Disease prevention NCLEX-RN Practice Questions

Disease prevention NCLEX-RN Practice Questions help you master the Health Promotion & Maintenance domain by focusing on real-world nursing actions that stop illness before it starts, detect it early, and prevent complications. In this topic-wise set, you’ll practice prioritizing vaccines across the lifespan, screening and counseling guidelines, infection control precautions, post-exposure management, and community health strategies. Each question targets clinical decision-making you’ll use in acute care, ambulatory, maternal–child, and community settings—such as selecting appropriate PPE, educating on STI prevention and PrEP, and implementing antibiotic stewardship. Designed for exam-level rigor and clarity, these MCQs will sharpen your ability to choose the safest, most evidence-based interventions that reduce risk, interrupt transmission, and promote population health.

Q1. Which action is an example of secondary prevention in population health?

• Mammography screening for women at average risk
• Administering childhood immunizations on schedule
• Post-stroke rehabilitation and gait training
• Installing car seats and teaching seatbelt use

Correct Answer: Mammography screening for women at average risk

Q2. A 28-year-old pregnant patient at 30 weeks asks which vaccine she should receive now to protect her newborn. What is the nurse’s best recommendation?

• Tdap during 27–36 weeks of each pregnancy
• Live attenuated influenza (intranasal) vaccine
• MMR vaccine to boost measles immunity
• Varicella vaccine to prevent chickenpox

Correct Answer: Tdap during 27–36 weeks of each pregnancy

Q3. It is early influenza season. What is the best prevention strategy for a healthy 6-month-old infant with no prior influenza vaccination?

• Administer the first of two doses of inactivated influenza vaccine now and the second dose in 4 weeks
• Defer influenza vaccination until 12 months of age
• Give intranasal live attenuated influenza vaccine today
• Rely on maternal antibodies for protection this season

Correct Answer: Administer the first of two doses of inactivated influenza vaccine now and the second dose in 4 weeks

Q4. A 21-year-old sexually active client presents for well-woman care. Which cervical cancer screening plan is most appropriate for average risk?

• Cytology (Pap test) every 3 years starting today
• No screening until age 25
• HPV primary testing every year starting at 21
• Co-testing (Pap + HPV) every 5 years starting at 21

Correct Answer: Cytology (Pap test) every 3 years starting today

Q5. A nurse sustains a needlestick from a used needle with unknown source status. What is the priority first action?

• Immediately wash the site with soap and water
• Start HIV post-exposure prophylaxis within 24 hours
• Report at end of shift to avoid delays in care
• Apply a tourniquet proximal to the injury

Correct Answer: Immediately wash the site with soap and water

Q6. A client with cough, fever, weight loss, and night sweats is suspected of having active tuberculosis. Which infection control measure is the priority?

• Place the client in a negative-pressure room with airborne precautions and N95 respirator use
• Institute droplet precautions and surgical mask use
• Use standard precautions only unless sputum is positive
• Apply contact precautions for all secretions

Correct Answer: Place the client in a negative-pressure room with airborne precautions and N95 respirator use

Q7. For which situation is handwashing with soap and water preferred over alcohol-based hand rubs?

• After removing gloves used for C. difficile patient care
• Before administering oral medications
• Between patients in a non-isolation unit
• Before donning sterile gloves for a clean wound dressing

Correct Answer: After removing gloves used for C. difficile patient care

Q8. Which routine newborn prophylaxis specifically prevents ophthalmia neonatorum?

• Erythromycin ophthalmic ointment applied to both eyes
• Vitamin K (phytonadione) intramuscular injection
• Hepatitis B vaccine within 24 hours of birth
• Hepatitis B immune globulin at birth

Correct Answer: Erythromycin ophthalmic ointment applied to both eyes

Q9. Which intervention most effectively reduces fall risk in a community-dwelling older adult with two prior falls?

• Conduct a home safety evaluation and initiate strength and balance exercises (e.g., Tai Chi)
• Start high-dose vitamin D supplementation
• Recommend bed rest to avoid risky ambulation
• Use sedative-hypnotics for improved sleep

Correct Answer: Conduct a home safety evaluation and initiate strength and balance exercises (e.g., Tai Chi)

Q10. A client requests antibiotics for a 2-day viral upper respiratory infection. What response best supports antibiotic stewardship?

• Explain antibiotics are ineffective for viral infections and provide evidence-based symptomatic care education
• Prescribe a broad-spectrum antibiotic to prevent secondary infection
• Offer leftover antibiotics if symptoms worsen
• Order a steroid dose pack to hasten recovery

Correct Answer: Explain antibiotics are ineffective for viral infections and provide evidence-based symptomatic care education

Q11. A client starting HIV pre-exposure prophylaxis (PrEP) asks about condoms. Which statement indicates correct understanding?

• I will keep using condoms to prevent other STIs even while on PrEP
• PrEP replaces condoms, so I won’t need barrier protection
• Condoms are only needed during the PrEP loading phase
• PrEP protects against pregnancy and most STIs

Correct Answer: I will keep using condoms to prevent other STIs even while on PrEP

Q12. Which statement best describes herd immunity?

• High community vaccination coverage reduces disease transmission and protects those who cannot be vaccinated
• Individuals develop immunity only by contracting the disease
• Antibiotics given to exposed persons prevent outbreaks
• Screening detects asymptomatic carriers to eliminate disease

Correct Answer: High community vaccination coverage reduces disease transmission and protects those who cannot be vaccinated

Q13. A newborn’s mother is HBsAg-positive. What immediate action is essential to prevent perinatal hepatitis B transmission?

• Administer both hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth at different sites
• Delay hepatitis B vaccine until the newborn’s first pediatric visit
• Give only hepatitis B immune globulin at birth
• Start antivirals for the newborn if LFTs are elevated

Correct Answer: Administer both hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth at different sites

Q14. A 28-year-old pregnant client plans travel to a region requiring yellow fever vaccination. What is the safest recommendation?

• Advise postponing travel; the yellow fever vaccine is live and generally contraindicated in pregnancy
• Administer the yellow fever vaccine routinely during pregnancy
• Provide intranasal influenza vaccine instead
• No precautions are needed if she is asymptomatic

Correct Answer: Advise postponing travel; the yellow fever vaccine is live and generally contraindicated in pregnancy

Q15. A 52-year-old at average risk asks about colorectal cancer screening. Which option is appropriate?

• Schedule a screening colonoscopy now and repeat every 10 years if normal
• Defer all screening until age 60
• Stool DNA-FIT test every month
• Sigmoidoscopy every 2 years

Correct Answer: Schedule a screening colonoscopy now and repeat every 10 years if normal

Q16. After a needlestick from an HIV-positive source, when should HIV post-exposure prophylaxis (PEP) be initiated?

• As soon as possible, ideally within 2 hours of exposure
• After confirmatory employee HIV testing returns
• Within 7 days of exposure
• Only if the source has AIDS

Correct Answer: As soon as possible, ideally within 2 hours of exposure

Q17. Which vaccine is contraindicated for a client receiving active chemotherapy with significant immunosuppression?

• MMR vaccine
• Inactivated influenza vaccine (IM)
• Recombinant zoster vaccine (Shingrix)
• Pneumococcal conjugate vaccine

Correct Answer: MMR vaccine

Q18. Parents of a 2-year-old living in a pre-1978 home ask how to reduce lead exposure. Which teaching is most effective?

• Wet-mop floors and window sills regularly, wash hands frequently, and avoid renovation dust
• Open windows daily to ventilate dust
• Use dry sweeping of paint chips for quicker cleanup
• Rinse toys monthly to preserve finish

Correct Answer: Wet-mop floors and window sills regularly, wash hands frequently, and avoid renovation dust

Q19. Which smoking-cessation plan offers the highest quit rates for a motivated adult smoker?

• Combination nicotine replacement therapy (patch plus short-acting) plus behavioral counseling/quitline referral
• Switching to light cigarettes
• Cold turkey without support
• Nicotine gum only as needed without follow-up

Correct Answer: Combination nicotine replacement therapy (patch plus short-acting) plus behavioral counseling/quitline referral

Q20. A traveler to a dengue-endemic area asks how to prevent mosquito-borne illness. What is the best advice?

• Use EPA-registered repellents (e.g., DEET), wear long sleeves, and use permethrin-treated clothing and nets
• Take antibiotics daily to prevent infection
• Rely on vitamin B complex to repel mosquitoes
• Apply perfume to deter insects

Correct Answer: Use EPA-registered repellents (e.g., DEET), wear long sleeves, and use permethrin-treated clothing and nets

Q21. A client with prediabetes asks about preventing type 2 diabetes. Which recommendation is best supported by evidence?

• Join an intensive lifestyle program targeting 150 minutes/week activity and 5–7% weight loss
• Begin insulin to prevent beta-cell failure
• Eliminate all carbohydrates indefinitely
• Start broad-spectrum antibiotics monthly

Correct Answer: Join an intensive lifestyle program targeting 150 minutes/week activity and 5–7% weight loss

Q22. A client is scheduled for elective splenectomy. Which prevention measure is a priority before the procedure?

• Administer pneumococcal, meningococcal, and Hib vaccines at least 2 weeks preoperatively
• Defer all vaccines until after discharge
• Start lifelong daily steroids
• Prescribe antiviral therapy for 10 days

Correct Answer: Administer pneumococcal, meningococcal, and Hib vaccines at least 2 weeks preoperatively

Q23. Which action best prevents transmission of C. difficile in the hospital?

• Perform hand hygiene with soap and water after contact with the patient or environment
• Use alcohol-based hand rub exclusively
• Remove contact precautions once diarrhea begins
• Place the patient on droplet precautions only

Correct Answer: Perform hand hygiene with soap and water after contact with the patient or environment

Q24. A 42-year-old woman at average risk asks about breast cancer screening. What is an appropriate recommendation based on current guidelines?

• Biennial screening mammography starting now
• Start mammography at age 50
• Breast MRI annually for all average-risk women
• No screening if she has no family history

Correct Answer: Biennial screening mammography starting now

Q25. A 24-year-old has never received the HPV vaccine. What should the nurse recommend?

• Initiate the HPV vaccine series today (3-dose schedule)
• Defer vaccination until age 30
• Administer a single HPV dose only
• Vaccinate only if a Pap test is abnormal

Correct Answer: Initiate the HPV vaccine series today (3-dose schedule)

Q26. A child is bitten by a stray dog. The skin is broken. Immunization history is unknown. Which immediate rabies prevention plan is correct?

• Thorough wound irrigation, rabies immune globulin infiltrated around the wound, and rabies vaccine on days 0, 3, 7, and 14
• Observe the dog for 30 days and defer treatment
• Start antibiotics only
• Give rabies vaccine alone six weeks after exposure

Correct Answer: Thorough wound irrigation, rabies immune globulin infiltrated around the wound, and rabies vaccine on days 0, 3, 7, and 14

Q27. Which dietary practice helps prevent listeriosis during pregnancy?

• Avoid unpasteurized soft cheeses and unheated deli meats
• Eat refrigerated smoked seafood frequently
• Drink unpasteurized milk for calcium
• Store ready-to-eat foods for two weeks before consuming

Correct Answer: Avoid unpasteurized soft cheeses and unheated deli meats

Q28. After a confirmed case of meningococcal meningitis in a college dorm, which prophylaxis is appropriate for close contacts?

• Administer rifampin for chemoprophylaxis as directed
• Begin amoxicillin for 10 days
• Offer influenza vaccine only
• Advise increased fluid intake and rest

Correct Answer: Administer rifampin for chemoprophylaxis as directed

Q29. A nonimmune adult was exposed to measles 48 hours ago. What is the best post-exposure prevention?

• Administer MMR vaccine within 72 hours of exposure
• Start broad-spectrum antibiotics
• Give intranasal influenza vaccine
• No action is needed if asymptomatic

Correct Answer: Administer MMR vaccine within 72 hours of exposure

Q30. A 68-year-old man with a 40 pack-year smoking history asks about aneurysm screening. What prevention strategy is appropriate?

• One-time abdominal aortic ultrasound screening for AAA
• Annual CT angiography of the abdomen
• No screening if asymptomatic
• Begin statins only

Correct Answer: One-time abdominal aortic ultrasound screening for AAA

Download