CSLB General Building (B) — All Questions
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A nurse is caring for a client on contact precautions for Clostridioides difficile. Which action is correct?
- a.Use alcohol-based hand rub after removing gloves
- b.Wear an N95 respirator when entering the room
- c.Wash hands with soap and water after client contact✓
- d.Place the client in a negative-pressure room
C. difficile spores are not reliably killed by alcohol-based rubs, so hand hygiene with soap and water is required. Contact precautions, not airborne precautions, are indicated.
Which client requires airborne precautions?
- a.A client with a draining wound infection
- b.A client with influenza
- c.A client with scabies
- d.A client with active pulmonary tuberculosis✓
Pulmonary tuberculosis is spread by airborne droplet nuclei and requires a negative-pressure room and an N95 respirator. Wound infections and scabies need contact precautions, and influenza needs droplet precautions.
When donning personal protective equipment (PPE), which sequence is correct?
- a.Gown, mask, goggles, gloves✓
- b.Gloves, gown, mask, goggles
- c.Mask, gloves, gown, goggles
- d.Goggles, gloves, gown, mask
The correct donning sequence is gown, then mask or respirator, then goggles or face shield, then gloves. The correct order reduces contamination risk to the wearer.
A nurse is assessing fall risk. Which client is at highest risk for falling?
- a.A 30-year-old ambulating independently
- b.An 82-year-old taking a sedative who is confused✓
- c.A 45-year-old on bed rest with side rails up
- d.A 25-year-old awaiting discharge
Advanced age, a sedating medication, and confusion together create a high fall risk. Interventions such as frequent rounding and bed alarms should be prioritized for this client.
Which action best prevents catheter-associated urinary tract infection (CAUTI)?
- a.Keeping the drainage bag above the level of the bladder
- b.Routinely irrigating the catheter every shift
- c.Removing the indwelling catheter as soon as it is no longer needed✓
- d.Disconnecting the tubing to obtain urine samples
Early removal of an unnecessary catheter is the most effective way to prevent CAUTI. The bag should stay below the bladder, the system should remain closed, and routine irrigation is not recommended.
A nurse discovers a small fire in a client's trash can. Using the RACE protocol, what is the first action?
- a.Activate the fire alarm
- b.Confine the fire by closing doors
- c.Extinguish the fire with an extinguisher
- d.Rescue any clients in immediate danger✓
RACE stands for Rescue, Alarm, Confine, and Extinguish. The first priority is to rescue anyone in immediate danger before activating the alarm and containing the fire.
A client is receiving oxygen at 4 L/min by nasal cannula. Which instruction promotes safety?
- a.Post no-smoking signs and keep open flames away from the oxygen✓
- b.Allow smoking if the client stays six feet from the tank
- c.Use petroleum-based lubricant on the client's dry lips
- d.Increase the flow rate whenever the client feels anxious
Oxygen supports combustion, so no smoking or open flames are permitted near it, and only water-based lubricants should be used. Flow rate changes require a provider order.
The nurse is preparing to move a heavy client up in bed. Which technique protects the nurse from injury?
- a.Bend at the waist and lift with the back
- b.Use a friction-reducing device and additional staff✓
- c.Twist at the trunk to reposition the client quickly
- d.Keep the feet close together for a narrow base
Safe patient handling uses mechanical aids and adequate help, a wide base of support, and the leg muscles rather than the back. Twisting and bending at the waist cause injury.
A nurse is verifying a client before a blood transfusion. Which action is essential to prevent a transfusion error?
- a.Begin the transfusion rapidly to reduce spoilage
- b.Use a standard IV line shared with dextrose solution
- c.Verify the client and blood product with a second qualified nurse✓
- d.Skip baseline vital signs to save time
Two qualified staff must independently verify the client identity and the blood product to prevent an ABO incompatibility reaction. Blood is infused with normal saline only, and baseline vital signs are required.
Which environmental modification best prevents falls for a confused older adult at home?
- a.Using throw rugs to mark walking paths
- b.Keeping the client in a dimly lit room to promote rest
- c.Placing frequently used items on high shelves
- d.Removing clutter and ensuring adequate lighting✓
Removing clutter and improving lighting reduces trip and fall hazards. Throw rugs, poor lighting, and out-of-reach items increase fall risk.
A nurse receives a client with a suspected external chemical exposure. What is the priority action?
- a.Decontaminate the client before further care✓
- b.Bring the client into the main unit for assessment
- c.Administer pain medication first
- d.Obtain a detailed medical history before any intervention
Decontamination prevents ongoing harm to the client and protects staff and other clients from secondary contamination. It precedes routine assessment and treatment.
The nurse is teaching a client about safe medication storage at home. Which statement indicates a need for further teaching?
- a.I will keep my medications in their original labeled containers
- b.I will keep expired medications in case I need them later✓
- c.I will store all medicines in a locked cabinet away from children
- d.I will not share my prescriptions with family members
Expired medications should be discarded because potency and safety cannot be assured. Keeping them for later use is unsafe and indicates a need for further teaching.
A nurse is caring for a client with a seizure disorder. Which item should be available at the bedside?
- a.A padded tongue blade to insert during a seizure
- b.Wrist restraints to prevent movement
- c.Functioning suction and oxygen equipment✓
- d.A bright overhead light kept on at all times
Suction and oxygen should be ready to maintain the airway during and after a seizure. Nothing should be inserted into the mouth, and restraints and constant stimulation are not appropriate.
Which client should be placed in a private room with droplet precautions?
- a.A client with methicillin-resistant Staphylococcus aureus in a wound
- b.A client with measles
- c.A client with a Clostridioides difficile infection
- d.A client with meningococcal meningitis✓
Meningococcal meningitis is transmitted by respiratory droplets and requires droplet precautions. MRSA wounds and C. difficile need contact precautions, and measles requires airborne precautions.
A nurse identifies a client with a latex allergy. Which action is appropriate?
- a.Ensure latex-free supplies and place an allergy alert on the chart✓
- b.Use only sterile latex gloves for procedures
- c.Keep latex products nearby in case they are needed
- d.Assume powdered latex gloves are safe to use
Clients with a latex allergy require latex-free supplies and clear allergy alerts to prevent an anaphylactic reaction. Powdered latex gloves increase airborne allergen exposure and are unsafe.
The nurse is applying restraints to an agitated client per provider order. Which action is correct?
- a.Tie the restraint to the movable side rail
- b.Secure the restraint with a quick-release knot to the bed frame✓
- c.Check circulation once every four hours
- d.Leave the client alone to reduce stimulation
Restraints are tied with a quick-release knot to a fixed part of the bed frame, never the side rails. Circulation, skin, and needs must be checked frequently, typically every 15 to 30 minutes.