1
Page | 1
NCLEX-RN 2025 Exam
Bundle | 150+ Practice
Questions + Rationales
| 100% Verified | NGN
Ready"
, 2
Question 1
Page | 2
A nurse enters the room of a client on contact precautions for Clostridioides difficile (C.
difficile). Which action is most appropriate before exiting the room?
a. Remove gloves and gown, then use alcohol-based hand rub
b. Remove gown, wash hands with soap and water, then remove gloves
c. Remove gloves and gown, then wash hands with soap and water
d. Remove gloves, use alcohol-based rub, and then remove gown
✔ Correct Answer: c. Remove gloves and gown, then wash hands with soap and water
Rationale
Clients with C. difficile infection (CDI) require contact precautions, including the use of
gloves and gowns. The spores of C. difficile are resistant to alcohol-based hand rubs;
therefore, handwashing with soap and water is essential after contact to prevent the
transmission of spores. The proper order for removing personal protective equipment (PPE)
is important to prevent self-contamination: the nurse should first remove gloves, which are
the most contaminated, followed by the gown. After PPE removal, hand hygiene must be
performed but in the case of C. difficile, handwashing with soap and water is required,
not alcohol-based rubs.
This distinction is critical for safety and infection control. Alcohol hand sanitizers do not kill
C. difficile spores; hence, using them in this situation would be ineffective and could allow
the nurse to inadvertently carry spores to other patients or surfaces, leading to healthcare-
, 3
associated infections (HAIs). HAIs are a major concern for hospital infection control
programs, and following the correct procedures is a core competency of safe nursing practice.
Page | 3 Understanding the rationale for contact precautions is important not only for NCLEX success
but also for patient and staff safety in clinical practice. C. difficile can lead to severe diarrhea,
pseudomembranous colitis, and even sepsis in vulnerable clients. Thus, the nurse’s actions
play a vital role in controlling its spread. Educating unlicensed assistive personnel (UAPs)
and visitors about proper precautions is also part of the nurse’s responsibility. Hand hygiene
specifically soap and water is the single most effective way to prevent transmission of C.
difficile in the healthcare setting.
DIF: Apply
TOP: Safety and Infection Control
MSC: Safe and Effective Care Environment – Safety and Infection Control
Question 2
The nurse is caring for a client newly diagnosed with tuberculosis (TB). Which is the most
appropriate action by the nurse upon initiating care?
a. Place the client in a private room with negative airflow
b. Initiate droplet precautions and provide a surgical mask
c. Move the client to a semiprivate room with similar patients
d. Notify the dietary department to deliver meals in disposable containers
✔ Correct Answer: a. Place the client in a private room with negative airflow
, 4
Rationale
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis. It
is transmitted primarily via airborne particles known as droplet nuclei, which can remain
Page | 4
suspended in the air for extended periods. Therefore, clients with confirmed or suspected
TB must be placed in airborne precautions, which includes isolation in a negative-pressure
room (airborne infection isolation room, or AIIR). These rooms are specifically designed to
prevent the escape of airborne pathogens into the hospital environment by ensuring that air
flows into the room but not out, thus protecting staff and other patients.
In addition to placing the client in a private, negative-pressure room, the nurse must wear a
fit-tested N95 respirator mask when entering the room. The client should also wear a
surgical mask when being transported outside the room, if necessary, to contain the
respiratory secretions. Option b incorrectly identifies droplet precautions, which are used
for pathogens like influenza but not for TB. Option c violates infection control protocols by
placing an airborne-infected patient in a semiprivate room. Option d, although practical, is
not the priority intervention for airborne disease containment.
Nurses play a pivotal role in preventing the transmission of TB within healthcare facilities.
Rapid recognition, prompt isolation, and consistent application of infection control measures
are fundamental. TB remains a global public health concern, and lapses in isolation protocol
have been linked to nosocomial outbreaks. The nurse's first step ensures that the source of
transmission is immediately controlled, thereby preventing additional exposure.
DIF: Apply
TOP: Safety and Infection Control
MSC: Safe and Effective Care Environment – Safety and Infection Control
Page | 1
NCLEX-RN 2025 Exam
Bundle | 150+ Practice
Questions + Rationales
| 100% Verified | NGN
Ready"
, 2
Question 1
Page | 2
A nurse enters the room of a client on contact precautions for Clostridioides difficile (C.
difficile). Which action is most appropriate before exiting the room?
a. Remove gloves and gown, then use alcohol-based hand rub
b. Remove gown, wash hands with soap and water, then remove gloves
c. Remove gloves and gown, then wash hands with soap and water
d. Remove gloves, use alcohol-based rub, and then remove gown
✔ Correct Answer: c. Remove gloves and gown, then wash hands with soap and water
Rationale
Clients with C. difficile infection (CDI) require contact precautions, including the use of
gloves and gowns. The spores of C. difficile are resistant to alcohol-based hand rubs;
therefore, handwashing with soap and water is essential after contact to prevent the
transmission of spores. The proper order for removing personal protective equipment (PPE)
is important to prevent self-contamination: the nurse should first remove gloves, which are
the most contaminated, followed by the gown. After PPE removal, hand hygiene must be
performed but in the case of C. difficile, handwashing with soap and water is required,
not alcohol-based rubs.
This distinction is critical for safety and infection control. Alcohol hand sanitizers do not kill
C. difficile spores; hence, using them in this situation would be ineffective and could allow
the nurse to inadvertently carry spores to other patients or surfaces, leading to healthcare-
, 3
associated infections (HAIs). HAIs are a major concern for hospital infection control
programs, and following the correct procedures is a core competency of safe nursing practice.
Page | 3 Understanding the rationale for contact precautions is important not only for NCLEX success
but also for patient and staff safety in clinical practice. C. difficile can lead to severe diarrhea,
pseudomembranous colitis, and even sepsis in vulnerable clients. Thus, the nurse’s actions
play a vital role in controlling its spread. Educating unlicensed assistive personnel (UAPs)
and visitors about proper precautions is also part of the nurse’s responsibility. Hand hygiene
specifically soap and water is the single most effective way to prevent transmission of C.
difficile in the healthcare setting.
DIF: Apply
TOP: Safety and Infection Control
MSC: Safe and Effective Care Environment – Safety and Infection Control
Question 2
The nurse is caring for a client newly diagnosed with tuberculosis (TB). Which is the most
appropriate action by the nurse upon initiating care?
a. Place the client in a private room with negative airflow
b. Initiate droplet precautions and provide a surgical mask
c. Move the client to a semiprivate room with similar patients
d. Notify the dietary department to deliver meals in disposable containers
✔ Correct Answer: a. Place the client in a private room with negative airflow
, 4
Rationale
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis. It
is transmitted primarily via airborne particles known as droplet nuclei, which can remain
Page | 4
suspended in the air for extended periods. Therefore, clients with confirmed or suspected
TB must be placed in airborne precautions, which includes isolation in a negative-pressure
room (airborne infection isolation room, or AIIR). These rooms are specifically designed to
prevent the escape of airborne pathogens into the hospital environment by ensuring that air
flows into the room but not out, thus protecting staff and other patients.
In addition to placing the client in a private, negative-pressure room, the nurse must wear a
fit-tested N95 respirator mask when entering the room. The client should also wear a
surgical mask when being transported outside the room, if necessary, to contain the
respiratory secretions. Option b incorrectly identifies droplet precautions, which are used
for pathogens like influenza but not for TB. Option c violates infection control protocols by
placing an airborne-infected patient in a semiprivate room. Option d, although practical, is
not the priority intervention for airborne disease containment.
Nurses play a pivotal role in preventing the transmission of TB within healthcare facilities.
Rapid recognition, prompt isolation, and consistent application of infection control measures
are fundamental. TB remains a global public health concern, and lapses in isolation protocol
have been linked to nosocomial outbreaks. The nurse's first step ensures that the source of
transmission is immediately controlled, thereby preventing additional exposure.
DIF: Apply
TOP: Safety and Infection Control
MSC: Safe and Effective Care Environment – Safety and Infection Control
