10–16% of the NCLEX-RN

NCLEX Safety and Infection Prevention and Control

How you keep clients and staff from harm: preventing falls and errors, using restraints only when nothing less will do, handling emergencies, and choosing the right precautions for each infection.

Practice Safety and Infection free10 questions a day free, no card

What it covers

  • Standard and transmission-based precautions
  • Fall and injury prevention
  • Restraints and least-restrictive measures
  • Medication and client identification safety
  • Emergency response and disaster triage
  • Handling hazardous materials and equipment

Three ways candidates lose points

  • Mixing up airborne and droplet precautions. Airborne (TB, measles, varicella) needs a negative-pressure room and an N95; droplet (influenza, pertussis) needs a surgical mask within about 3 feet.
  • Reaching for a restraint or side rails first. The least-restrictive measure comes first: observation, a low bed, hourly rounding, a room near the station.
  • Putting equipment before the person. In a fire, the client in danger is moved before the alarm is pulled; in any emergency, people come before things.

How to approach it

Ask what could hurt this client in the next few minutes and which option removes that risk with the least restriction. For precautions, name the organism's route (contact, droplet, airborne) before you look at the options; the right personal protective equipment follows from the route.

Free chapters to read

Openly licensed textbooks written by nursing faculty, free to read online. Read the sections your misses point to, not the whole book.

Try three real questions

From WriteSpan’s own bank, the same questions students practice with. Answer first; the explanation opens after.

Question 1NGN: Safe Patient Handling Matrix

A nurse is planning transfers and mobility for four clients on the unit. For each client indicate the most appropriate transfer or mobility method.

The answer is D

POST-TKR PARTIAL WEIGHT BEARING: A gait belt provides the nurse with a secure grip to assist and support the client if they lose balance. One nurse is appropriate for a client who can partially bear weight with a walker. Monitor for pain escalation and compliance with weight-bearing restrictions. POST-STROKE COMPLETE PARALYSIS 91 KG: A 91 kg completely dependent client cannot be safely manually transferred by nursing staff — the force required exceeds safe lifting limits and creates injury risk for both the client and the nurse. A ceiling or floor lift with a full-body sling is the evidence-based safe approach. POST-APPENDECTOMY 6 HOURS STABLE: This client has already safely ambulated once and is clinically stable with well-controlled pain. Promoting progressive independence with a call light within reach is appropriate — hovering unnecessarily delays return to function. COPD CLIENT TO BATHROOM: Ambulation is safe and beneficial for COPD clients. Maintaining oxygen delivery during ambulation is the key safety element — ensure the tubing is long enough or use portable oxygen. Denying ambulation to the bathroom risks falls if the client attempts independently.

Clinical pearl: Clinical Pearl: Transfer decision framework: (1) Can the client bear any weight? (2) What is the client's weight? (3) How many staff are available? (4) What assistive devices are present? (5) What are the activity orders? Ceiling lifts should be the first choice for all dependent transfers above 35 lbs (16 kg) of dependent weight. Promoting independence in stable clients accelerates recovery — early mobilization after surgery reduces complications.

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Question 2Environmental Safety

A nurse is making a home visit to a client receiving home health care. The client lives alone and uses a portable home oxygen concentrator. During the visit the nurse notices several potential safety hazards. Which finding requires the most urgent intervention?

The answer is C

Correct! An open-element space heater within 3 feet of an oxygen concentrator is an immediate fire and explosion hazard. Oxygen dramatically increases combustibility — materials that would not normally ignite can burn explosively in an oxygen-enriched environment. An open heating element is a direct ignition source. This combination requires immediate intervention — the space heater must be turned off and moved away from the oxygen equipment. The minimum safe distance for heat sources near oxygen is 5 feet (some guidelines recommend further).

Clinical pearl: Clinical Pearl: Home oxygen safety education: (1) No smoking in the home or within 15 feet of the client outdoors, (2) No open flames — candles, gas stoves, fireplaces with open flames, space heaters with open elements, (3) Keep oxygen equipment at least 5 feet from heat sources, (4) Post oxygen in use signs on doors, (5) No petroleum products near the face — use water-based lip balm, (6) Secure tubing to prevent tripping, (7) Check tubing regularly for kinks or damage.

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Question 3Safe Patient Handling

A nurse is ambulating a client for the first time after three days of bed rest following abdominal surgery. The client weighs 78 kg and rates their pain as 4 out of 10 which is well controlled with oral analgesics. As the client stands up from the bed, they suddenly state "I feel dizzy and everything is going dark." Which action should the nurse take first?

The answer is C

Correct! A client who reports feeling dizzy and states "everything is going dark" is about to faint — if the nurse attempts to hold up a fainting client, both the client and the nurse are at risk for injury from the fall. The nurse must immediately perform a controlled descent — guiding the client safely to the floor or back to the bed. Call for help while controlling the descent. This is the fundamental safety principle for managing a client who is about to collapse: never attempt to catch or hold up a fainting person.

Clinical pearl: Clinical Pearl: When a client reports syncope prodrome (dizziness, visual changes, nausea) while standing: (1) Do NOT try to hold them up — both will fall, (2) Lower to the floor in a controlled manner — bend your knees, support their head, (3) Call for help, (4) Lower their head and elevate legs if possible, (5) Assess vital signs and level of consciousness, (6) Do not attempt to stand them up again immediately. Prevention: dangle before standing, orthostatic vital signs before first ambulation, ensure adequate hydration.

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