NCLEX-RN Quiz: Standard And Transmission Based Precautions
20 questions · exam conditions
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Standard And Transmission Based PrecautionsQuestion 1 of 20

A 19-year-old college student presents to an urgent care clinic with abrupt onset fever, myalgias, sore throat, and cough; rapid influenza A test is positive. Vital signs: T 39.1°C (102.4°F), HR 110/min, RR 22/min, BP 118/70 mmHg, SpO2 95% on room air. Which type of isolation is necessary for this client while awaiting discharge instructions?

Airborne precautions
Contact precautions only
Droplet precautions
Protective (neutropenic) precautions
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NCLEX-RN Quiz

NCLEX-RN Quiz: Standard And Transmission Based Precautions

Practice Standard And Transmission Based Precautions in NCLEX-RN with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Standard And Transmission Based Precautions, giving you a quick way to practice the rules, question types, and explanations that matter most for NCLEX-RN.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A 19-year-old college student presents to an urgent care clinic with abrupt onset fever, myalgias, sore throat, and cough; rapid influenza A test is positive. Vital signs: T 39.1°C (102.4°F), HR 110/min, RR 22/min, BP 118/70 mmHg, SpO2 95% on room air. Which type of isolation is necessary for this client while awaiting discharge instructions?

  1. Airborne precautions
  2. Contact precautions only
  3. Droplet precautions (correct answer)
  4. Protective (neutropenic) precautions
Explanation: This question tests the application of standard and transmission-based precautions. The specific precaution relevant to this scenario is droplet precautions for influenza A, which involves wearing a surgical mask when within 3-6 feet of the client. Implementing droplet precautions is essential for infection control to prevent the spread of large respiratory droplets containing the influenza virus during coughing or talking. Airborne precautions (B) are not required as influenza does not remain suspended in air; contact precautions only (C) overlook droplet transmission; protective precautions (D) are for immunocompromised clients, not infectious ones. Principles of infection prevention include isolating based on transmission mode to protect healthcare workers and others. Control measures focus on early identification of symptoms and rapid testing to guide precautions. A general strategy for selecting appropriate precautions is to assess clinical presentation and diagnostic results to determine if droplet, airborne, or contact isolation is warranted.

Question 2

A nurse is caring for a 68-year-old client on contact precautions for MRSA in a wound. The nurse has completed wound care and is preparing to leave the room. What precaution should the nurse take FIRST to prevent self-contamination?

  1. Remove the mask before removing gloves
  2. Remove gloves before removing the gown (correct answer)
  3. Perform hand hygiene and then remove PPE
  4. Keep PPE on and chart at the nurses' station
Explanation: This question tests the application of standard and transmission-based precautions. The specific guideline relevant to this scenario is the proper doffing sequence for contact precautions PPE to prevent self-contamination. Removing gloves before the gown is essential for infection control to avoid transferring contaminants from gloves to the nurse's skin or clothing. Hand hygiene before removal (B) is incorrect as PPE should be removed first; removing mask before gloves (C) risks hand contamination; keeping PPE on for charting (D) spreads pathogens outside the room. Principles of infection prevention include following a sequence that removes most contaminated items first. Control measures stress doffing inside the room followed by hand hygiene. A general strategy for selecting appropriate precautions is to adhere to PPE protocols, ensuring safe removal to maintain a clean environment.

Question 3

A 64-year-old client is 1 day post-op after a colectomy and has an abdominal incision with a dry, intact dressing; the nurse will empty the Jackson-Pratt drain. Vital signs: T 37.2°C (99.0°F), HR 84/min, RR 16/min, BP 138/80 mmHg, SpO2 97% on room air. The nurse should prioritize which infection control measure consistent with standard precautions?

  1. Institute contact precautions for 24 hours after surgery
  2. Wear gloves when handling the drain and perform hand hygiene before and after the task (correct answer)
  3. Place the client in a negative-pressure room
  4. Wear an N95 respirator for all post-operative clients
Explanation: This question tests the application of standard and transmission-based precautions. The specific guideline relevant to this scenario is standard precautions, which require gloves when handling potentially infectious materials like drainage from a Jackson-Pratt drain. Wearing gloves and performing hand hygiene is essential for infection control to prevent contact with body fluids that may contain pathogens, even in post-operative clients without known infections. Negative-pressure room (B) is for airborne precautions, not surgical drains; N95 respirator (C) is unnecessary without aerosol generation; contact precautions for 24 hours (D) are not routinely required post-surgery. Principles of infection prevention include assuming all body fluids are infectious and using barriers accordingly. Control measures stress hand hygiene as a cornerstone to reduce healthcare-associated infections. A general strategy for selecting appropriate precautions is to anticipate exposure risks during procedures and apply standard precautions universally, escalating to transmission-based as needed.

Question 4

A 28-year-old client with influenza is being transported from the medical unit to radiology for a chest x-ray. Vital signs: T 38.7°C (101.7°F), HR 98/min, RR 20/min, BP 116/68 mmHg, SpO2 96% on room air. The nurse should prioritize which infection control measure during transport under droplet precautions?

  1. Wrap the client in a sterile sheet and avoid masking
  2. Place a surgical mask on the client during transport (correct answer)
  3. Have the client wear an N95 respirator during transport
  4. Delay transport until the client has been afebrile for 24 hours
Explanation: This question tests the application of standard and transmission-based precautions. The specific guideline relevant to this scenario is droplet precautions for influenza, requiring a surgical mask on the client during transport. Placing a surgical mask on the client is essential for infection control to contain respiratory droplets and prevent transmission to others in shared spaces. N95 on client (B) is unnecessary and may be uncomfortable; sterile sheet wrapping (C) is not standard; delaying until afebrile (D) may not be feasible for necessary tests. Principles of infection prevention include source control measures like client masking during movement. Control measures focus on minimizing exposure time and notifying receiving departments. A general strategy for selecting appropriate precautions is to plan transports with PPE that matches the isolation type, ensuring client and staff safety.

Question 5

A 52-year-old client is admitted with bacterial meningitis suspected due to fever, severe headache, nuchal rigidity, and photophobia; antibiotics are being prepared. Vital signs: T 39.4°C (102.9°F), HR 112/min, RR 20/min, BP 128/72 mmHg, SpO2 97% on room air. What precaution should the nurse take FIRST when initiating care?

  1. Obtain blood cultures before applying any isolation precautions
  2. Implement droplet precautions and wear a surgical mask upon room entry (correct answer)
  3. Implement contact precautions and wear gown and gloves only
  4. Implement airborne precautions and wear an N95 respirator
Explanation: This question tests the application of standard and transmission-based precautions. The specific precaution relevant to this scenario is droplet precautions for suspected bacterial meningitis, requiring a surgical mask upon room entry. Implementing droplet precautions is essential for infection control to block large droplets carrying bacteria like Neisseria meningitidis during close contact. Airborne precautions (B) are not needed as meningitis is droplet-spread; contact only (C) ignores respiratory transmission; blood cultures before isolation (D) delay necessary precautions. Principles of infection prevention include prophylactic measures for close contacts and prompt isolation. Control measures emphasize masking during the initial 24 hours of antibiotics. A general strategy for selecting appropriate precautions is to recognize meningeal signs and initiate droplet isolation until bacterial etiology is confirmed or ruled out.

Question 6

A 62-year-old client has Clostridioides difficile infection with frequent diarrhea and is on contact precautions. The nurse is leaving the room after assisting with toileting. The nurse should prioritize which infection control measure to reduce transmission?

  1. Wash hands with soap and water after removing gloves (correct answer)
  2. Double-glove for all future entries instead of hand hygiene
  3. Use alcohol-based hand rub only after removing gloves
  4. Wear a surgical mask when leaving the room
Explanation: This question tests the application of standard and transmission-based precautions. The specific guideline relevant to this scenario is hand hygiene for C. difficile under contact precautions, requiring soap and water due to spore resistance. Washing hands with soap and water is essential for infection control to mechanically remove C. difficile spores that alcohol-based rubs cannot kill. Alcohol rub only (B) is ineffective against spores; double-gloving (C) does not replace hygiene; mask when leaving (D) is unnecessary without droplet risks. Principles of infection prevention include using soap for spore-forming pathogens to reduce transmission. Control measures emphasize thorough handwashing after contact with feces. A general strategy for selecting appropriate precautions is to tailor hygiene methods to the pathogen's characteristics, opting for soap over alcohol for enteric spores.

Question 7

A 45-year-old client with confirmed pertussis has paroxysmal coughing fits and post-tussive vomiting. Vital signs: T 37.7°C (99.9°F), HR 102/min, RR 24/min, BP 120/70 mmHg, SpO2 95% on room air. What personal protective equipment (PPE) is required for the nurse when entering the room under the indicated precautions?

  1. Gloves and gown only
  2. N95 respirator upon room entry
  3. No PPE is required if the nurse has been vaccinated
  4. Surgical mask upon room entry (correct answer)
Explanation: This question tests the application of standard and transmission-based precautions. The specific precaution relevant to this scenario is droplet precautions for confirmed pertussis, requiring a surgical mask upon room entry. Wearing a surgical mask is essential for infection control to protect against large droplets expelled during paroxysmal coughing fits. N95 (B) is for airborne, not droplet; gloves and gown only (C) ignore respiratory transmission; no PPE if vaccinated (D) is unsafe as breakthrough occurs. Principles of infection prevention include masking for bacterial droplet pathogens. Control measures emphasize post-exposure prophylaxis. A general strategy for selecting appropriate precautions is to identify coughing patterns and implement droplet isolation for diseases like pertussis.

Question 8

A 48-year-old client on contact precautions for MRSA has a blood pressure cuff and stethoscope in the room labeled for single-client use. Another client on the unit needs vital signs taken urgently, and no other cuff is immediately available. What precaution should the nurse take FIRST?

  1. Obtain equipment dedicated to the other client or disinfect shared equipment per facility policy before use (correct answer)
  2. Cover the cuff with a towel and use it without cleaning
  3. Place the other client on contact precautions after using the cuff
  4. Use the MRSA-room cuff on the other client because the cuff does not touch mucous membranes
Explanation: This question tests the application of standard and transmission-based precautions. The specific guideline relevant to this scenario is equipment management under contact precautions, requiring dedicated or disinfected items to prevent cross-contamination. Obtaining dedicated or disinfected equipment is essential for infection control to avoid transmitting MRSA to another client via shared items. Using the cuff without cleaning (B or D) risks spread; placing the other on precautions (C) is unnecessary if cleaned. Principles of infection prevention include disinfecting non-dedicated equipment between uses. Control measures focus on labeling and cleaning protocols. A general strategy for selecting appropriate precautions is to assess equipment sharing risks and ensure disinfection per policy for isolation clients.

Question 9

A 45-year-old client presents to the emergency department with fever, myalgias, cough, and sore throat for 24 hours; rapid influenza test is positive. VS: T 38.6°C (101.5°F), HR 104/min, RR 22/min, BP 122/70 mm Hg, SpO2 95% RA. What personal protective equipment (PPE) is required for the nurse to enter the room to perform an assessment?

  1. Surgical mask; add eye protection if splashes/sprays are anticipated (correct answer)
  2. N95 respirator and negative-pressure room placement
  3. Gown and gloves only for all room entry
  4. Sterile gloves and sterile gown for routine assessment
Explanation: This question tests application of standard and transmission-based precautions for influenza management. Droplet precautions requiring a surgical mask are the appropriate PPE for influenza, which spreads through large respiratory droplets when infected persons cough or sneeze. This protection is essential for infection control because influenza droplets can travel up to 6 feet and infect others through mucous membrane contact. An N95 respirator (B) is unnecessary as influenza is not airborne, gown and gloves only (C) would not protect against respiratory droplets, and sterile equipment (D) is excessive for routine assessment. The principles of infection prevention match the level of protection to the pathogen's transmission route. When selecting appropriate precautions, remember that droplet precautions require masks for close contact, while eye protection is added when splashes or sprays are anticipated during procedures.

Question 10

A 58-year-old client in a long-term care facility has watery diarrhea and stool positive for Clostridioides difficile; history includes recent clindamycin use. VS: T 37.6°C (99.7°F), HR 92/min, RR 18/min, BP 128/72 mm Hg. What precaution should the nurse take FIRST when entering the room to assist with toileting?

  1. Don gown and gloves before room entry (contact precautions) (correct answer)
  2. Wear a surgical mask for droplet precautions
  3. Wear an N95 respirator for airborne precautions
  4. Use standard precautions only and avoid gloves unless visible stool is present
Explanation: This question tests application of standard and transmission-based precautions for C. difficile infection. Contact precautions requiring gown and gloves before room entry are essential for C. difficile, which spreads through spores on contaminated surfaces and hands. This protection is essential for infection control because C. difficile spores are resistant to alcohol-based hand sanitizers and can persist in the environment for months. Droplet precautions (B) are inappropriate as C. diff is not respiratory, airborne precautions (C) are unnecessary, and standard precautions alone (D) would not prevent spore transmission. The principles of infection prevention require soap and water handwashing (not alcohol gel) after C. difficile contact and thorough environmental cleaning with sporicidal agents. When selecting appropriate precautions, remember that enteric pathogens like C. difficile require contact precautions and special attention to hand hygiene.

Question 11

A 52-year-old client in an outpatient infusion center is receiving IV antibiotics through a peripheral IV; history includes chronic kidney disease. The nurse notes the IV site is intact and there is no anticipated splash or spray during medication administration. The nurse should prioritize which infection control measure?

  1. Perform hand hygiene before and after client contact and wear clean gloves when accessing the IV (correct answer)
  2. Place the client on contact precautions and wear a gown for all interactions
  3. Place the client on droplet precautions and wear a surgical mask for all interactions
  4. Place the client on airborne precautions and wear an N95 respirator for all interactions
Explanation: This question tests application of standard and transmission-based precautions for routine IV medication administration. Standard precautions including hand hygiene before and after client contact and clean gloves when accessing the IV are appropriate for this routine procedure without additional infection risks. This protection is essential for infection control because it prevents introduction of pathogens into the IV system and protects the nurse from potential blood exposure. Contact precautions (B) are unnecessary without a known transmissible infection, droplet (C) and airborne (D) precautions are inappropriate without respiratory pathogens present. The principles of infection prevention emphasize using standard precautions for all patients during routine care involving potential blood exposure. When selecting appropriate precautions, avoid over-isolating patients unnecessarily while maintaining appropriate protection for anticipated exposures.

Question 12

A 38-year-old client is admitted to an inpatient unit with suspected pulmonary tuberculosis after 3 weeks of cough, night sweats, and weight loss; chest x-ray is concerning. VS: T 37.9°C (100.2°F), HR 96/min, RR 20/min, BP 118/74 mm Hg, SpO2 94% RA. The nurse should prioritize which infection control measure?

  1. Place the client on droplet precautions and wear a surgical mask upon entry
  2. Initiate airborne precautions, place the client in a negative-pressure room, and wear an N95 respirator (correct answer)
  3. Use contact precautions with gown and gloves for all room entry
  4. Use standard precautions only until sputum cultures are confirmed
Explanation: This question tests application of standard and transmission-based precautions for suspected tuberculosis. Airborne precautions with negative-pressure room placement and N95 respirator use are required for TB, which spreads through tiny airborne particles that can remain suspended in air for hours. This approach is essential for infection control because TB bacteria in these particles can be inhaled deep into the lungs and cause infection. Droplet precautions (A) are insufficient as TB particles are smaller than droplets, contact precautions (C) don't address airborne transmission, and waiting for culture confirmation (D) would delay necessary protection. The principles of infection prevention require immediate implementation of the highest level of precautions for suspected cases. When selecting appropriate precautions for respiratory symptoms, consider whether the pathogen produces airborne particles (TB, measles, varicella) requiring negative-pressure isolation.

Question 13

A 66-year-old client is 1 day post-op after a total hip arthroplasty and has a closed incision with a dry dressing; history includes hypertension. VS: T 36.8°C (98.2°F), HR 78/min, RR 16/min, BP 130/76 mm Hg, SpO2 97% RA. What precaution should the nurse take FIRST before emptying the client's urinary drainage bag?

  1. Don a surgical mask and place the client on droplet precautions
  2. Perform hand hygiene and apply clean gloves (correct answer)
  3. Don an N95 respirator and place the client in a negative-pressure room
  4. Don a sterile gown and sterile gloves
Explanation: This question tests application of standard and transmission-based precautions for routine post-operative care. Standard precautions including hand hygiene and clean gloves are appropriate when handling body fluids like urine, regardless of the patient's infection status. This protection is essential for infection control because it prevents transmission of bloodborne pathogens and other microorganisms that may be present in urine. A surgical mask (A) is unnecessary as no respiratory transmission risk exists, an N95 respirator (C) is excessive for this task, and sterile equipment (D) is not required for emptying drainage bags. The principles of infection prevention emphasize using standard precautions for all patients when contact with body fluids is anticipated. When selecting appropriate precautions, consider the specific task being performed and whether contact with blood or body fluids is expected.

Question 14

A 63-year-old client is admitted with influenza (droplet precautions) and also has a draining leg wound culture positive for MRSA (contact precautions). VS: T 38.1°C (100.6°F), HR 98/min, RR 20/min, BP 134/82 mm Hg, SpO2 95% RA. Which type of isolation is necessary for this client?

  1. Airborne precautions only
  2. Droplet precautions only
  3. Contact and droplet precautions (use gown, gloves, and surgical mask upon entry) (correct answer)
  4. Standard precautions only
Explanation: This question tests application of standard and transmission-based precautions for clients with multiple infections. Contact and droplet precautions requiring gown, gloves, and surgical mask upon entry are necessary when a patient has both MRSA (contact) and influenza (droplet). This combined approach is essential for infection control because it addresses both transmission routes simultaneously - direct contact for MRSA and respiratory droplets for influenza. Using only airborne (A) or droplet (B) precautions would not address the MRSA contact risk, while standard precautions alone (D) would be insufficient for either infection. The principles of infection prevention require implementing all necessary precautions when multiple transmission routes exist. When selecting appropriate precautions for patients with multiple infections, use the combination of precautions that addresses all identified pathogens.

Question 15

A 67-year-old client has both confirmed influenza and a positive stool test for Clostridioides difficile. Vital signs: T 38.4°C (101.1°F), HR 106/min, RR 22/min, BP 112/68 mmHg, SpO2 95% on room air. Which infection control approach is necessary while providing routine bedside care?

  1. Use airborne precautions only with an N95 respirator and negative pressure
  2. Use droplet precautions only and prioritize masking without gown or gloves
  3. Use standard precautions only because the infections involve different body systems
  4. Use droplet plus contact precautions (gown and gloves on entry; surgical mask on entry) and perform soap-and-water hand hygiene after care (correct answer)
Explanation: Transmission-based precautions are selected by how each organism actually travels, and when a client carries two organisms the nurse layers everything each one requires rather than choosing between them. Influenza moves in respiratory droplets, which is why a surgical mask on entry is required, and Clostridioides difficile moves by contact with spores, which is why gown and gloves on entry plus soap-and-water hand hygiene are required — alcohol-based rub does not kill spores. Masking with droplet precautions alone leaves the spore route completely unprotected during hands-on bedside care, and relying on standard precautions because the infections involve different body systems misapplies the concept: standard precautions are the baseline for every client, not a substitute for organism-specific precautions. An N95 respirator with negative pressure is the wrong precaution type here, since neither influenza during routine bedside care nor C. difficile is spread by the airborne route, and using it would still leave the contact route uncovered. Remember that transmission-based precautions follow the organism's route of spread, not the severity of the illness — and when more than one organism is present, you add the precautions together instead of picking the strictest-sounding one.

Question 16

A 39-year-old client has a newly diagnosed draining pressure injury with heavy exudate; the wound cannot be fully covered with a dressing. Vital signs: T 37.3°C (99.1°F), HR 88/min, RR 16/min, BP 122/76 mmHg, SpO2 98% on room air. The nurse should prioritize which infection control measure?

  1. Initiate droplet precautions and have the client wear a mask in the room
  2. Initiate airborne precautions and place the client in negative pressure
  3. Initiate contact precautions and use dedicated equipment when possible (correct answer)
  4. Post a sign for standard precautions only because the organism is unknown
Explanation: Precaution type is chosen by the route the organism would take out of this client, and a draining wound with heavy exudate that cannot be contained under a dressing spreads by direct and indirect contact with that drainage. Contact precautions with gown and gloves and dedicated equipment interrupt that route by keeping drainage off hands, clothing, and shared items such as blood pressure cuffs and thermometers. Posting standard precautions only because the organism is unknown is the trap: you act on the route the drainage creates, not on a pending culture result, and uncontained exudate exceeds what standard precautions are designed to handle. Droplet precautions with a mask on the client and airborne precautions with negative pressure both target respiratory spread, and nothing in this client's presentation — respiratory rate 16, SpO2 98 percent on room air, no respiratory findings — points to a respiratory source. Match the precaution to the route: uncontained wound drainage means contact, and an unidentified organism is a reason to add precautions, never a reason to withhold them.

Question 17

A 63-year-old client with suspected tuberculosis is admitted from the emergency department to a medical unit; the nurse notes the assigned room is a standard private room without negative pressure. Vital signs: T 38.1°C (100.6°F), HR 94/min, RR 20/min, BP 128/80 mmHg, SpO2 95% on room air. The nurse should prioritize which infection control measure?

  1. Place the client on contact precautions and use dedicated equipment
  2. Initiate droplet precautions because TB is spread by coughing
  3. Keep the client in the current room and close the door as the only intervention
  4. Request transfer to an airborne infection isolation room and keep the client masked until moved (correct answer)
Explanation: Transmission-based precautions are selected by how the organism travels, and Mycobacterium tuberculosis travels in droplet nuclei that stay suspended and drift on air currents, which makes it an airborne pathogen requiring a negative-pressure airborne infection isolation room. Requesting transfer to that room and keeping the client masked until the move happens is correct because it controls the airborne particles both in transit and after arrival, and masking the source is the interim protection while the appropriate room is arranged. Droplet precautions are the wrong precaution type because they assume large droplets that fall within a few feet, which underestimates TB's true route, and contact precautions with dedicated equipment target organisms spread by touch and surfaces, not inhaled particles. Keeping the client in a standard room and simply closing the door is also the wrong environment because a closed door without negative pressure does not prevent infectious air from escaping into the corridor when the door opens. Transmission-based precautions follow the organism's route, not the severity of the illness or the convenience of the room already assigned.

Question 18

A 7-year-old child in the emergency department has fever, cough, coryza, and conjunctivitis; the parent reports the child is not immunized and was exposed to measles at school. Vital signs: T 39.0°C (102.2°F), HR 120/min, RR 26/min, BP 98/60 mmHg, SpO2 96% on room air. What personal protective equipment (PPE) is required for the nurse when entering the room under the indicated precautions?

  1. Surgical mask and gloves
  2. No PPE is required if the nurse stays 6 feet away
  3. N95 respirator (or PAPR) before room entry (correct answer)
  4. Gown and gloves only
Explanation: Measles is spread by the airborne route, and airborne precautions require the nurse to don an N95 respirator or PAPR before entering the room, so fit-tested respiratory protection put on prior to room entry is the required PPE here. The classic presentation of fever with cough, coryza, and conjunctivitis in an unimmunized child with a known exposure should trigger airborne precautions immediately rather than after diagnostic confirmation, because measles is extremely contagious and the virus remains suspended in the air. A surgical mask with gloves is the wrong level of respiratory protection because a surgical mask does not filter or seal against the small particles that carry measles, and gown and gloves alone protect against contact spread while leaving the nurse's airway completely unprotected. Assuming no PPE is needed at a six-foot distance applies droplet-precaution logic to an airborne organism, and distance does not protect against particles that travel on air currents throughout the room. Match PPE to the organism's transmission route, and put airborne protection on before you cross the threshold, not after you are in the room.

Question 19

A nurse is preparing to suction a tracheostomy for a 60-year-old client with thick secretions and intermittent coughing; the client is not on isolation precautions. Vital signs: T 36.9°C (98.4°F), HR 86/min, RR 18/min, BP 140/84 mmHg, SpO2 92% on 4 L/min trach collar. What personal protective equipment (PPE) is required based on standard precautions for this procedure?

  1. N95 respirator because suctioning generates airborne particles
  2. No PPE is needed if sterile technique is used
  3. Gloves and eye protection (with mask) due to risk of splashes/sprays (correct answer)
  4. Sterile gown and shoe covers for all suctioning
Explanation: PPE is selected by anticipated exposure, and standard precautions apply to every client regardless of diagnosis or isolation status. Tracheostomy suctioning in a client with thick secretions who coughs intermittently is a predictable source of splashes and sprays of respiratory secretions, so gloves plus eye protection with a mask are required to protect the hands and the mucous membranes of the eyes, nose, and mouth. An N95 respirator belongs to airborne precautions and is indicated when a pathogen spread by the airborne route is known or suspected, which is not the case for this client. A sterile gown and shoe covers exceed what the procedure calls for and reflect surgical practice rather than standard precautions. Believing no PPE is needed because sterile technique is used confuses two different goals, since sterile technique protects the client from contamination while PPE protects the nurse from exposure. Choose PPE by the exposure the task creates, and add transmission-based precautions only when the organism's route of spread calls for them.

Question 20

A 66-year-old client with pneumonia has a positive sputum culture for MRSA and is producing copious purulent sputum; the client frequently coughs into tissues. Vital signs: T 38.1°C (100.6°F), HR 100/min, RR 22/min, BP 118/72 mmHg, SpO2 92% on 2 L/min nasal cannula. Which type of isolation is necessary for this client?

  1. Contact precautions (correct answer)
  2. Airborne precautions only
  3. Protective (neutropenic) precautions
  4. Droplet precautions only
Explanation: This question tests the application of standard and transmission-based precautions. The specific precaution relevant to this scenario is contact precautions for MRSA in sputum, due to copious purulent secretions that can contaminate the environment. Implementing contact precautions is essential for infection control to prevent transmission via contaminated hands, equipment, or surfaces from coughing. Droplet only (B) or airborne only (C) do not address contact risks; protective precautions (D) are for client protection, not containment. Principles of infection prevention include isolating multidrug-resistant organisms regardless of site. Control measures emphasize PPE for handling secretions. A general strategy for selecting appropriate precautions is to consider secretion volume and pathogen resistance to determine if contact isolation supplements respiratory care.