NCLEX infection control practice questions

Know which diseases need airborne, droplet or contact precautions, the PPE for each and the order to put it on and take it off.

1. Question 1

   While a nurse is cleaning equipment with a disinfectant solution, some of it splashes into the nurse's eyes. What should the nurse do first?

   • A.Report the splash to employee health
   • B.Read the safety data sheet to find out what to do
   • C.Cover both eyes with a dry gauze pad
   • D.Flush both eyes at the eyewash station for at least 15 minutes
   Show answer and explanation

   Answer: D

   For a chemical or hazardous drug splash to the eyes, flush immediately with water or saline at an eyewash station for at least 15 minutes, holding the eyelids open. Then report the exposure, review the safety data sheet (SDS) and get medical evaluation.

   • A. Reporting is needed but comes after the eyes are flushed.
   • B. The safety data sheet gives useful information, but flushing must not be delayed while reading it.
   • C. Covering the eyes traps the chemical against the eye surface.
   • D. Immediate, prolonged flushing removes the chemical and limits damage to the eye.

   Key concept: Eye splash: flush first and flush long.

   Tip: "Splash? Flush 15."

2. Question 2

   A nurse in an outpatient infusion center prepares to hang a bag of IV chemotherapy that was mixed in the pharmacy. Which actions protect the nurse from hazardous drug exposure? Select all that apply.

   Select all that apply.

   • A.Place used tubing and the empty bag in the hazardous drug waste container
   • B.Use a closed-system drug-transfer device when connecting the tubing
   • C.Remove air bubbles by venting the line with the drug into a gauze pad
   • D.Wear two pairs of chemotherapy-tested gloves
   • E.Reuse the same gown for the next client if it is not visibly soiled
   • F.Wear a disposable, impermeable gown that closes in the back
   Show answer and explanation

   Answer: A, B, D, F

   Nurses can absorb hazardous drugs through skin, by inhalation and by ingestion. Protection includes two pairs of chemotherapy-tested gloves, a single-use impermeable gown, closed-system transfer devices, eye and face protection if splashing may occur, and disposal of all contaminated items in hazardous drug waste.

   • A. Items that touched the drug are hazardous waste and must go in the labeled container, not regular trash.
   • B. Closed-system devices prevent leaks and aerosols during connection and disconnection.
   • C. Venting or priming with the drug releases droplets and aerosols. Lines should be primed with a non-drug solution or by the pharmacy.
   • D. Double gloving with gloves tested for chemotherapy permeation is the standard when handling hazardous drugs.
   • E. Gowns used for hazardous drugs are single use. Invisible contamination can be present on a gown that looks clean.
   • F. A low-permeability gown with a back closure and tight cuffs protects skin and clothing from splashes.

   Key concept: Hazardous drug safety relies on PPE, closed systems and correct disposal at every step.

   Tip: Chemo = "two gloves, one gown, closed system, yellow (hazardous) bin".

3. Question 3

   A provider orders sputum induction to collect specimens from a client with suspected pulmonary tuberculosis. Where and how should the nurse perform the procedure?

   • A.In an airborne infection isolation room or sputum booth, with the nurse wearing an N95 respirator
   • B.At the bedside in a shared room with the curtain closed
   • C.In the hallway near an open window
   • D.In a regular private room with the nurse wearing a surgical mask
   Show answer and explanation

   Answer: A

   Cough-inducing procedures such as sputum induction and bronchoscopy for clients with suspected TB are done in an airborne infection isolation room or a ventilated booth. Staff wear fit-tested N95 respirators, and the room is left empty for the required air-change time afterward. Specimens are collected on three separate occasions, with at least one early morning sample.

   • A. Sputum induction makes the client cough forcefully and produces infectious aerosols. Negative pressure and an N95 protect staff and others.
   • B. A curtain does not contain airborne particles and other clients would be exposed.
   • C. Hallways expose staff and visitors to airborne particles.
   • D. A surgical mask does not protect against airborne TB particles.

   Key concept: Cough-inducing procedures for suspected TB need negative pressure and an N95.

   Tip: "Make them cough? Negative room, N95 on."

4. Question 4

   A client's IV line becomes disconnected and a small amount of blood spills on the floor. After making the client safe, how should the nurse clean the spill?

   • A.Pour undiluted bleach on the spill and wipe it up without gloves
   • B.Cover the spill with paper towels and leave it for housekeeping at the end of the shift
   • C.Spray disinfectant on the blood and wipe it dry right away
   • D.Put on gloves, absorb the blood with disposable towels, then clean the area with a hospital-approved disinfectant
   Show answer and explanation

   Answer: D

   For a blood spill: wear gloves (and more PPE if splashing is possible), absorb visible blood with disposable material, clean, then apply an EPA-registered disinfectant or freshly diluted bleach for the required contact time. Discard soiled materials in a biohazard bag.

   • A. Bare hands contact blood, and undiluted bleach can harm skin and airways. Gloves are always required.
   • B. Leaving blood on the floor exposes others to infection and slipping.
   • C. Disinfectant cannot work through a large amount of blood and needs its full contact time before wiping.
   • D. Gloves protect the nurse, absorbing removes most of the blood, and the disinfectant then kills remaining organisms when left on for the labeled contact time.

   Key concept: Absorb first, then disinfect, always with gloves.

   Tip: Spill steps: "Glove, Absorb, Disinfect, Dispose."

5. Question 5

   A nurse is reviewing hand hygiene with new UAPs. In which situations should staff wash with soap and water rather than use alcohol-based hand rub? Select all that apply.

   Select all that apply.

   • A.After caring for a client with C. diff diarrhea
   • B.Before eating
   • C.Before putting on clean gloves to start an IV
   • D.After using the restroom
   • E.After taking the blood pressure of a client on standard precautions
   • F.When the hands are visibly soiled
   Show answer and explanation

   Answer: A, B, D, F

   Alcohol-based hand rub is the preferred method for most hand hygiene in health care because it is fast and effective. Soap and water is needed when hands are visibly soiled, after caring for clients with spore-forming organisms such as C. diff or with norovirus, after using the restroom and before eating.

   • A. Alcohol does not kill C. diff spores. Washing removes them mechanically.
   • B. Washing before eating removes contamination that alcohol rub may not remove.
   • C. Alcohol rub is preferred for routine hand hygiene before procedures when hands are not visibly soiled.
   • D. Soap and water is the standard after using the toilet.
   • E. Alcohol rub is appropriate after routine contact with intact skin.
   • F. Alcohol rub does not remove dirt or organic material. Washing is needed.

   Key concept: Use alcohol rub for routine care; wash with soap and water for dirt, spores, toilet use and food.

   Tip: "Dirty, diarrhea, toilet, eating: wash with soap."