I85PREP
⌘ K
MNMC Nurses' Competency Exam study materials
MNMC Nurses' Competency Exam study resources

MNMC Nurses' Competency Exam practice questions

One question at a time. Build your MNMC Nurses' Competency Exam understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Patient Safety and Risk Management

A nurse is about to administer a high-alert medication. Which action best reflects the purpose of an independent double-check in preventing medication errors?

  1. Documenting the administration before giving the drug to save time
  2. Having a second nurse verify the drug, dose, and route separately before administration Correct answer.
  3. Asking the patient to repeat the medication name back before administration
  4. Reading the medication label aloud to the patient during administration

Explanation

An independent double-check requires a second qualified clinician to verify the key elements (drug, dose, route, concentration, pump settings) without being influenced by the first nurse's reading. This independence catches errors that a single check may miss. Patient teach-back and prompt documentation do not substitute for a second professional verification.

Question 2Patient Safety and Risk Management

Which action is the most reliable way for a nurse to reduce the risk of wrong-patient errors during specimen collection?

  1. Confirming identity using two identifiers at the bedside immediately before collection Correct answer.
  2. Labeling the specimen at the nurses' station after finishing the round
  3. Using the room number as the primary identifier for the patient
  4. Asking the patient whether the name on the label looks correct

Explanation

Two patient identifiers (such as name and date of birth) verified at the point of care immediately before the procedure are the standard safeguard against wrong-patient errors. Labeling must occur at the bedside, not later at a distant location. Room numbers and patient self-confirmation alone are not acceptable identifiers.

Question 3Patient Safety and Risk Management

A nurse notices a colleague consistently failing to perform hand hygiene before entering patient rooms. What is the most appropriate first action according to just culture principles?

  1. Document the behavior in the patient record without informing anyone
  2. Report the colleague to the licensing board immediately
  3. Speak with the colleague directly and privately about the observed behavior Correct answer.
  4. Ignore the behavior because it is a system issue, not a personal one

Explanation

Just culture encourages respectful, direct, private feedback for at-risk behavior before escalating, while still holding clinicians accountable. Immediate regulatory reporting is reserved for serious breaches, and ignoring the behavior endangers patients. The conversation should be documented through appropriate channels, not in a patient's chart.

Question 4Patient Safety and Risk Management

Which element is essential when documenting a fall incident in the medical record?

  1. A statement that the fall was unavoidable given the patient's age
  2. Speculation about which staff member was responsible for the fall
  3. A factual, objective description of the event, patient condition, and interventions taken Correct answer.
  4. An estimate of the cost the fall will add to the hospital stay

Explanation

Incident documentation in the health record should be factual, objective, and focused on the patient's condition and the care provided. Blame, speculation, and cost estimates do not belong in the clinical record. Responsibility analysis belongs in a separate incident reporting system.

Question 5Patient Safety and Risk Management

A patient is receiving a blood transfusion. Which assessment finding should prompt the nurse to stop the transfusion immediately?

  1. A blood pressure of 118/76 mm Hg
  2. A sudden rise in temperature with chills and flank pain Correct answer.
  3. A heart rate of 88 beats per minute
  4. Mild itching at the intravenous insertion site

Explanation

Fever, chills, and flank pain during transfusion suggest an acute hemolytic reaction, which requires immediate cessation of the transfusion and rapid notification of the provider and blood bank. Stable vital signs and localized itching do not indicate a hemolytic reaction. Any suspected reaction warrants stopping the infusion while maintaining IV access.

Question 6Patient Safety and Risk Management

Which practice best prevents pressure injuries in an immobile patient?

  1. Keeping the head of the bed elevated at 45 degrees continuously
  2. Repositioning the patient on a scheduled interval and inspecting bony prominences Correct answer.
  3. Limiting fluid intake to reduce the need for repositioning
  4. Massaging reddened bony areas vigorously during each shift

Explanation

Scheduled repositioning combined with skin inspection at pressure points is a core intervention for pressure injury prevention. Massaging reddened areas can worsen tissue damage, and prolonged high head-of-bed elevation increases shear and pressure on the sacrum. Adequate hydration and nutrition support skin integrity.

Question 7Patient Safety and Risk Management

When a nurse receives a verbal order from a physician, what is the safest practice?

  1. Ask another nurse to guess the intended dose from context
  2. Write the order, read it back to the prescriber, and obtain confirmation Correct answer.
  3. Transcribe the order directly onto the medication administration record without verification
  4. Accept the order and enter it later without read-back

Explanation

Verbal orders require a read-back of the complete order to the prescriber to confirm accuracy, followed by documentation and timely countersignature per policy. Skipping read-back or relying on another nurse's interpretation introduces error. Direct transcription without verification bypasses safety checks.

Question 8Patient Safety and Risk Management

Which of the following best describes the purpose of a rapid response team in a hospital?

  1. To handle only patients who have already lost consciousness
  2. To bring critical care expertise to a deteriorating patient before cardiac arrest occurs Correct answer.
  3. To manage staffing shortages on medical-surgical units
  4. To replace the primary nurse's assessment during emergencies

Explanation

Rapid response teams provide early intervention for patients showing signs of clinical deterioration, aiming to prevent arrest and unplanned ICU transfer. They support rather than replace the bedside nurse's assessment. Their focus is on early deterioration, not only on patients who are already unresponsive.

Question 9Patient Safety and Risk Management

A nurse is preparing to insert a urinary catheter. Which action most directly reduces the risk of catheter-associated urinary tract infection?

  1. Keeping the drainage bag above the level of the bladder
  2. Irrigating the catheter routinely every shift
  3. Using sterile technique and maintaining a closed drainage system Correct answer.
  4. Changing the catheter every 24 hours regardless of need

Explanation

Sterile insertion technique and a closed drainage system are cornerstone measures for preventing catheter-associated urinary tract infection. Routine irrigation and unnecessary catheter changes increase infection risk, and the drainage bag must remain below bladder level to prevent backflow.

Question 10Patient Safety and Risk Management

A nurse discovers that a patient received the wrong dose of insulin. Which sequence of actions best reflects safe error management?

  1. Document the error in the chart but omit it from the incident reporting system
  2. Wait for the next shift to report the error to reduce workload
  3. Complete the incident report first, then assess the patient once time permits
  4. Assess the patient, notify the provider, treat as needed, complete an incident report, and document clinically Correct answer.

Explanation

Patient assessment and treatment take priority after a medication error, followed by provider notification and completion of an incident report through the safety system. The clinical record should reflect objective findings and interventions, not blame. Incident reports are separate from the chart and support system learning.

Question 11Patient Safety and Risk Management

Which situation most clearly requires the nurse to activate the chain of command?

  1. The unit clerk cannot locate a wheelchair for discharge
  2. A patient asks for a different meal than the one delivered
  3. A family member requests an update on discharge timing
  4. A provider repeatedly dismisses a nurse's report of a patient's new confusion and falling oxygen saturation Correct answer.

Explanation

The chain of command is used when a clinician's concerns about a deteriorating patient are not being addressed and patient safety is at risk. It escalates the concern to successive levels of authority until it is resolved. Routine service requests and non-clinical matters do not warrant chain-of-command activation.

Question 12Patient Safety and Risk Management

A nurse is caring for a patient with a known allergy to penicillin. Which action is the strongest safeguard against administering a contraindicated antibiotic?

  1. Checking the allergy only after the first dose is given
  2. Verifying the allergy against the order and pharmacy record before administration Correct answer.
  3. Relying on the patient to mention the allergy at the time of administration
  4. Assuming a cephalosporin is always safe because it is a different class

Explanation

Allergy verification against the order and pharmacy record before administration is a required safety check that prevents administration of contraindicated drugs. Cross-reactivity between penicillin and some cephalosporins exists, so a different class is not automatically safe. Checking after administration is too late to prevent harm.

Question 13Patient Safety and Risk Management

Which measure is most effective for reducing health care-associated infections related to central venous catheters?

  1. Flushing the line with tap water between uses
  2. Daily review of catheter necessity and prompt removal when no longer indicated Correct answer.
  3. Keeping the dressing unchanged until it falls off
  4. Routine replacement of the catheter over a guidewire every week

Explanation

Daily assessment of whether a central line is still needed, with prompt removal, is a key element of bloodstream infection prevention bundles. Routine guidewire exchanges increase risk, dressings require scheduled changes per policy, and only sterile solutions should be used for flushing.

Question 14Patient Safety and Risk Management

A patient is at risk for falls and has an active order for a bed alarm. The nurse finds the alarm turned off by a visitor. What is the priority action?

  1. Document the event and continue the shift without further action
  2. Reactivate the alarm and re-educate the patient and visitor about fall precautions Correct answer.
  3. Restrain the patient to prevent further interference
  4. Move the patient to a room nearer the nurses' station without reassessing

Explanation

The immediate priority is restoring the safety device and educating the patient and family about its purpose. Documentation alone does not address the ongoing risk, and restraints require a specific order and are not a response to visitor interference. Reassessment should follow any change in safety status.

Question 15Patient Safety and Risk Management

Which of the following best describes a root cause analysis after a sentinel event?

  1. A financial audit of the costs associated with the event
  2. A disciplinary hearing to determine which staff member should be terminated
  3. A brief note added to the patient's chart summarizing the event
  4. A structured team review that identifies system vulnerabilities and corrective actions Correct answer.

Explanation

Root cause analysis is a structured, non-punitive review that examines system factors contributing to a sentinel event and identifies corrective actions. It is not a disciplinary process, and its findings are generally protected from the clinical record. Financial review is not its purpose.

Question 16Patient Safety and Risk Management

A nurse is preparing to administer a medication through a nasogastric tube. Which action best prevents a tube-related medication error?

  1. Administering all medications together in one syringe to save time
  2. Flushing the tube only after the last medication
  3. Confirming tube placement and using liquid or crushed forms appropriate for tube administration Correct answer.
  4. Giving enteric-coated tablets whole through the tube

Explanation

Verifying tube placement and selecting formulations appropriate for tube administration prevents obstruction and absorption errors. Medications should generally be given separately with flushes between doses. Enteric-coated tablets should not be crushed or given whole through a small-bore tube, and flushing only at the end risks tube occlusion and drug interactions.

Question 17Patient Safety and Risk Management

Which patient finding should the nurse report as a potential sign of clinical deterioration using a track-and-trigger approach?

  1. A single blood pressure reading of 118/74 mm Hg
  2. A rising respiratory rate with new confusion in a postoperative patient Correct answer.
  3. A temperature of 37.0 degrees Celsius
  4. A pain score of 3 out of 10 after analgesia

Explanation

Track-and-trigger systems use abnormal vital signs and mental status changes to identify deterioration early. A rising respiratory rate with new confusion is a recognized warning pattern. Normal vital signs and expected post-analgesia pain scores do not trigger escalation.

Question 18Patient Safety and Risk Management

A nurse is asked to witness a patient's informed consent for a procedure. What is the nurse's appropriate role?

  1. Explain the procedure in detail and answer all clinical questions personally
  2. Verify that the patient understands the procedure and that consent is voluntary before witnessing Correct answer.
  3. Persuade the patient to proceed even if the patient expresses doubt
  4. Sign as the person who obtained the consent from the provider

Explanation

The nurse's role in informed consent is to verify the patient's understanding, voluntariness, and capacity, and to witness the signature. Explaining the procedure and obtaining consent are the provider's responsibilities. Coercing a hesitant patient violates the principle of autonomy.

Question 19Patient Safety and Risk Management

Which action best demonstrates the use of a surgical safety checklist to prevent wrong-site surgery?

  1. Completing the checklist after the procedure is finished
  2. Confirming patient identity, procedure, site, and side as a team before incision Correct answer.
  3. Skipping the time-out when the team is behind schedule
  4. Having only the surgeon read the checklist silently

Explanation

The time-out is a team process performed before incision to confirm patient identity, procedure, site, and side, along with other key elements. Completing it after the procedure or skipping it under time pressure defeats its purpose. Silent review by one person does not ensure team agreement.

Question 20Patient Safety and Risk Management

A nurse manager notes repeated near-misses involving look-alike medication labels on a unit. Which response best reflects a proactive safety culture?

  1. Counsel the individual nurse who reported the near-miss
  2. Wait for an actual harm event before taking action
  3. Discourage reporting near-misses to avoid alarming staff
  4. Analyze the near-miss reports and implement label or storage changes to prevent recurrence Correct answer.

Explanation

Near-miss reporting is valuable because it reveals system hazards before harm occurs. Analyzing patterns and modifying storage or labeling is a proactive, system-focused response. Waiting for harm, discouraging reports, or blaming reporters undermines safety culture.

Question 21Patient Safety and Risk Management

A patient with a history of falls is admitted and the nurse completes a fall risk assessment. Which action best reflects appropriate use of the assessment result?

  1. Implement targeted interventions matched to the identified risk factors Correct answer.
  2. Repeat the assessment only at discharge
  3. Document the score and take no further action if it is high
  4. Apply the same interventions to every patient regardless of score

Explanation

Fall risk assessment is useful only when it drives individualized interventions matched to the patient's specific risk factors, such as mobility limits, medications, or continence issues. Uniform interventions ignore the assessment's purpose, and a high score requires action, not documentation alone. Risk should be reassessed when the patient's condition changes.

Question 22Patient Safety and Risk Management

During a medication reconciliation at discharge, the nurse notices the patient's home list includes a drug that was intentionally discontinued during the hospital stay. What is the most appropriate action?

  1. Omit the reconciliation step to save time during a busy discharge
  2. Clarify with the prescriber and ensure the discharge list reflects the intended regimen Correct answer.
  3. Ask the patient to decide which medications to continue
  4. Add the discontinued drug back to the discharge list to match the home list

Explanation

Medication reconciliation requires resolving discrepancies between home and hospital regimens with the prescriber so that the discharge list reflects intentional changes. Re-adding a discontinued drug or skipping reconciliation can cause harm. Patients should be educated, but clinical decisions about continuation rest with the prescriber.

Question 23Patient Safety and Risk Management

A nurse is reviewing an order for a high-alert medication with a dosing range that is ambiguous. Which action best demonstrates safe practice?

  1. Ask a peer to select a dose based on past experience
  2. Clarify the intended dose with the prescriber before administration Correct answer.
  3. Choose the highest dose in the range to ensure effectiveness
  4. Administer the lowest dose and document the ambiguity later

Explanation

Ambiguous orders for high-alert medications must be clarified with the prescriber before administration, since guessing either the high or low end of a range can cause harm. Peer experience and post-hoc documentation do not replace prescriber clarification.

Question 24Patient Safety and Risk Management

A nurse observes that the unit's emergency cart is frequently missing a specific item after codes. Which approach best reflects systems thinking in risk management?

  1. Review the restocking process and standardize checks to prevent future shortages Correct answer.
  2. Remove the item from the cart to avoid future complaints
  3. Instruct staff to check the cart more carefully without changing the process
  4. Report the shortage only if a patient is harmed

Explanation

Systems thinking examines the process that allowed the shortage rather than blaming individuals. Standardizing restocking and verification reduces reliance on memory and catches failures before they affect patient care. Reporting only after harm or removing the item avoids the underlying problem.

Question 25Patient Safety and Risk Management

A nurse is caring for a patient receiving multiple intravenous infusions through a single pump. Which action best reduces the risk of a programming error?

  1. Using the drug library on the smart pump and verifying settings against the order Correct answer.
  2. Bypassing the drug library when the pump alerts
  3. Adjusting the rate without documenting the change
  4. Programming the pump from memory to save time

Explanation

Smart pump drug libraries provide dose limits and alerts that reduce programming errors, and settings should be verified against the order. Bypassing alerts, relying on memory, and undocumented rate changes remove safeguards and leave no reliable record.

Question 26Patient Safety and Risk Management

A nurse is caring for a patient who is confused and repeatedly attempts to climb out of bed despite a bed alarm. Which action best addresses the immediate safety risk while preserving the patient's dignity?

  1. Place the patient in a low bed with a mat and increase supervised rounding Correct answer.
  2. Ask the family to stay continuously without documenting the arrangement
  3. Raise all four side rails and leave the room to reduce stimulation
  4. Apply soft wrist restraints without an order to prevent climbing

Explanation

Least-restrictive measures come first: a low bed, floor mat, and more frequent supervised checks reduce fall and injury risk without restricting the patient. Restraints require a provider order and must be the last resort after less restrictive options fail.

Question 27Patient Safety and Risk Management

A nurse is preparing to give a shift handoff using a structured format. Which element is essential to communicate the patient's current safety risks during handoff?

  1. The nurse's personal opinion of the patient's personality
  2. The patient's insurance status and admission source
  3. The patient's current fall, allergy, and deterioration risk status Correct answer.
  4. A summary of the patient's social history and hobbies

Explanation

Structured handoff should convey actionable safety information, including allergies, fall risk, and signs of clinical deterioration, so the incoming nurse can act immediately. Administrative and social details are secondary to these safety-critical items.

Question 28Patient Safety and Risk Management

A nurse notices that a colleague consistently bypasses the barcode scanner when administering medications during busy periods. Which response best reflects a just-culture approach to this safety concern?

  1. Discuss the workflow barrier with the colleague and escalate through unit leadership Correct answer.
  2. Report the colleague to the licensing board immediately
  3. Ignore the behavior because the colleague is experienced
  4. Post an anonymous note in the break room criticizing the practice

Explanation

A just culture separates human error from at-risk behavior and system issues, encouraging open reporting and correction of workflow barriers. Direct, respectful discussion followed by leadership escalation supports learning and system improvement rather than blame.

Question 29Patient Safety and Risk Management

A nurse is caring for a patient with an epidural infusion for postoperative pain. Which nursing action most directly prevents a catastrophic complication from this therapy?

  1. Encouraging the patient to ambulate independently
  2. Changing the epidural dressing every shift
  3. Verifying the correct tubing and pump programming for epidural delivery Correct answer.
  4. Flushing the epidural catheter with saline before each dose

Explanation

Epidural medications must never be given through the wrong route or pump; verifying dedicated tubing and correct pump programming prevents inadvertent intravenous administration, which can be fatal. Dressing changes and flushing follow specific protocols and are not the primary safeguard against route errors.

Question 30Patient Safety and Risk Management

During a code, a nurse notices that the team has given a medication but no one has documented the dose or time. Which action best reflects the nurse's responsibility for safe documentation during a resuscitation?

  1. Document only the medications the nurse personally administered
  2. Delegate documentation to the family member present
  3. Wait until the code ends to reconstruct the events from memory
  4. Assign a dedicated recorder to log doses and times in real time Correct answer.

Explanation

Real-time documentation by a designated recorder during a code improves accuracy of medication timing and supports later review and quality improvement. Reconstructing events from memory or documenting only one's own actions creates gaps that compromise patient safety and team accountability.

Question 31Infection Prevention and Control

A nurse is preparing to insert a peripheral IV catheter. Which action best demonstrates the principle of asepsis during this procedure?

  1. Applying clean gloves and palpating the site after skin antisepsis
  2. Using friction and appropriate contact time when applying the skin antiseptic Correct answer.
  3. Wiping the skin with an alcohol swab for two seconds before puncture
  4. Re-palpating the vein with a sterile-gloved finger only after the catheter is inserted

Explanation

Effective skin antisepsis requires mechanical friction plus the manufacturer's specified contact (dry) time so the antiseptic can kill transient and resident flora. Rushing the application or touching the site afterward recontaminates it and defeats the purpose of the prep.

Question 32Infection Prevention and Control

According to standard precautions, how should a nurse treat a patient's blood and body fluids when the patient's infection status is unknown?

  1. Apply precautions only after a positive culture result is reported
  2. Reserve gowns and eye protection for confirmed cases of hepatitis
  3. Use gloves only when the patient has a known bloodborne pathogen
  4. Treat all blood and body fluids as potentially infectious regardless of diagnosis Correct answer.

Explanation

Standard precautions are based on the principle that all blood, body fluids, secretions, and non-intact skin may carry transmissible pathogens. Precautions are applied to every patient, so care does not depend on knowing a diagnosis.

Question 33Infection Prevention and Control

A nurse has just performed hand hygiene with an alcohol-based hand rub. Which situation requires washing with soap and water instead?

  1. Hands are visibly soiled with blood Correct answer.
  2. Hands are being decontaminated before donning sterile gloves
  3. Hands are dry after removing non-sterile gloves
  4. Hands are socially clean before entering a patient room

Explanation

Alcohol-based rubs are ineffective when organic material such as blood or visible dirt is present, because the soil protects organisms and inactivates the product. Visible soiling requires soap and water to physically remove the material before any further antisepsis.

Question 34Infection Prevention and Control

Which statement correctly describes the purpose of a surgical mask worn by a coughing patient during transport?

  1. It replaces the need for the transporting staff to wear respiratory protection
  2. It protects the patient from inhaling airborne pathogens in the corridor
  3. It sterilizes the air the patient exhales
  4. It contains respiratory secretions and reduces dispersal of droplets into the environment Correct answer.

Explanation

Source control masks trap large respiratory droplets at the point of emission, reducing contamination of the surrounding environment during movement through shared spaces. They do not filter inhaled air for the wearer or eliminate the need for staff protection.

Question 35Infection Prevention and Control

A nurse is removing a pair of contaminated gloves after wound care. Which sequence reflects safe doffing?

  1. Remove gloves after leaving the room to avoid contaminating the doorway
  2. Peel both gloves off together by the cuffs and discard them
  3. Remove the first glove by grasping the outside, then remove the second by sliding fingers under the cuff of the still-gloved hand Correct answer.
  4. Remove both gloves by pulling the fingertips, then wash hands with alcohol rub

Explanation

Safe doffing keeps bare skin from contacting the contaminated exterior: the first glove is removed by grasping its outer surface, and the second is removed by hooking fingers under the cuff of the gloved hand so it inverts over itself. Hand hygiene follows immediately.

Question 36Infection Prevention and Control

Which of the following is the single most important measure for preventing transmission of healthcare-associated infections between patients?

  1. Daily environmental fogging of patient rooms
  2. Hand hygiene at the World Health Organization's five moments Correct answer.
  3. Routine prophylactic antibiotics for all surgical patients
  4. Replacing intravenous tubing every twelve hours for all patients

Explanation

Hands are the principal vehicle for transferring organisms between patients and the environment, so hand hygiene at the defined moments of patient contact is the cornerstone of prevention. Other measures support but do not replace this practice.

Question 37Infection Prevention and Control

A nurse is caring for a patient with an indwelling urinary catheter. Which action best reduces the risk of catheter-associated urinary tract infection?

  1. Routinely replacing the catheter every 48 hours
  2. Irrigating the catheter daily with an antiseptic solution
  3. Disconnecting the catheter from the tubing to obtain urine samples each shift
  4. Keeping the drainage bag below the level of the bladder and off the floor Correct answer.

Explanation

Gravity drainage with the bag below bladder level prevents backflow of contaminated urine into the bladder, and keeping the bag off the floor avoids contact with environmental organisms. Maintaining a closed system is central to preventing CAUTI.

Question 38Infection Prevention and Control

Which set of precautions is appropriate for a patient with suspected pulmonary tuberculosis who is coughing?

  1. Contact precautions with gown and gloves
  2. Airborne precautions with a fit-tested N95 or equivalent respirator and a negative-pressure room Correct answer.
  3. Droplet precautions with a surgical mask and a private room with the door open
  4. Standard precautions only

Explanation

Tuberculosis is transmitted by airborne droplet nuclei that remain suspended and travel on air currents, so an airborne infection isolation room with negative pressure and a fit-tested respirator is required. A surgical mask does not provide adequate inhalation protection for staff.

Question 39Infection Prevention and Control

A nurse is performing a dressing change on a surgical wound. Which practice is consistent with sterile technique?

  1. Reaching across the sterile field to retrieve a dropped gauze
  2. Touching the inner wrapper of a sterile pack with bare hands
  3. Placing the sterile drape on a surface that has been wiped with a dry cloth
  4. Holding sterile supplies above the waist and within the field of vision Correct answer.

Explanation

Sterile items must remain above waist level and within the nurse's direct line of sight so that they are not contaminated by contact with unsterile surfaces or by unseen events. Reaching across a field and touching non-sterile surfaces break the sterile boundary.

Question 40Infection Prevention and Control

A patient is admitted with Clostridioides difficile infection and diarrhea. Which combination of precautions and hand hygiene is correct?

  1. Droplet precautions; surgical mask and alcohol-based hand rub
  2. Airborne precautions; N95 respirator and soap and water
  3. Contact precautions; soap and water handwashing with gown and gloves Correct answer.
  4. Standard precautions; alcohol-based hand rub after contact

Explanation

C. difficile spores are spread by contact and are resistant to alcohol, so contact precautions with gown and gloves plus soap-and-water handwashing (which physically removes spores) are required. Alcohol rub does not reliably kill spores.

Question 41Infection Prevention and Control

A nurse sustains a needlestick injury from a hollow-bore needle while caring for an unknown-source patient. What is the priority first action?

  1. Apply a tight tourniquet above the puncture site
  2. Wash the wound with soap and water and report immediately for post-exposure evaluation Correct answer.
  3. Report to occupational health after completing the shift
  4. Obtain the patient's consent before any wound care

Explanation

Immediate wound washing reduces the inoculum, and prompt reporting allows timely risk assessment, source testing, and initiation of post-exposure prophylaxis if indicated. Delay reduces the effectiveness of prophylaxis for pathogens such as HIV and hepatitis B.

Question 42Infection Prevention and Control

Which action correctly demonstrates the safe handling of a specimen bag containing blood tubes for transport?

  1. Stapling the requisition to the outside of the specimen bag
  2. Placing the tubes loose in a cloth tote bag
  3. Placing the tubes in a leakproof bag with the requisition in a separate outer pocket Correct answer.
  4. Carrying the tubes in a uniform pocket until reaching the lab

Explanation

Specimens must be transported in a leakproof secondary container, with paperwork kept separate from the specimen to prevent contamination of the requisition. This maintains the integrity of the sample and protects staff from exposure.

Question 43Infection Prevention and Control

A nurse is preparing to care for a patient on contact precautions for a multidrug-resistant organism. Which sequence of PPE application is correct?

  1. Hand hygiene, gown, then gloves over the gown cuffs Correct answer.
  2. Gown, mask, eye protection, then hand hygiene, then gloves
  3. Gloves first, then gown, then perform hand hygiene
  4. Mask, gloves, gown, then hand hygiene

Explanation

PPE is applied after hand hygiene, with the gown donned first and gloves pulled over the gown cuffs to create a continuous barrier at the wrist. This order ensures the most contaminated item is removed first and the barrier remains intact.

Question 44Infection Prevention and Control

Which practice best prevents contamination of a multidose vial used for multiple patients?

  1. Cleaning the vial septum with an alcohol swab and using a new needle and syringe for each entry Correct answer.
  2. Leaving the needle inserted in the septum to speed up subsequent doses
  3. Storing the vial at room temperature on the medication cart between uses
  4. Reusing the same needle to withdraw doses from the vial for each patient

Explanation

Disinfecting the septum and using a fresh sterile needle and syringe for every entry prevents the introduction of organisms and cross-contamination between patients. Leaving needles in place or reusing them creates a direct route for contamination.

Question 45Infection Prevention and Control

A nurse is caring for a patient with a draining wound colonized with methicillin-resistant Staphylococcus aureus. Which action reflects correct use of barriers?

  1. Wearing gloves and a gown for any contact with the patient or their environment and removing them before leaving the room Correct answer.
  2. Wearing a gown and gloves only if the drainage is visible
  3. Wearing gloves but no gown, since the wound is covered by a dressing
  4. Wearing a surgical mask to protect against wound colonization

Explanation

Contact precautions require gown and gloves for all contact with the patient and their immediate environment, with removal before exiting to prevent contamination of shared spaces. Colonization still poses a transmission risk even without active infection.

Question 46Infection Prevention and Control

Which statement about the chain of infection is most accurate for a nurse planning interventions?

  1. Breaking any single link is sufficient to prevent transmission Correct answer.
  2. Only the infectious agent link can be targeted effectively
  3. The chain applies only to airborne pathogens
  4. Breaking the portal of entry link is impossible in clinical settings

Explanation

The chain of infection has six links, and interrupting any one of them stops transmission. This is why hand hygiene, environmental cleaning, and immunization are all valid but different strategies.

Question 47Infection Prevention and Control

A nurse is teaching a patient about preventing surgical site infection after discharge. Which instruction is most appropriate?

  1. Scrub the incision with an alcohol wipe twice daily
  2. Clean the incision gently with soap and water as directed and keep it dry between cleans Correct answer.
  3. Keep the incision covered with the original dressing until the follow-up visit in two weeks
  4. Apply an over-the-counter antibiotic ointment daily to the incision

Explanation

Gentle cleansing with soap and water according to the surgeon's instructions, followed by keeping the area dry, supports healing while avoiding irritation. Routine antibiotic ointment and alcohol scrubbing can damage tissue and are not recommended.

Question 48Infection Prevention and Control

Which action best reflects appropriate use of personal protective equipment when caring for a patient requiring both contact and droplet precautions?

  1. Wearing a surgical mask, gown, and gloves, and removing the mask after leaving the room
  2. Wearing only gloves and a mask, since the gown is unnecessary for droplet precautions
  3. Wearing an N95 respirator regardless of the pathogen involved
  4. Wearing a surgical mask, gown, and gloves, and removing the mask last, after leaving the room and closing the door Correct answer.

Explanation

When contact and droplet precautions are combined, gloves, gown, and a surgical mask are worn, and the mask is removed last, after leaving the room, so that contamination is not carried into the corridor. The mask must be removed by the ties or ear loops without touching the front.

Question 49Infection Prevention and Control

A nurse is preparing to insert a central venous catheter at the bedside. Which bundle element is most strongly associated with reducing central line-associated bloodstream infections?

  1. Applying a topical antibiotic to the insertion site daily
  2. Using maximal sterile barrier precautions including cap, mask, sterile gown, sterile gloves, and full-body drape Correct answer.
  3. Changing the dressing every 24 hours regardless of condition
  4. Flushing the catheter with sterile water after each use

Explanation

Maximal sterile barrier precautions during insertion are a core element of the central line bundle and substantially reduce contamination of the insertion site and catheter. Other bundle elements include hand hygiene, chlorhexidine skin antisepsis, and prompt removal when no longer needed.

Question 50Infection Prevention and Control

A patient with a known history of hepatitis B is admitted. Which statement about standard precautions for this patient is correct?

  1. The patient must be placed in a negative-pressure room
  2. Only staff who have been vaccinated may provide care
  3. Standard precautions apply, with additional precautions determined by the specific clinical situation and route of transmission Correct answer.
  4. Additional transmission-based precautions are required for all interactions

Explanation

Hepatitis B is transmitted by blood and body fluids, so standard precautions are the foundation of care. Additional precautions are added only when the clinical situation, such as significant bleeding or another pathogen, warrants them.