NCLEX-RN · Client-needs page 2 · 3 min read
Safety and Infection Prevention and Control
NCLEX-RN client-needs category for 10 to 16% of items (renamed in the 2026 test plan): standard and transmission-based precautions, client identification, falls, restraints, allergies, hazardous materials, error reporting and emergency response. What it covers, how it is tested, a worked example and the usual traps.
What this category covers
This category protects clients and staff from harm in the care environment. In the 2026 test plan it takes 10 to 16% of scored items, and it has a new name: Safety and Infection Prevention and Control (it was "Safety and Infection Control").
The activity list covers, in short:
- Infection prevention: hand hygiene, aseptic and sterile technique, isolation, standard and enhanced barrier precautions, and teaching clients and staff about them.
- Injury prevention: falls, safe equipment use, ergonomics, client identification, allergies.
- Restraints: when they may be used and the rules that go with them.
- Hazards and security: biohazardous and hazardous materials, newborn security, violence, controlled access, emergency planning and response.
- Reporting: practice errors and near misses, and escalating unsafe practice by staff (for example substance misuse or improper care).
- Checking orders: verifying that a treatment order is appropriate and accurate.
How it is usually tested
Expect matrix grids that pair conditions with the right precautions, select-all-that-apply items on what to put on or do before entering a room, single-answer items on the first action in a fire or after a fall, and ordered-response items for steps such as donning and removing protective equipment.
Worked example (our own)
A client has diarrhea and a positive stool test for Clostridioides difficile. For each action, is it indicated or not indicated?
| Action | Indicated? |
|---|---|
| Place the client on contact precautions in a private room | Indicated |
| Wear a gown and gloves to enter the room | Indicated |
| Clean hands with alcohol-based rub as the only hand hygiene after care | Not indicated |
| Wash hands with soap and water after removing gloves | Indicated |
| Use a dedicated stethoscope and blood pressure cuff in the room | Indicated |
| Wear an N95 respirator for routine care | Not indicated |
C. difficile forms spores that alcohol does not kill reliably, so soap and water (the friction removes the spores) is the hand hygiene after care, and the room is cleaned with a sporicidal agent such as a bleach product. It spreads by contact, not through the air, so a respirator adds nothing. Dedicated equipment stops the spores leaving the room.
Common pitfalls
- Mixing up the three transmission routes. Contact (gown and gloves), droplet (surgical mask within close range; for example influenza, pertussis) and airborne (N95 and a negative-pressure room; for example tuberculosis, measles, varicella).
- Restraints as the first answer. Try less restrictive measures first; a restraint needs a provider order, a time limit, regular checks of circulation, skin and needs, and release for care.
- Rushing past identification. Two identifiers (for example name and date of birth), never the room number.
- Hiding an error. Errors and near misses are reported through the facility's system; the incident report is not part of the client's record and is not mentioned in it.
- Fire order. Rescue clients in immediate danger, raise the alarm, contain the fire by closing doors, then extinguish or evacuate (the RACE sequence).
Category names and percentage ranges: NCSBN, 2026 NCLEX-RN Test Plan (effective April 1, 2026 to March 31, 2029). Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved. Explanations and examples are our own.