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NCLEX-RN Infection control practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Infection control sits inside the Safety and Infection Control category of the NCLEX-RN. Our bank holds 38 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Infection control sample questions

Question 1

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
Show the answer and explanation

Correct answer: D

Purulent drainage, redness, warmth, and a fever of 38.6°C at a central catheter site suggest a catheter-related infection that may already involve the bloodstream. The provider must be notified right away to order blood cultures and antibiotics and to decide whether to remove the catheter.

Why the other options are wrong:
A: Antibiotics should start after blood cultures are drawn, under a provider order, so that the organism can be identified.
B: Cultures are needed, but blood cultures matter most, and obtaining any culture should not delay notifying the provider.
C: A new sterile dressing does not treat a probable catheter-related bloodstream infection.

Question 2

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
Show the answer and explanation

Correct answer: C

A urinary drainage bag must always stay below the level of the bladder. Hanging it higher lets urine flow back into the bladder, which raises the risk of catheter-associated urinary tract infection, so the nurse must intervene.

Why the other options are wrong:
A: Coiling tubing on the bed without kinks keeps drainage flowing and is acceptable practice.
B: Using a separate washcloth for perineal care and placing it in the linen bag is appropriate and prevents cross-contamination.
D: Emptying the bag at the end of the shift and recording the output is routine, correct care.

Question 3

A 66-year-old client in the surgical unit has a surgical wound that is red, warm, and draining purulent fluid. The nurse is changing the wound dressing. Which action best reduces the risk of transmitting infection to other clients?

  1. A Applying topical antibiotic ointment to the wound
  2. B Disposing of the soiled dressing in a biohazard bag immediately
  3. C Wearing sterile gloves for the dressing change
  4. D Cleaning the wound with sterile saline before applying a new dressing
Show the answer and explanation

Correct answer: B

Immediate disposal of the soiled dressing in a biohazard bag prevents contaminated material from contacting surfaces or other clients, which is key to infection control. Sterile gloves (the option "Wearing sterile gloves for the dressing change" protect the wound but do not address disposal of contaminated waste. Applying antibiotic ointment (the option "Applying topical antibiotic ointment to the wound" treats the wound but does not prevent transmission. Cleaning the wound (the option "Cleaning the wound with sterile saline before applying a new dressing" is part of wound care but does not reduce the risk of spreading pathogens to others.

Question 4

A 58-year-old female with a urinary tract infection is placed on contact precautions due to a positive urine culture for multidrug-resistant Escherichia coli. The nurse enters the room to assess the patient. Which action should the nurse perform first?

  1. A Clean the stethoscope with alcohol before entering the room.
  2. B Remove the gown after leaving the patient's room.
  3. C Perform hand hygiene before putting on gloves and gown.
  4. D Apply a mask and eye shield before entering the room.
Show the answer and explanation

Correct answer: C

Hand hygiene comes first, before putting on the gown and gloves, so organisms are not transferred to the PPE or the client. Contact precautions then require a gown and gloves for room entry.

Why the other options are wrong:
A: Shared equipment is cleaned after use, and contact precautions favor a dedicated stethoscope, so this is not the first step.
B: The gown is removed before leaving the room, not after, to keep contamination inside the room.
D: A mask and eye protection are not required for contact precautions unless splashing is expected.

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