NCLEX-RN Safety and Infection Control practice questions

Question 1

A nurse in the emergency department is caring for a 34-year-old client who was exposed to an unknown chemical powder on the skin and clothing during a workplace accident. The client is alert, with heart rate 112/min, respiratory rate 24/min, and blood pressure 138/86 mm Hg. Which action should the nurse take first?

1. A Administer supplemental oxygen via non-rebreather mask at 15 L/min
2. B Apply a surgical mask to the client to prevent inhalation
3. C Remove the client's contaminated clothing and rinse skin with water
4. D Call the poison control center for decontamination instructions

Question 2

A 34-year-old client with a history of bipolar disorder is admitted to the psychiatric unit after a manic episode. The client becomes agitated, clenches fists, and states, "I am going to hurt someone if you don't let me leave." Which action should the nurse take first?

1. A Administer a prescribed intramuscular antipsychotic as needed.
2. B Maintain a calm demeanor and offer the client a choice to sit quietly.
3. C Call security to escort the client to a seclusion room.
4. D Place the client in four-point restraints for safety of staff and others.

Question 3

A 55-year-old client in a hemodialysis unit has a central venous catheter that was inserted 3 days ago. The nurse observes redness, warmth, and purulent drainage at the insertion site. The client's temperature is 38.6°C. Which action should the nurse take first?

1. A Start empiric antibiotics per protocol
2. B Obtain a wound culture from the site
3. C Apply a sterile dressing over the site
4. D Notify the healthcare provider immediately

Question 4

The nurse is setting up a sterile field for a urinary catheter insertion. After donning sterile gloves, the nurse opens the sterile kit. Which action by the nurse requires immediate correction?

1. A Pouring antiseptic solution into the sterile cup without touching the cup.
2. B Reaching across the sterile field to adjust the position of the collection bag.
3. C Placing the sterile drape with the moisture-proof side facing down.
4. D Holding the catheter package 6 inches above the sterile field and dropping it.

Question 5

The nurse is preparing to assist the surgeon with a sterile dressing change for a client who had an abdominal wound debridement 2 days ago. The nurse opens the sterile kit and places the sterile drape. Which action by the nurse demonstrates correct surgical asepsis?

1. A The nurse positions the sterile drape on the bedside table and adjusts it with bare hands.
2. B The nurse places the sterile drape on the table and reaches across it to obtain a forceps.
3. C The nurse sets the sterile drape on the client's bed and flips it open with a flick of the wrist.
4. D The nurse holds the sterile drape at waist level and unfolds it away from the body.

Question 6

A nurse is preparing to administer intravenous chemotherapy in a medical-surgical unit. The spill kit is located 10 feet away. During priming of the tubing, the nurse accidentally drops the vial, and a small amount of liquid splashes onto the counter. What is the nurse's priority action?

1. A Alert the charge nurse, complete an incident report, and clean the spill after the patient's infusion is complete.
2. B Wipe the counter with a 10% bleach solution and dispose of the paper towel in the regular trash.
3. C Don a new pair of gloves, cover the spill with absorbent pads from the spill kit, and notify the hazardous materials team.
4. D Immediately place the vial in the sharps container and continue priming with a new vial of chemotherapy.

Question 7

A home health nurse is visiting an 80-year-old client who lives alone and has a history of falls. The client uses a walker and reports tripping on the edge of a rug last week. Which recommendation should the nurse prioritize to reduce fall risk?

1. A Move the client's bed to the first floor to avoid stair climbing.
2. B Install grab bars in the bathroom near the toilet and shower.
3. C Remove all throw rugs and secure loose carpet edges with tape.
4. D Place a non-slip mat inside the bathtub and on the bathroom floor.

Question 8

A nursing assistant is caring for a 70-year-old client with a urinary catheter in a long-term care facility. Which action by the nursing assistant requires the nurse to intervene?

1. A The nursing assistant keeps the catheter tubing coiled on the bed and ensures no kinks are present
2. B The nursing assistant uses a separate washcloth for perineal care and then discards it in a linen bag
3. C The nursing assistant hangs the drainage bag on the bed frame, at a level above the client's bladder
4. D The nursing assistant empties the drainage bag at the end of the shift and records the output as 350 mL

Question 9

A nurse is caring for a 68-year-old client who is postoperative after hip replacement surgery. The client is confused and repeatedly tries to get out of bed, despite the bed being in the lowest position and the side rails up. Which action should the nurse take first?

1. A Place a bed alarm and reorient the client every hour.
2. B Ask a family member to stay with the client to provide supervision.
3. C Request a prescription for a sedative medication from the provider.
4. D Apply a wrist restraint to the client’s dominant hand.

Question 10

A nurse is assessing four clients on a medical-surgical unit. Which client has the highest risk for a fall?

1. A A 65-year-old client with a urinary tract infection who has a temperature of 38.3°C (101°F).
2. B A 70-year-old client who received lorazepam 1 mg intravenously 30 minutes ago for anxiety.
3. C A 45-year-old client who is post-operative day 1 from a knee replacement and uses a walker.
4. D A 55-year-old client with type 2 diabetes who has a blood glucose of 140 mg/dL and uses a cane.