Standard and Transmission-Based Precautions Practice Questions
20 free Standard and Transmission-Based Precautions practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A nurse is caring for a client with a suspected diagnosis of pulmonary tuberculosis. Which protective equipment should the nurse don before entering the client's room?
- A Surgical mask
- B Isolation gown
- C N95 respirator
- D Face shield
Correct answer: N95 respirator
Tuberculosis is spread by airborne droplet nuclei, so the nurse must don a fit-tested N95 respirator before entering the room. A surgical mask does not filter particles that small, and an isolation gown or face shield are needed only when contact with secretions or splashes is anticipated, not for airborne protection alone.
A client is admitted with a large draining wound infected with Methicillin-resistant Staphylococcus aureus (MRSA). Which precaution should the nurse implement?
- A Droplet precautions
- B Airborne precautions
- C Contact precautions
- D Standard precautions only
Correct answer: Contact precautions
MRSA is a multidrug-resistant organism primarily spread by direct or indirect contact. Contact precautions require the use of gloves and a gown when entering the room to prevent the spread of the pathogen to other clients and the environment.
A nurse is caring for a client with Clostridioides difficile (C. diff). Which hand hygiene method is mandatory after providing care?
- A Using an alcohol-based hand rub
- B Washing hands with soap and water
- C Rinsing hands with sterile water
- D Wiping hands with a 70% isopropyl alcohol pad
Correct answer: Washing hands with soap and water
C. diff produces spores that are resistant to alcohol-based hand sanitizers. Mechanical friction and rinsing with soap and water are necessary to physically remove the spores from the hands.
Which client should the nurse place in a private room with monitored negative air pressure?
- A A client with Neisseria meningitidis
- B A client with disseminated Herpes zoster
- C A client with Mycoplasma pneumoniae
- D A client with uncomplicated seasonal influenza
Correct answer: A client with disseminated Herpes zoster
Disseminated Herpes zoster requires both contact and airborne precautions until the lesions are dry and crusted. Airborne precautions necessitate a negative pressure room to prevent the spread of infectious particles through the ventilation system.
A nurse is preparing to exit the room of a client on contact precautions. In which order should the nurse remove their personal protective equipment (PPE)?
- A Gown, gloves, mask, goggles
- B Gloves, goggles, gown, mask
- C Goggles, mask, gloves, gown
- D Mask, gown, goggles, gloves
Correct answer: Gloves, goggles, gown, mask
The most contaminated items, the gloves, are removed first. This is followed by the face shield or goggles, the gown, and finally the mask or respirator to minimize self-contamination.
A client has been diagnosed with bacterial meningitis. Which PPE is required for the nurse when providing direct bedside care?
- A N95 respirator
- B Surgical mask
- C Gloves
- D No PPE is required if staying 2 feet away
Correct answer: Surgical mask
Bacterial meningitis is spread through large respiratory droplets. Droplet precautions require a surgical mask when working within 3 to 6 feet of the client.
Which action by the nurse is consistent with Standard Precautions?
- A Wearing gloves for all client contact regardless of the task performed.
- B Recapping used needles before placing them into a sharps container.
- C Wearing a mask and goggles for procedures likely to generate blood splashes.
- D Placing all clients in private isolation rooms to prevent cross-contamination.
Correct answer: Wearing a mask and goggles for procedures likely to generate blood splashes.
Standard precautions apply to all clients and include the use of PPE when there is a potential for exposure to blood, body fluids, non-intact skin, or mucous membranes. Mask and eye protection are used specifically for anticipated splashes.
A client on droplet precautions must be transported to the radiology department. What action should the nurse take?
- A Cancel the test until the client is no longer infectious.
- B Notify the radiology department and have the client wear a surgical mask.
- C Ensure the transport personnel wear N95 respirators for the entire transport.
- D Cover the client entirely with a sterile sheet during transport.
Correct answer: Notify the radiology department and have the client wear a surgical mask.
Clients on droplet or airborne precautions should only leave their rooms for essential purposes. During transport, the client must wear a surgical mask to contain respiratory secretions.
The nurse is assigned to four clients. Which client requires the use of a gown for all entries into the room?
- A A client with Pertussis
- B A client with scabies infestation
- C A client with viral meningitis
- D A client with Legionnaires' disease
Correct answer: A client with scabies infestation
Scabies is a parasitic skin infestation that is highly contagious through direct contact. It requires contact precautions, which include the use of a gown and gloves.
A nurse is caring for a client with an upper respiratory infection. For which diagnosis would the nurse implement droplet precautions?
- A Measles (Rubeola)
- B Varicella (Chickenpox)
- C Bordetella pertussis
- D Respiratory syncytial virus (RSV)
Correct answer: Bordetella pertussis
Pertussis (whooping cough) is transmitted via large droplets and requires droplet precautions. Measles and Varicella require airborne precautions, while RSV often requires contact precautions.
The nurse is entering a room to perform a dressing change for a client with an infected wound. The nurse notes a 'Contact Precautions' sign on the door. Which action is correct?
- A Don gloves only, as the nurse is not touching the client's face.
- B Don a gown only if the nurse anticipates contact with the wound.
- C Don a surgical mask, gown, and gloves.
- D Don a gown and gloves before entering the room.
Correct answer: Don a gown and gloves before entering the room.
Under contact precautions, the nurse must don a gown and gloves upon entry into the room because the environment itself may be contaminated with the pathogen. This prevents the nurse's clothing from carrying the organism to other areas.
A client with Neutropenia is placed on Protective Environment (Reverse Isolation). Which intervention is appropriate for this client?
- A Allowing the client to have fresh flowers in the room.
- B Requiring all visitors to wear an N95 respirator.
- C Ensuring the client's room has positive pressure airflow.
- D Encouraging the client to eat fresh, unpeeled fruits and vegetables.
Correct answer: Ensuring the client's room has positive pressure airflow.
Protective environments for immunocompromised clients use positive pressure to keep outside contaminants from entering the room. Fresh flowers and unpeeled fruits are prohibited because they may harbor fungi or bacteria.
Which of the following is an example of indirect transmission by a fomite?
- A An infection spread by a nurse's contaminated hands.
- B An infection spread by an insect bite.
- C An infection spread by touching a contaminated doorknob.
- D An infection spread by sneezing directly onto another person.
Correct answer: An infection spread by touching a contaminated doorknob.
Indirect transmission by a fomite happens when a susceptible host touches a contaminated inanimate object such as a doorknob, stethoscope or bed rail. An insect bite is indirect transmission too, but vector-borne rather than fomite-borne, which is why the stem names the route. A nurse's hands are not a fomite — fomites are inanimate — and a sneeze delivered straight onto another person is droplet spread.
A nurse is educating a student about when to use goggles. Which procedure requires eye protection according to standard precautions?
- A Administering a subcutaneous heparin injection.
- B Assessing a client's radial pulse.
- C Changing a dry, intact gauze dressing.
- D Emptying a urinary catheter drainage bag.
Correct answer: Emptying a urinary catheter drainage bag.
Emptying a urinary catheter bag carries a risk of splashing urine, which is a body fluid. Standard precautions require the use of eye protection whenever a splash is anticipated.
A client is admitted with suspected Rubella (German Measles). What type of precautions should the nurse initiate?
- A Airborne precautions
- B Contact precautions
- C Strict isolation
- D Droplet precautions
Correct answer: Droplet precautions
Rubella is spread through large droplets from the respiratory tract. It requires droplet precautions, unlike Rubeola (Measles), which requires airborne precautions.
When donning PPE, in which order should the nurse apply the items?
- A Gown, mask, goggles, gloves
- B Gloves, gown, mask, goggles
- C Mask, goggles, gown, gloves
- D Goggles, gown, gloves, mask
Correct answer: Gown, mask, goggles, gloves
The correct sequence for donning PPE is Gown, then Mask or Respirator, then Goggles or Face Shield, and finally Gloves. This ensures maximum coverage and that the gloves are pulled over the cuffs of the gown.
A nurse is caring for a client on airborne precautions. The client is confused and keeps leaving the room. What is the best nursing action?
- A Assign a staff member to sit with the client and keep the door closed.
- B Place the client in soft wrist restraints.
- C Move the client to a room near the nurses' station and leave the door open.
- D Sedate the client to keep them in bed.
Correct answer: Assign a staff member to sit with the client and keep the door closed.
Safety and infection control must be balanced. Maintaining airborne precautions (keeping the door closed) is essential. Constant observation by a sitter is the least restrictive and safest way to manage the confused client while maintaining isolation.
A nurse stabs their finger with a used needle from a client whose HIV status is unknown. What is the nurse's first action?
- A Wash the wound immediately with soap and water; avoid squeezing it.
- B Notify the nurse manager and document the incident.
- C Go to the emergency department immediately for post-exposure prophylaxis evaluation.
- D Ask the client if they have any infectious diseases.
Correct answer: Wash the wound immediately with soap and water; avoid squeezing it.
Current guidance recommends washing a needlestick injury immediately with soap and water; squeezing or milking the wound is no longer advised, since it does not reduce infection risk and may cause added tissue trauma. Reporting the incident and pursuing post-exposure prophylaxis evaluation are important next steps, but washing the wound comes first.
Which task can be safely delegated to an unlicensed assistive personnel (UAP) regarding a client on contact precautions?
- A Determining which PPE is needed for the client's care.
- B Educating family members on how to don and doff PPE.
- C Assessing the client's skin for new signs of infection.
- D Measuring and recording the client's intake and output.
Correct answer: Measuring and recording the client's intake and output.
UAPs can perform routine tasks such as measuring intake and output. They must follow the established precautions, but they cannot perform assessments, patient education, or clinical determinations.
A client on contact precautions is being discharged. How should the nurse ensure the room is properly cleaned?
- A Follow facility policy for terminal cleaning of an isolation room.
- B Fog the room with disinfectant gas.
- C Clean only the items the client touched directly.
- D Leave the room completely empty for 24 hours to allow the organisms to die.
Correct answer: Follow facility policy for terminal cleaning of an isolation room.
Terminal cleaning is a specialized, thorough disinfection process of the entire room after an isolation client is discharged. It is essential to remove all pathogens from surfaces before a new client is admitted.