Free NCLEX safety and infection control questions
Four free NCLEX-RN safety and infection control items covering sentinel events, airborne precautions for TB, restraint rules, and SATA TB precautions. Safety is 10–16% of the test and overlaps with Management of Care priority questions.
The 4 isolation precaution categories every NCLEX student must know
- Standard precautions. Universal for every client. Hand hygiene, gloves with body fluid contact, PPE based on anticipated exposure.
- Contact precautions. Gown + gloves. Used for C. diff, MRSA, VRE, draining wounds, scabies, RSV. For C. diff, soap and water hand hygiene (alcohol doesn't kill spores).
- Droplet precautions. Surgical mask within 3 feet. Used for influenza, pertussis, meningitis (until 24 hr of antibiotics), rubella, mumps.
- Airborne precautions. Negative-pressure room + N95 respirator or PAPR. Used for TB, measles, varicella, disseminated zoster, COVID-19 with aerosol- generating procedures.
Sentinel event vs near miss vs error
- Sentinel event: unanticipated event involving death or serious physical/psychological injury. Requires immediate RCA.
- Adverse event: patient harm from care delivery (not always preventable).
- Near miss: error that did not reach the patient (interception, luck, or detection).
- Medical error: failure to complete a planned action correctly.
Restraint rules tested on NCLEX
- Use the least-restrictive option that ensures safety.
- Requires a provider order — within 1 hour for behavioral restraints.
- Behavioral restraints: re-evaluate every hour (adult) or every 30 min (child).
- Medical restraints: re-evaluate every 24 hr.
- Tie restraints to bed frame, NOT side rails (rail movement can cause injury).
- Quick-release knot.
- Monitor skin, circulation, ROM every 2 hours minimum.
- Document: rationale, type, time, monitoring findings.
The 5 fall-risk red flags
- Age > 65.
- Multiple medications, especially benzodiazepines, opioids, antihypertensives.
- History of prior fall in past 6 months.
- Cognitive impairment or delirium.
- Orthostatic hypotension or gait/balance impairment.
Hand hygiene rules
Alcohol-based sanitizer for routine. Soap and water for: visibly soiled hands, C. diff, norovirus, after using the restroom, before eating. Friction matters more than time — 15 seconds of good technique beats 30 seconds of poor.
Try these 4 questions now
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- Question 1 · Safety · MCQ
A nurse identifies a sentinel event after a client falls and sustains a hip fracture. Which is the priority next action?
- a.Document the event in the chart
- b.Notify the provider and immediately assess the client
- c.Begin a root cause analysis
- d.Complete an incident report
Show answer + rationale
Correct: B. Assessment and provider notification are immediate priorities — client safety first. Documentation, incident report, and RCA follow. The incident report is internal QI documentation and is NOT placed in the chart.
- Question 2 · Safety · MCQ
Which client requires airborne precautions?
- a.Client with C. difficile diarrhea
- b.Client with active pulmonary tuberculosis
- c.Client with MRSA wound infection
- d.Client with influenza
Show answer + rationale
Correct: B. TB requires airborne precautions (negative pressure room, N95). C. diff and MRSA require contact precautions. Flu requires droplet precautions. Airborne diseases include TB, measles, varicella.
- Question 3 · Safety · MCQ
When restraining a client for safety, which is the MOST critical nursing action?
- a.Use the least-restrictive option that ensures safety
- b.Tie restraints to the side rails for accessibility
- c.Restrain the client until family arrives
- d.Document the restraint use at the end of shift
Show answer + rationale
Correct: A. Least-restrictive principle is foundational. Restraints tied to side rails can cause injury when the rail moves. Restraints require a time-limited provider order (1 hour for behavioral, up to 24 hours for medical) with monitoring every 15–30 min and reassessment at order expiration.
- Question 4 · Infection control · SATA
A client is admitted with active pulmonary tuberculosis. Which precautions should the nurse implement? Select all that apply.
- a.Place the client in a negative-pressure room
- b.Wear an N95 respirator when entering the room
- c.Use a surgical mask when transporting the client
- d.Have the client wear an N95 during transport
- e.Keep the door open for ventilation
Show answer + rationale
Correct: A, B. TB requires airborne precautions: negative-pressure room with door closed, N95 or PAPR for staff. During transport the client wears a surgical mask (not N95) to contain droplet nuclei — the staff member outside the room can wear a regular mask. Door must remain closed to maintain negative pressure.
These are 5 of 5,000+ NCLEX questions in the Clarity bank. The full bank includes real NGN case studies, bow-tie items, AI tutor follow-up, and 5 readiness exams.
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What's the difference between airborne and droplet precautions?
Airborne: small particles that travel in the air, requiring negative pressure rooms and N95. Examples: TB, measles, varicella. Droplet: larger particles that fall within 3 feet, requiring a surgical mask. Examples: flu, pertussis, meningitis.
Why do C. diff patients need soap and water?
Alcohol-based sanitizer does not kill C. diff spores. Soap and water with friction physically removes the spores from your hands. Always use soap and water before AND after contact with C. diff patients.
What's a sentinel event?
An unexpected event involving death or serious physical or psychological injury. Examples: wrong-site surgery, suicide of an inpatient, infant abduction, hemolytic transfusion reaction. Requires immediate root cause analysis.
How often do restraints need reassessment?
Behavioral restraints: every 15–30 min monitoring, full reassessment every hour (adult) or every 30 min (child). Medical restraints (less common): reassess at least every 24 hours, monitor skin/circulation every 2 hours minimum.