at increased risk for infection due to functional asplenia, and infections can trigger vaso-occlusive crises. Teaching strict hand hygiene and strategies to avoid exposure helps prevent serious complications. The other options are inappropriate: dehydration should be prevented (not fluid restriction), excessive aerobic exercise can promote hypoxia/dehydration, and high-iron intake is not routinely recommended and may worsen iron overload in frequently transfused clients.
Category reason: The question asks what nursing education topics should be taught to promote safety and prevent complications in a client with SCD, which is primarily infection-prevention teaching within Safety and Infection Control.

Question 32

The infection control nurse is assigned to a patient with osteomyelitis related to a heel ulcer. The wound is 5cm in diameter and the drainage saturates the dressing so that it must be changed every hour. What is her priority intervention?

Accepted Answer

Answer reason: Use strict aseptic technique when caring for the wound Osteomyelitis associated with an open heel ulcer represents a high-risk infectious process; preventing contamination during frequent dressing changes is the priority to reduce bacterial introduction and spread. Strict aseptic technique during wound care is a core infection-control intervention that directly addresses the nurse’s role and the problem described (copious drainage with frequent dressing changes). Contact precautions are not routinely indicated for osteomyelitis unless there is drainage that cannot be contained or a pathogen requiring isolation. Reinforcing dressings or elevating the leg may be supportive measures but do not supersede infection-prevention during wound care.
Category reason: This item tests the nurse’s priority action to prevent transmission/contamination during wound care, which is an Infection Control decision within the NCLEX Safety and Infection Control category.

Question 33

Hand hygiene is the single most effective way to prevent infections.?

Accepted Answer

Answer reason: True Hand hygiene is widely recognized as the most important single measure to reduce transmission of microorganisms and prevent healthcare-associated infections. It interrupts the chain of infection by removing transient flora from hands before patient contact and after exposure to body fluids or contaminated surfaces. Consistent hand hygiene (soap and water when soiled or with C. difficile, alcohol-based rub otherwise) significantly lowers infection rates across care settings.
Category reason: This item tests a core nursing safety practice (hand hygiene) aimed at preventing infection transmission in patient care settings, which is categorized under Safety and Infection Control—Infection Control.

Question 34

The nurse places highest priority on taking which of the following actions to reduce the spread of microorganisms when caring for a client at risk for infection?

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to prevent transmission of microorganisms and is required regardless of diagnosis, symptoms, or the use of gloves. Gloves can have microtears and can become contaminated during removal, so they do not replace handwashing. Transmission-based precautions and private rooms are implemented based on known/suspected pathogens and mode of transmission, but for a client merely “at risk,” consistent hand hygiene is the highest-priority universal action.
Category reason: This is a nursing-practice question focused on preventing spread of infection through priority interventions, which aligns with Safety and Infection Control—Infection Control.

Question 35

True or False Nurses should always use alcohol-based hand sanitizer instead of washing hands with soap and water.?

Accepted Answer

Answer reason: Alcohol-based hand rub is appropriate in many routine situations, but soap and water is required when hands are visibly soiled and after caring for patients with spore-forming organisms (e.g., C. difficile) because alcohol does not reliably eliminate spores. Soap-and-water washing also helps physically remove certain contaminants that sanitizer may not fully address. Therefore, it is incorrect to say nurses should always use sanitizer instead of washing with soap and water.
Category reason: This question tests infection prevention practice and appropriate hand hygiene methods in clinical care, which falls under Safety and Infection Control—Infection Control.

Question 36

[Infection Control] While inserting a Foley catheter, the nurse touches the tip to the patient’s thigh accidentally. What is the best action?

Accepted Answer

Answer reason: C. Discard and start over with a new kit Touching the catheter tip to the patient’s thigh contaminates the sterile portion that will enter the urinary tract, breaking aseptic technique. Introducing a contaminated catheter increases the risk of catheter-associated urinary tract infection, so the sterile item must be replaced rather than “cleaned.” Flushing does not restore sterility of the catheter surface, and proceeding because it “looks clean” is unsafe. Allergy assessment is not the priority in response to a sterile-field contamination event.
Category reason: This question tests the nurse’s immediate action to maintain sterility during an invasive procedure, which is a core Safety and Infection Control competency.

Question 37

What is the maximum duration of time the nurse allows an IV bag of solution to infuse in to a patient?

Accepted Answer

Answer reason: D. 24 hours Primary IV solution containers (e.g., maintenance crystalloids) are typically changed at least every 24 hours to reduce contamination risk and subsequent infusion-related infection. Allowing a bag to hang longer increases time for microbial growth and breaks in asepsis during handling. This standard supports infection prevention practices in routine IV therapy, separate from tubing or lipid/TPN change intervals which may be shorter.
Category reason: This is a nursing practice question about safe IV therapy timing to prevent contamination and infection, aligning with Infection Control under Safety and Infection Control.

Question 38

Most important aspect of hand washing is......?

Accepted Answer

Answer reason: Mechanical rubbing during hand hygiene is what physically dislodges transient microorganisms, dirt, and organic material from the skin and under nails. While adequate duration and appropriate cleansing agents support effectiveness, without sufficient rubbing the microbial load is not reliably reduced. Soap mainly helps emulsify oils and allows organisms to be lifted off the skin, but the key action is the scrubbing motion that removes them before rinsing.
Category reason: This question tests a core infection-prevention principle and proper hand hygiene technique used in patient care, which fits Safety and Infection Control (Infection Control).

Question 39

True or False: Nurses should use soap and water instead of alcohol-based hand sanitizer when dealing with Clostridium difficile.?

Accepted Answer

Answer reason: Alcohol-based hand rubs are not reliably effective against C. difficile spores, so mechanical removal with soap and water is required after caring for affected patients or contact with potentially contaminated surfaces. This practice helps reduce spore transmission and healthcare-associated infection. It should be paired with contact precautions and appropriate environmental cleaning using sporicidal agents.
Category reason: This item tests nursing infection prevention practices (hand hygiene choice for a specific organism), which is part of Safety and Infection Control.

Question 40

The most common mode of transmission of hospital-acquired infections is?

Accepted Answer

Answer reason: Most healthcare-associated infections are transmitted via contact, especially through inadequate hand hygiene between patient contacts. Hands become contaminated from direct patient contact or from touching the patient’s environment and then transfer organisms to another site or person. Consistent hand hygiene (soap-and-water or alcohol-based rub, depending on organism and soiling) is therefore the most effective primary prevention strategy compared with focusing on less common routes like foodborne, insect vectors, or true airborne spread.
Category reason: This question tests infection transmission in the healthcare setting and the key preventive measure (hand hygiene), which is a core patient-safety and infection-control competency in nursing practice.

Question 41

A female client is instructed by the nurse regarding the procedure for collecting a midstream urine sample. Which action should the nurse tell the client to perform?

Accepted Answer

Answer reason: This reduces contamination of the urine specimen by moving organisms away from the urethral meatus and limiting transfer of fecal flora. Proper cleansing is a key infection-control step to improve specimen accuracy and decrease false-positive culture results. Other choices either increase contamination risk or reflect incorrect timing/collection technique for a clean-catch midstream sample.
Category reason: This item tests nursing instruction and aseptic technique to prevent specimen contamination during urine collection, which aligns with Infection Control.

Question 42

Which of the following diseases is best prevented by breaking the chain of transmission at the portal of exit?

Accepted Answer

Answer reason: This targets interruption at the portal of exit, which for enteric infections is primarily feces and sometimes urine from infected or carrier individuals. Typhoid transmission is fecal–oral, so controlling excreta through safe disposal, hand hygiene after toileting, and sanitation effectively blocks organisms leaving the host and contaminating food/water. Measles exits via respiratory secretions but is best controlled by airborne precautions and vaccination, while tetanus is not spread person-to-person and polio prevention is more strongly tied to immunization and fecal–oral control but classically emphasized less than typhoid for excreta-focused measures.
Category reason: The question is about interrupting the chain of infection (portal of exit) using infection-prevention measures, which is a nursing infection-control concept rather than detailed biomedical pathophysiology.

Question 43

. The single most effective way to prevent infection is?

Accepted Answer

Answer reason: It is the most consistently effective measure to interrupt transmission of microorganisms by removing transient flora from the hands, which are a primary vector for cross-contamination. Gloves, masks, and disinfectants are helpful but are either task-specific, can be used incorrectly, or do not replace cleaning hands before and after contact. Proper technique and timing (before/after patient contact and after removing gloves) are essential to maximize infection prevention.
Category reason: This tests the nurse’s primary infection-prevention intervention used in routine patient care, which aligns with Safety and Infection Control—Infection Control.

Question 44

Which of the following is considered as the most important aspect of hand washing?

Accepted Answer

Answer reason: Mechanical rubbing is what physically dislodges transient microorganisms, dirt, and organic material from the skin surface and from around nails and skin folds. Soap and water (or alcohol-based rub) support the process, but without adequate rubbing technique organisms are not removed effectively. Duration matters, but time alone without proper rubbing is less effective than thorough friction throughout all hand surfaces.
Category reason: This question tests infection prevention principles and correct hand hygiene technique, which is a core Safety and Infection Control topic in nursing practice.

Question 45

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check for lice?

Accepted Answer

Answer reason: Nits (eggs) are firmly adherent to hair shafts—commonly at the nape/occipital region and behind the ears—and do not brush off easily. This finding is more specific for pediculosis capitis than nonspecific rash or excoriations from scratching. White flaky particles are more consistent with dandruff or dry scalp because they tend to be loose and removable. A positive head check is based on identifying live lice and/or attached nits.
Category reason: This item tests recognition of an infectious/infestation assessment finding to identify head lice and support prevention of transmission in a school setting, aligning with Infection Control.

Question 46

There is a patient on the unit with herpes zoster. You would avoid assigning this patient to a staff member who has never had or been vaccinated for?

Accepted Answer

Answer reason: Herpes zoster is reactivation of varicella-zoster virus, and susceptible individuals can acquire primary varicella from exposure, especially via direct contact with lesion fluid (and potentially airborne spread if disseminated). A staff member without prior infection or vaccination lacks immunity and is at risk for developing varicella, which can be severe in adults and poses transmission risk to vulnerable patients. Therefore, such a staff member should not be assigned to care for a patient with shingles unless appropriate precautions and immunity status are ensured. The other listed illnesses are caused by different viruses and are not the relevant susceptibility concern for zoster exposure.
Category reason: This question tests preventing transmission of an infectious disease to non-immune healthcare staff and appropriate assignment decisions, which fits Infection Control under NCLEX safety.

Question 47

Which condition places a client at the highest risk for developing infection?

Accepted Answer

Answer reason: Large-area burns destroy the skin barrier, creating extensive portals of entry for microorganisms and exposing moist, protein-rich tissue that supports bacterial growth. They also trigger systemic inflammatory and immune dysfunction, increasing susceptibility to sepsis. Compared with localized surgical punctures, a single catheter, or a prosthesis, major burns create a far larger compromised surface area and higher overall infection burden risk.
Category reason: This question asks the nurse to identify a client condition that most increases infection risk, which is a patient-safety judgment aligned with Infection Control.

Question 48

During a home visit, a community health nurse finds a child with measles in a densely populated slum. What is the most appropriate immediate action to prevent a outbreak?

Accepted Answer

Answer reason: Measles is highly contagious, and rapid post-exposure prophylaxis is the key outbreak-control measure in crowded settings. Giving MMR to susceptible contacts within 72 hours can prevent or significantly attenuate infection and interrupts transmission chains. Isolation and supportive care help the index child but do not immediately protect exposed contacts. Vitamin A reduces morbidity in the infected child and reporting is important, but neither is as immediately effective at preventing spread as prompt vaccination of contacts.
Category reason: This question tests immediate public-health nursing actions to control transmission of a communicable disease (measles) in the community, which fits Infection Control within Safety and Infection Control.

Question 49

In managing an infant with chronic lung disease, what is the primary goal of nursing care?

Accepted Answer

Answer reason: Infants with chronic lung disease are prone to impaired gas exchange and increased work of breathing, so maintaining adequate oxygenation is a central care priority. They are also at higher risk for respiratory infections, which can rapidly worsen respiratory status and increase oxygen needs. Nursing care therefore focuses on supporting ventilation/oxygen therapy as prescribed, conserving energy, and minimizing exposure to pathogens through strict hygiene and infection-prevention practices.
Category reason: This is a patient-care priority question focused on nursing management goals and preventing complications (not basic physiology facts), which aligns with NCLEX nursing judgment; the most direct tested focus is infection prevention along with respiratory support.

Question 50

An adult man has a tracheostomy tube in place. which of the following actions is appropriate for the nurse to take when suctioning the tracheostomy?

Accepted Answer

Answer reason: Sterile technique is indicated for tracheostomy suctioning to reduce introduction of pathogens into the lower airway. Suction should be applied only while withdrawing the catheter, not during insertion, to minimize mucosal trauma and hypoxemia. The other options include unsafe suction duration (20 seconds is too long), incorrect technique (clean rather than sterile), or an inappropriate schedule-based disposal practice rather than single-use per suction episode per policy.
Category reason: This item tests the nurse’s correct and safe procedure for airway suctioning to prevent infection and complications, which aligns with Infection Control under Safety and Infection Control.

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