Safety and Infection Control Reviewer for NCLEX-RN 2026 (Complete Guide)

Safety and Infection Control comprises 10-16% of the NCLEX-RN. This category tests your ability to prevent harm and infection, two of the most important responsibilities in nursing. The NCLEX heavily emphasizes infection precautions, which Filipino nurses must master in their US-standardized forms.

This reviewer covers all major Safety and Infection Control topics tested on the 2026 NCLEX-RN.

Transmission-Based Precautions (Most Heavily Tested)

Master the three types of transmission-based precautions and which diseases require each.

Standard Precautions (All Patients)

Applied to ALL patients regardless of diagnosis:

• Hand hygiene before and after every patient contact
• Gloves when touching body fluids
• Gown, mask, eye protection when splashing is likely
• Safe injection practices
• Proper disposal of sharps

Assume all body fluids (except sweat) are potentially infectious.

Contact Precautions

For: MRSA, VRE, C. difficile, RSV, scabies, wound infections, multidrug-resistant organisms.

Requirements:

• Private room (or cohort with same infection)
• Gown and gloves for all contact
• Dedicated equipment
• Hand hygiene (soap and water for C. diff - alcohol does not kill spores)

Droplet Precautions

For: Influenza, pertussis, meningitis, mumps, rubella, pneumonia.

Requirements:

• Private room (or cohort)
• Surgical mask within 3-6 feet
• Patient wears mask during transport

Airborne Precautions

For: Tuberculosis, measles (rubeola), varicella (chickenpox), disseminated zoster.

Requirements:

• Negative pressure room (AIIR)
• N95 respirator (fit-tested)
• Door kept closed
• Patient wears surgical mask during transport

Memory aid for airborne: "My Chicken Has TB" (Measles, Chickenpox, Herpes zoster, TB)

Protective (Reverse) Isolation

For: severely immunocompromised patients (HSCT, neutropenia).

Requirements:

• Positive pressure room with HEPA filtration
• No fresh flowers, raw fruits/vegetables
• No sick visitors
• Strict hand hygiene

Personal Protective Equipment (PPE)

Donning (Putting On) Order

• Gown
• Mask/respirator
• Goggles/face shield
• Gloves

Doffing (Removing) Order

• Gloves (most contaminated)
• Goggles/face shield
• Gown
• Mask/respirator

Then perform hand hygiene immediately.

NCLEX trick: Gloves come off FIRST when doffing because they are most contaminated.

Hand Hygiene

The single most effective infection prevention practice.

WHO Five Moments:

• Before patient contact
• Before aseptic task
• After body fluid exposure risk
• After patient contact
• After contact with patient surroundings

Alcohol-based hand rub is effective for most situations EXCEPT:

• C. difficile (use soap and water - spores resist alcohol)
• Visibly soiled hands (use soap and water)

Patient Safety

Patient Identification

Always use two identifiers (name and date of birth, or name and medical record number). Never use room number alone.

Fall Prevention

Assessment tools: Morse Fall Scale, Hendrich II.

Interventions:

• Bed in low position
• Call light within reach
• Non-slip footwear
• Scheduled toileting
• Bed/chair alarms for high-risk
• Adequate lighting
• Clear pathways

Restraints

Last resort after less restrictive measures fail.

Requirements:

• Provider order (time-limited, renewed per protocol)
• Cannot be PRN (as needed) orders
• Monitor every 2 hours (circulation, skin, ROM, toileting)
• Tie to bed frame, NOT side rails
• Document need, type, monitoring, and attempts at alternatives

Restraint alternatives: sitters, family presence, frequent reorientation, addressing underlying causes (pain, hypoxia, full bladder), covering lines with clothing.

Emergency Response

Fire Safety: RACE

• Rescue patients in immediate danger
• Alarm (pull alarm, call code)
• Confine (close doors)
• Extinguish (if small and safe)

Fire Extinguisher: PASS

• Pull the pin
• Aim at the base
• Squeeze the handle
• Sweep side to side

Disaster Triage

In mass casualties, tag patients:

• Red: immediate (life-threatening but survivable)
• Yellow: delayed (serious but stable)
• Green: minor (walking wounded)
• Black: expectant (deceased or non-survivable)

Medication Safety

High-Alert Medications

Require double verification: heparin, insulin, opioids, concentrated electrolytes (potassium chloride), chemotherapy, neuromuscular blockers.

Rights of Medication Administration

Right patient, medication, dose, route, time (plus right documentation, reason, response).

Look-Alike/Sound-Alike Drugs

Use tall man lettering to differentiate (hydrOXYzine vs hydrALAZINE).

Surgical Asepsis (Sterile Technique)

Principles:

• Only sterile touches sterile
• Keep sterile field in view (turn back = contaminated)
• 1-inch border of sterile field is non-sterile
• Items below waist are non-sterile
• Do not reach over sterile field
• Hold sterile items above waist

Common Safety Question Examples

Example 1: Precaution Type

Question: A client with active tuberculosis requires which type of precautions?

A. Contact

B. Droplet

C. Airborne

D. Standard only

Answer: C - TB requires airborne precautions with negative pressure room and N95 respirator.

Example 2: C. diff Hand Hygiene

Question: After caring for a client with C. difficile, the nurse should:

A. Use alcohol-based hand rub

B. Wash hands with soap and water

C. No hand hygiene needed if gloves were worn

D. Use hand lotion only

Answer: B - C. diff spores resist alcohol. Soap and water physically removes spores.

Example 3: PPE Removal

Question: When removing PPE, which item is removed first?

A. Gown

B. Mask

C. Gloves

D. Goggles

Answer: C - Gloves are removed first because they are most contaminated.

Practice Safety and Infection Control at LisensyaPrep

LisensyaPrep's NCLEX Quiz Module 3 contains 50 practice questions on Safety and Infection Prevention and Control.

Start Module 3: Safety Practice

Related NCLEX Articles

• Management of Care Reviewer for NCLEX-RN
• Pharmacology Reviewer for NCLEX-RN
• Physiological Adaptation Reviewer for NCLEX-RN
• How to Pass the NCLEX on Your First Take
• NCLEX 2026 Coverage and Test Plan Changes