Infection Control and Safety – LPN Practice Questions

These 15 items are written at NCLEX-PN complexity for the subject Infection Control and Safety. They emphasize correct application of standard and transmission-based precautions, safe use of personal protective equipment, hazard recognition in the environment, and knowing what must be reported to the registered nurse. Options are numbered as they render on the page. Items marked Select all that apply have more than one correct option.

Question 1

The licensed practical nurse is preparing to enter the room of a client on contact and droplet precautions. In which order should the personal protective equipment be applied after hand hygiene?

1. Gloves, gown, mask, goggles.
2. Gown, mask, goggles, gloves.
3. Mask, gloves, gown, goggles.
4. Goggles, gloves, gown, mask.

Answer: 2. Gown, mask, goggles, gloves.

Rationale: The donning sequence is hand hygiene, then gown, then mask or respirator, then goggles or face shield, then gloves last so the gloves can be pulled over the gown cuffs. All other options place gloves before items that would then have to be handled with contaminated hands.

Question 2

The nurse has finished caring for a client with Clostridioides difficile. Which hand hygiene action is correct?

1. Apply alcohol-based hand rub and allow the hands to air dry.
2. Wash the hands with soap and water for at least 20 seconds.
3. Apply alcohol-based hand rub twice for added effect.
4. Rinse the hands with water only, since gloves were worn.

Answer: 2. Wash the hands with soap and water for at least 20 seconds.

Rationale: C. difficile forms spores that alcohol does not kill. The friction of handwashing physically removes spores. Gloves reduce but do not eliminate hand contamination, so hand hygiene is always performed after glove removal.

Question 3

A client is admitted with suspected pulmonary tuberculosis. Which action by the nurse is correct?

1. Wear a surgical mask when entering the room and leave the door open for ventilation.
2. Wear a fit-tested N95 respirator, keep the door closed, and place the client in a negative-pressure room.
3. Wear a gown and gloves only, since tuberculosis is spread by contact with sputum.
4. Place a fit-tested N95 respirator on the client whenever staff enter the room.

Answer: 2. Wear a fit-tested N95 respirator, keep the door closed, and place the client in a negative-pressure room.

Rationale: Tuberculosis requires airborne precautions: an airborne infection isolation room with negative pressure, the door kept closed, and a fit-tested N95 or higher respirator for anyone entering. A surgical mask does not protect the wearer from droplet nuclei. The client wears a surgical mask, not an N95, and only when leaving the room.

Question 4

Select all that apply. Which findings should the licensed practical nurse report to the registered nurse promptly?

1. A postoperative client's incision now has purulent drainage and surrounding redness.
2. A client on contact precautions asks for a second pillow.
3. An older adult client who was oriented this morning is now confused and pulling at the intravenous line.
4. A client on airborne precautions has a room door that has been propped open.
5. A client's urinary catheter bag is emptied at the end of the shift and recorded.
6. A client with a temperature of 101.8 degrees Fahrenheit and shaking chills.

Answer: 1, 3, 4, and 6.

Rationale: New purulent drainage suggests surgical site infection, new-onset confusion may be the first sign of infection or delirium in an older adult and also creates a safety risk, an open door defeats airborne containment and is an infection control breach, and fever with rigors suggests systemic infection. Options 2 and 5 are routine care within the LPN scope that do not require escalation.

Question 5

The nurse enters a client's room and finds a frayed electrical cord on the bedside pump. Which action should the nurse take first?

1. Wrap the frayed area with tape and continue to use the pump.
2. Unplug the pump, remove it from service, tag it, and obtain a replacement.
3. Document the finding and report it at the end of the shift.
4. Ask maintenance to repair the cord while the pump remains in use.

Answer: 2. Unplug the pump, remove it from service, tag it, and obtain a replacement.

Rationale: Damaged electrical equipment must be taken out of use immediately, tagged, and reported so it cannot be used by another staff member. Nurses do not repair equipment, tape is not a repair, and continuing to use damaged equipment risks shock and fire. Delayed reporting leaves the hazard in place.

Question 6

A client is receiving oxygen at 4 liters per minute by nasal cannula. Which observation requires the nurse to intervene immediately?

1. The client is wearing a cotton gown and cotton socks.
2. A visitor has brought in an electric razor and is plugging it in at the bedside.
3. An "oxygen in use" sign is posted on the door.
4. The oxygen cylinder in the corner is secured upright in a holder.

Answer: 2. A visitor is plugging in an electric razor at the bedside.

Rationale: Oxygen supports combustion, so spark-producing devices such as electric razors are avoided in an oxygen-enriched environment. Options 1, 3, and 4 are all correct safety practices: cotton generates less static than wool or synthetics, signage is required, and cylinders must be secured upright so they cannot fall.

Question 7

The nurse is removing personal protective equipment after caring for a client on contact precautions. Which item should be removed first?

1. Gown.
2. Mask.
3. Gloves.
4. Goggles.

Answer: 3. Gloves.

Rationale: Gloves are the most contaminated item and are removed first, followed by goggles or face shield, then gown, then mask. Hand hygiene is performed immediately after all equipment is removed, and at any point during removal if the hands become contaminated. A respirator is removed after exiting the room.

Question 8

Select all that apply. Which nursing actions help prevent falls for a hospitalized older adult?

1. Keep the bed in the lowest position with the wheels locked.
2. Place the call light and personal items within the client's reach.
3. Raise all four side rails whenever the client is in bed.
4. Provide nonskid footwear before ambulation.
5. Offer toileting on a regular schedule rather than waiting for a request.
6. Keep the room dimly lit at all times so the client will rest.

Answer: 1, 2, 4, and 5.

Rationale: A low locked bed, accessible call light and belongings, nonskid footwear, and scheduled toileting are core fall prevention measures, since unassisted trips to the bathroom cause many hospital falls. Option 3 is a restraint and increases the risk of injury from climbing over the rails. Option 6 increases the risk of falls; adequate lighting including a night light and a clear path to the bathroom is needed.

Question 9

A client with soft wrist restraints in place says, "My fingers feel numb and tingly." Which action should the nurse take first?

1. Reassure the client that this is a normal sensation with restraints.
2. Check circulation, sensation, and movement in both hands and loosen or remove the restraint as needed.
3. Document the complaint and recheck in two hours.
4. Notify the registered nurse and wait for direction before touching the restraint.

Answer: 2. Check circulation, sensation, and movement in both hands and loosen or remove the restraint as needed.

Rationale: Numbness and tingling suggest impaired circulation or nerve compression and require immediate assessment and correction; a restraint should allow two fingers to slide underneath. The nurse acts to relieve the harm first and then notifies the registered nurse and documents. Numbness is never a normal expected finding, and waiting two hours risks permanent injury. A restraint may be discontinued at any time without a new order.

Question 10

The nurse is changing the linens on the bed of a client with a draining wound. Which action is correct?

1. Shake the soiled linens to loosen debris before placing them in the hamper.
2. Hold the soiled linens away from the uniform and place them directly into the linen bag in the room.
3. Place the soiled linens on the floor until the bed is remade.
4. Carry the soiled linens to the hallway hamper pressed against the chest.

Answer: 2. Hold the soiled linens away from the uniform and place them directly into the linen bag in the room.

Rationale: Soiled linen is handled with minimal agitation to avoid aerosolizing organisms and skin scales, is never shaken, is never placed on the floor or on clean surfaces, and is never held against the uniform. Bagging in the room prevents contamination of the corridor.

Question 11

A client on droplet precautions for influenza must be transported to the radiology department. Which action by the nurse is correct?

1. Place a surgical mask on the client before leaving the room.
2. Have the client wear a gown and gloves during transport.
3. Cancel the test because clients on droplet precautions cannot leave the room.
4. Wear a fit-tested N95 respirator and place no mask on the client.

Answer: 1. Place a surgical mask on the client before leaving the room.

Rationale: Masking the client at the source contains respiratory droplets and is the standard measure for transport. Gowns and gloves on the client are not indicated for droplet transmission. Necessary tests are not canceled; transport is limited and, when required, is performed with source control and advance notice to the receiving department.

Question 12

The nurse has just administered an intramuscular injection. Which action is correct?

1. Recap the needle carefully with two hands before disposal.
2. Break the needle from the syringe before placing it in the sharps container.
3. Activate the safety device and drop the entire syringe into the sharps container at the point of use.
4. Place the used syringe on the bedside table until care is completed.

Answer: 3. Activate the safety device and drop the entire syringe into the sharps container at the point of use.

Rationale: Used needles are not recapped, bent, broken, or manipulated. The safety device is engaged and the assembly is discarded immediately in a puncture-resistant container at the point of use, which is replaced when about three-quarters full. Setting a used syringe down creates a needlestick risk for the nurse, colleagues, and the client.

Question 13

The nurse is opening a sterile dressing tray. Which action indicates correct technique?

1. The first flap of the wrapper is opened toward the nurse's body.
2. The sterile tray is set up on the overbed table with items placed within the outer 1-inch border.
3. The nurse opens the first flap away from the body, then the sides, then the flap toward the body.
4. The nurse turns to obtain supplies from the cart after the field is open.

Answer: 3. Open the first flap away from the body, then the sides, then the flap toward the body.

Rationale: Opening the far flap first prevents reaching across the exposed sterile field. The outer 1-inch border of the field is considered contaminated, so items are placed inside it. A sterile field is never turned away from or left unattended; all supplies are gathered before the field is opened.

Question 14

Select all that apply. Which situations require the nurse to perform hand hygiene?

1. Before applying clean gloves.
2. Immediately after removing gloves.
3. After touching the client's bedside rail and monitor, even if the client was not touched.
4. Before preparing medications.
5. Only when the hands appear visibly soiled.
6. After using the restroom.

Answer: 1, 2, 3, 4, and 6.

Rationale: Hand hygiene is performed before and after client contact, before a clean or aseptic task, after body fluid exposure risk, after contact with the client's surroundings, before and after glove use, before medication and food handling, and after using the restroom. Option 5 is incorrect: visible soiling determines which product to use, soap and water rather than alcohol rub, not whether hand hygiene is done at all.

Question 15

The nurse discovers a small fire in a client's trash can. Which action should the nurse take first?

1. Pull the fire alarm.
2. Move the client out of the room.
3. Close the door to the room.
4. Use the extinguisher on the base of the fire.

Answer: 2. Move the client out of the room.

Rationale: RACE means Rescue first, then Alarm, then Confine, then Extinguish. The client in immediate danger is removed before any other action. When using an extinguisher, remember PASS: pull the pin, aim at the base of the fire, squeeze the handle, and sweep side to side. During evacuation, never use an elevator.

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