NURS 104L | Hand Hygiene & Infection Control Skills | 2026/2027
Update WCU
1. When performing hand hygiene with soap and water after caring for a patient
with Clostridium difficile, which action by the nurse is correct?
A. Apply 3 to 5 mL of alcohol-based hand rub before washing.
B. Dry hands starting from the wrists and moving down to the fingertips.
C. Use hot water to ensure all bacterial spores are killed.
D. Rub hands together vigorously for at least 15 to 20 seconds.
Answer: D
Rationale: For C. difficile, soap and water are mandatory because alcohol-based rubs are
ineffective against spores. Vigorous friction for 15-20 seconds is required to mechanically
remove organisms. Water should be warm, not hot, to prevent skin damage.
2. A nurse is preparing to enter a room of a patient on Airborne Precautions for
suspected tuberculosis. Which piece of PPE is the priority?
A. Surgical mask
B. N95 respirator
C. Face shield
D. Gown and gloves
Answer: B
Rationale: Airborne precautions require an N95 or higher-level respirator that has been
fit-tested. A standard surgical mask does not filter out the small droplets (less than 5
microns) associated with TB.
,3. In which order should the nurse remove personal protective equipment (PPE)
after leaving a contact isolation room?
A. Gloves, goggles, gown, mask
B. Gown, mask, goggles, gloves
C. Mask, goggles, gloves, gown
D. Goggles, mask, gloves, gown
Answer: A
Rationale: The standard sequence for doffing is gloves (most contaminated), followed by
goggles/face shield, gown, and finally the mask/respirator to avoid contaminating the face
with soiled gloves or gown.
4. The nurse is setting up a sterile field. Which action would result in the
contamination of the field?
A. Opening the outermost flap of the sterile kit away from the body.
B. Placing sterile gauze 2 inches inside the edge of the sterile drape.
C. Keeping the sterile field above the level of the waist.
D. Reaching over the sterile field to pick up a sterile instrument.
Answer: D
Rationale: Reaching over a sterile field contaminates it because micro-organisms can fall
from the nurse’s sleeves or arms onto the field. All other options follow aseptic principles.
5. A patient has a large abdominal wound that requires frequent dressing
changes. Which laboratory result most directly indicates a systemic infection?
A. Hemoglobin level of 11.5 g/dL
B. White blood cell (WBC) count of 16,000/mm3
C. Platelet count of 200,000/mm3
D. Serum potassium of 3.8 mEq/L
Answer: B
, Rationale: An elevated WBC count (leukocytosis) is a classic sign of systemic infection as
the body increases production of white cells to fight pathogens. The normal range is
typically 5,000 to 10,000/mm3.
6. Which link in the chain of infection is broken when a nurse performs proper
hand hygiene?
A. Reservoir
B. Portal of entry
C. Susceptible host
D. Mode of transmission
Answer: D
Rationale: Hand hygiene is the most effective way to break the mode of transmission link,
preventing the transfer of pathogens from one person or object to another.
7. A nurse is caring for a patient who is highly susceptible to infection due to
chemotherapy. Which type of environment is most appropriate?
A. Negative pressure room
B. Standard contact isolation
C. Protective environment (Positive pressure)
D. Negative airflow with HEPA filtration
Answer: C
Rationale: A protective environment uses positive pressure and HEPA filtration to ensure
that air flows out of the room, preventing outside pathogens from entering the patient’s
room.
Update WCU
1. When performing hand hygiene with soap and water after caring for a patient
with Clostridium difficile, which action by the nurse is correct?
A. Apply 3 to 5 mL of alcohol-based hand rub before washing.
B. Dry hands starting from the wrists and moving down to the fingertips.
C. Use hot water to ensure all bacterial spores are killed.
D. Rub hands together vigorously for at least 15 to 20 seconds.
Answer: D
Rationale: For C. difficile, soap and water are mandatory because alcohol-based rubs are
ineffective against spores. Vigorous friction for 15-20 seconds is required to mechanically
remove organisms. Water should be warm, not hot, to prevent skin damage.
2. A nurse is preparing to enter a room of a patient on Airborne Precautions for
suspected tuberculosis. Which piece of PPE is the priority?
A. Surgical mask
B. N95 respirator
C. Face shield
D. Gown and gloves
Answer: B
Rationale: Airborne precautions require an N95 or higher-level respirator that has been
fit-tested. A standard surgical mask does not filter out the small droplets (less than 5
microns) associated with TB.
,3. In which order should the nurse remove personal protective equipment (PPE)
after leaving a contact isolation room?
A. Gloves, goggles, gown, mask
B. Gown, mask, goggles, gloves
C. Mask, goggles, gloves, gown
D. Goggles, mask, gloves, gown
Answer: A
Rationale: The standard sequence for doffing is gloves (most contaminated), followed by
goggles/face shield, gown, and finally the mask/respirator to avoid contaminating the face
with soiled gloves or gown.
4. The nurse is setting up a sterile field. Which action would result in the
contamination of the field?
A. Opening the outermost flap of the sterile kit away from the body.
B. Placing sterile gauze 2 inches inside the edge of the sterile drape.
C. Keeping the sterile field above the level of the waist.
D. Reaching over the sterile field to pick up a sterile instrument.
Answer: D
Rationale: Reaching over a sterile field contaminates it because micro-organisms can fall
from the nurse’s sleeves or arms onto the field. All other options follow aseptic principles.
5. A patient has a large abdominal wound that requires frequent dressing
changes. Which laboratory result most directly indicates a systemic infection?
A. Hemoglobin level of 11.5 g/dL
B. White blood cell (WBC) count of 16,000/mm3
C. Platelet count of 200,000/mm3
D. Serum potassium of 3.8 mEq/L
Answer: B
, Rationale: An elevated WBC count (leukocytosis) is a classic sign of systemic infection as
the body increases production of white cells to fight pathogens. The normal range is
typically 5,000 to 10,000/mm3.
6. Which link in the chain of infection is broken when a nurse performs proper
hand hygiene?
A. Reservoir
B. Portal of entry
C. Susceptible host
D. Mode of transmission
Answer: D
Rationale: Hand hygiene is the most effective way to break the mode of transmission link,
preventing the transfer of pathogens from one person or object to another.
7. A nurse is caring for a patient who is highly susceptible to infection due to
chemotherapy. Which type of environment is most appropriate?
A. Negative pressure room
B. Standard contact isolation
C. Protective environment (Positive pressure)
D. Negative airflow with HEPA filtration
Answer: C
Rationale: A protective environment uses positive pressure and HEPA filtration to ensure
that air flows out of the room, preventing outside pathogens from entering the patient’s
room.
