Infection Control & Patient Safety NCLEX Practice Questions

Airborne (negative pressure room, N95 mask): TB, measles, varicella, disseminated herpes zoster. Droplet (surgical mask, private room or 3 feet distance): influenza, bacterial meningitis, mumps, pertussis, rubella, strep pharyngitis. Contact (gloves and gown): MRSA, VRE, C. difficile, wound infections, scabies. Standard precautions apply to every patient for every encounter.

Use soap and water (not alcohol-based hand sanitizer) when hands are visibly soiled or contaminated, after contact with Clostridioides difficile (C. diff) — alcohol does NOT kill C. diff spores, before eating, and after restroom use. Alcohol-based hand rub is effective and preferred for most clinical situations when hands are not visibly soiled.

Restraints are a last resort after all alternatives have failed. Require a provider order (renewed every 24 hours for medical-surgical, every 4 hours for behavioral health in adults). Assess circulation, sensation, and movement (CSM) of restrained extremities every 1-2 hours. Release restraints every 2 hours for ROM, toileting, hydration, and nutrition. Document ongoing assessment and the continued need for restraints. Restraints tied with quick-release knots to the bed frame (not side rails).

Assess fall risk on admission and with any change in condition using a validated tool (e.g., Morse Fall Scale). Interventions: bed in lowest position with brakes locked, call light within reach, non-skid footwear, adequate lighting, toileting assistance on schedule, minimize clutter, and educate the patient to call for help before ambulating. High-risk patients: consider bed alarms, 1:1 sitter, and medication review (sedatives, opioids, diuretics, and antihypertensives increase fall risk).

Key principles: a sterile field is contaminated if touched by any unsterile object, if it becomes wet (moisture wicks bacteria), or if it falls below waist level. Never turn your back on a sterile field. Open sterile packages away from you first. Sterile gloves: inside of the wrapper is sterile, glove dominant hand first. Surgical hand scrub: 3-5 minutes, keep hands above elbows. If there is ANY doubt about sterility, consider it contaminated and start over.

Key NPSG areas: use at least two patient identifiers before any procedure or medication (name and DOB — not room number), improve communication (read-back of verbal and telephone orders), label all medications on and off the sterile field, reduce patient harm from falls, prevent healthcare-associated infections (hand hygiene compliance, CAUTI/CLABSI bundles), and identify patient safety risks including suicide risk screening in behavioral health settings.