NCLEX Infection Control Mastery questions
The PrepScore bank has 85 Infection Control Mastery questions, each with a rationale and two tags: the Client Needs category from the test plan and the clinical judgment step it tests. In this topic the items lean on Recognize cues and Take action, which is worth knowing before you practise it. Three worked samples are below, answers behind a reveal.
Deep dive on PPE selection, isolation precautions, hand hygiene exceptions (C. diff), and CDC HAI bundles (CLABSI/CAUTI/VAP). NCLEX Safety & Infection Control core.
Three worked questions
Q1. The infection control nurse reviews antimicrobial stewardship. Which actions SUPPORT antimicrobial stewardship? Select all that apply.
- A. De-escalate broad-spectrum antibiotics based on culture sensitivities + clinical response
- B. Time-out at 48-72h to review need + appropriateness; stop if not needed; narrow if possible
- C. Use shortest effective duration (e.g., 5-7 days for many infections; 5 days for many CAP)
- D. Educate prescribers + patients about appropriate use + avoiding antibiotics for viral illnesses (URI, bronchitis)
- E. Monitor antibiotic resistance patterns (antibiogram) + multi-drug resistant organism (MDRO) tracking + outcomes
- F. Broad-spectrum antibiotics for all infections (OPPOSITE)
Show answer and rationale
Answer: De-escalate broad-spectrum antibiotics based on culture sensitivities + clinical responseTime-out at 48-72h to review need + appropriateness; stop if not needed; narrow if possibleUse shortest effective duration (e.g., 5-7 days for many infections; 5 days for many CAP)Educate prescribers + patients about appropriate use + avoiding antibiotics for viral illnesses (URI, bronchitis)Monitor antibiotic resistance patterns (antibiogram) + multi-drug resistant organism (MDRO) tracking + outcomes
Antimicrobial stewardship: de-escalate + time-out + shortest duration + education + monitor resistance.
Q2. The ICU nurse reviews VAP prevention bundle. Which interventions are PART of the VAP prevention bundle? Select all that apply.
- A. HEAD OF BED 30-45° (reduce aspiration risk)
- B. Daily SEDATION INTERRUPTION + SBT (spontaneous breathing trial) + assessment for extubation readiness
- C. ORAL CARE with CHLORHEXIDINE 0.12% q4-12h (reduces oropharyngeal colonization)
- D. DVT prophylaxis + GI stress ulcer prophylaxis (per protocol)
- E. Endotracheal tube cuff pressure maintenance 20-30 cmH2O; subglottic suctioning if available; minimize circuit changes
- F. Allow HOB supine (UNSAFE — increases aspiration)
Show answer and rationale
Answer: HEAD OF BED 30-45° (reduce aspiration risk)Daily SEDATION INTERRUPTION + SBT (spontaneous breathing trial) + assessment for extubation readinessORAL CARE with CHLORHEXIDINE 0.12% q4-12h (reduces oropharyngeal colonization)DVT prophylaxis + GI stress ulcer prophylaxis (per protocol)Endotracheal tube cuff pressure maintenance 20-30 cmH2O; subglottic suctioning if available; minimize circuit changes
VAP bundle: HOB elevation + sedation interruption + oral CHX + DVT/stress prophylaxis + cuff pressure + subglottic suction.
Q3. The ED nurse evaluates for early sepsis recognition. Which sign is MOST consistent with early sepsis?
- A. Routine fever (insufficient — need other signs)
- B. CONCERNING tachycardia + tachypnea + AMS + temperature change + lactate elevation + qSOFA ≥ 2 indicators + organ dysfunction signs in patient with suspected infection — URGENT sepsis 1-hour bundle activation
- C. Stable mental status (sepsis often AMS)
- D. Slow heart rate (NOT typical early — usually tachycardia)
Show answer and rationale
Answer: CONCERNING tachycardia + tachypnea + AMS + temperature change + lactate elevation + qSOFA ≥ 2 indicators + organ dysfunction signs in patient with suspected infection — URGENT sepsis 1-hour bundle activation
Early sepsis: tachy + AMS + temperature + lactate + qSOFA + organ dysfunction with suspected infection.
The rules that decide these questions
From the pack's rule cards — the reasoning shortcuts a wrong answer usually means you were missing.
Airborne precautions = N95 + negative pressure + door closed. Surgical mask on patient is source control, not protective.
Bacterial meningitis (esp. meningococcal) = droplet precautions + 1-hr abx + mandatory contact prophylaxis.
Contact precautions = private room + gown + gloves + dedicated equipment. Hand hygiene with alcohol OR soap & water (both effective for MRSA — different from C. diff).
C. diff = SOAP + WATER hand wash (alcohol fails) + bleach environment + dedicated equipment. The one exception to 'alcohol is fine'.
Neutropenic precautions = reverse isolation: protect the patient FROM the environment. Different mindset from contact/droplet/airborne which protect others FROM the patient.
Sterile field break = STOP + correct. Any team member can call it. Time pressure / surgeon authority doesn't override asepsis principles.
Practise the whole pack, tagged and explained
Every item carries its Client Needs category and clinical judgment step, so a wrong answer names the step that failed.
Frequently asked questions
How many Infection Control Mastery questions does the bank have?
85 multiple-choice items, plus 10 unfolding cases in the Infection Control Mastery pack, each with a rationale.
Are the samples real bank items?
Yes — the three questions above are drawn from the live bank, with their real rationales and tags.
Which clinical judgment steps does this topic train?
Most items in this topic test Recognize cues and Take action, though every step appears.
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