Isolation precautions NCLEX-RN Practice Questions

Isolation precautions NCLEX-RN Practice Questions focus on protecting patients and healthcare workers by interrupting transmission of pathogens via contact, droplet, or airborne routes. In this topic-wise question blog for NCLEX-RN Exams, you will apply core principles from the Reduction of Risk Potential domain—selecting appropriate transmission-based precautions, donning and doffing PPE correctly, prioritizing immediate safety actions, cohorting wisely, and preventing device- and procedure-related spread. These questions challenge you with real-world scenarios—tuberculosis placement, C. difficile cleaning, RSV cohorting, COVID-19 aerosol procedures, and more—requiring you to synthesize guidelines rather than memorize lists. Ideal for M. Pharma students aiming for clinical precision, these MCQs emphasize critical thinking, safe delegation, and evidence-based infection prevention.

Q1. A client arrives with cough, night sweats, weight loss, and a positive sputum AFB smear. What is the nurse’s priority action?

• Initiate droplet precautions and place a surgical mask on the client
• Place the client in a negative-pressure room and don an N95 respirator before entry
• Start contact precautions and obtain a stool sample
• Provide a private room with the door open and use a face shield only

Correct Answer: Place the client in a negative-pressure room and don an N95 respirator before entry

Q2. The nurse prepares to care for a client with suspected measles (rubeola). Which PPE and isolation combination is appropriate?

• Droplet precautions with surgical mask
• Contact precautions with gown and gloves only
• Airborne precautions with N95 respirator in a negative-pressure room
• Standard precautions only with hand hygiene

Correct Answer: Airborne precautions with N95 respirator in a negative-pressure room

Q3. A client with profuse watery diarrhea tests positive for C. difficile. Which infection control strategy is most essential?

• Use alcohol-based sanitizer only after glove removal
• Use soap and water for hand hygiene and clean with a sporicidal (bleach) agent
• Use sterile gloves and a face shield only
• Place the client on droplet precautions

Correct Answer: Use soap and water for hand hygiene and clean with a sporicidal (bleach) agent

Q4. The nurse is assigning rooms. Which cohorting decision is most appropriate?

• Cohort a MRSA wound infection client with a C. difficile client
• Cohort two clients with confirmed influenza on the same antiviral regimen
• Cohort a client with RSV and a client with bacterial pneumonia
• Cohort a client with TB and a client on neutropenic precautions

Correct Answer: Cohort two clients with confirmed influenza on the same antiviral regimen

Q5. Which sequence reflects correct donning of PPE for contact precautions?

• Gloves, gown, mask, goggles
• Gown, mask/respirator, goggles/face shield, gloves
• Mask, gloves, gown, face shield
• Goggles, gloves, gown, mask

Correct Answer: Gown, mask/respirator, goggles/face shield, gloves

Q6. Which is the correct order for removing PPE after caring for a client on droplet precautions?

• Mask, gown, goggles, gloves
• Gloves, goggles/face shield, gown, mask
• Gown, gloves, mask, goggles
• Goggles, mask, gloves, gown

Correct Answer: Gloves, goggles/face shield, gown, mask

Q7. A client with disseminated herpes zoster is admitted. What isolation is required?

• Standard precautions only
• Contact and droplet precautions
• Airborne and contact precautions in a negative-pressure room
• Airborne precautions only

Correct Answer: Airborne and contact precautions in a negative-pressure room

Q8. During transport of a client with active pulmonary TB to radiology, which action is correct?

• Place an N95 respirator on the client and transport
• Have the client wear a surgical mask during transport
• No mask is needed if transport time is under 10 minutes
• Cover client’s face with a sheet; staff do not need masks

Correct Answer: Have the client wear a surgical mask during transport

Q9. The nurse is assigned to a pregnant staff member. Which client should the pregnant nurse avoid?

• Client with localized shingles and covered lesions
• Client with varicella who is not yet crusted over
• Client with MRSA in a wound under contact precautions
• Client with influenza A on droplet precautions

Correct Answer: Client with varicella who is not yet crusted over

Q10. You enter a room labeled “Droplet Precautions.” Which PPE is required upon entry?

• Surgical mask; add gown and gloves if contact with secretions is anticipated
• N95 respirator and powered air-purifying respirator (PAPR)
• Sterile gloves and cap only
• No PPE; mask only during aerosol-generating procedures

Correct Answer: Surgical mask; add gown and gloves if contact with secretions is anticipated

Q11. The nurse is caring for an infant with RSV bronchiolitis. Which isolation is best?

• Contact and droplet precautions with eye protection
• Airborne precautions only
• Standard precautions only
• Contact precautions only; masks are unnecessary

Correct Answer: Contact and droplet precautions with eye protection

Q12. After removing gloves when caring for a client with C. difficile, which hand hygiene method is required?

• Alcohol-based hand rub for 10 seconds
• Soap and water for at least 20 seconds
• No hand hygiene if gloves were intact
• Alcohol-based hand rub followed by lotion

Correct Answer: Soap and water for at least 20 seconds

Q13. A client with suspected meningococcal meningitis is admitted. Which immediate action is correct?

• Initiate droplet precautions and administer prescribed antibiotics
• Place in a negative-pressure room with N95 respirator
• Start contact precautions only
• Implement airborne precautions for 24 hours only

Correct Answer: Initiate droplet precautions and administer prescribed antibiotics

Q14. Which statement indicates correct understanding about equipment for a client on contact precautions?

• Designate and keep equipment in the room; disinfect before use on another client
• Use sterile equipment for all tasks to reduce transmission
• Shared equipment does not require cleaning if the client is afebrile
• Send all equipment to central sterilization after each use

Correct Answer: Designate and keep equipment in the room; disinfect before use on another client

Q15. The nurse suspects pertussis in a coughing client with post-tussive emesis. Which isolation is appropriate?

• Droplet precautions
• Airborne precautions
• Contact precautions
• Standard precautions only

Correct Answer: Droplet precautions

Q16. Which scenario requires airborne precautions plus contact precautions?

• Localized herpes zoster with covered lesions
• Varicella (chickenpox) with active vesicles
• Influenza during peak season
• Scarlet fever in a child on day 3 of antibiotics

Correct Answer: Varicella (chickenpox) with active vesicles

Q17. Which action reduces risk when collecting a nasopharyngeal swab from a client on droplet precautions?

• Perform the procedure without a mask to ensure visibility
• Wear a surgical mask, eye protection, gloves, and perform hand hygiene before and after
• Wear sterile gloves only and avoid eye protection
• Limit PPE to a gown to prevent clothing contamination

Correct Answer: Wear a surgical mask, eye protection, gloves, and perform hand hygiene before and after

Q18. A nurse preparing to enter a room with “Airborne Precautions” posts a sign: “Door Closed.” What additional action is essential?

• Ensure the client wears an N95 while in bed
• Verify negative-pressure function and wear an N95 respirator
• Keep the door open during medication administration
• Use a surgical mask unless coughing is severe

Correct Answer: Verify negative-pressure function and wear an N95 respirator

Q19. Which client may safely share a room with a client on contact precautions for MRSA?

• A postoperative client with a clean surgical wound
• A client with MRSA in a wound on similar therapy
• An elderly client with neutropenia
• A client with untreated pulmonary TB

Correct Answer: A client with MRSA in a wound on similar therapy

Q20. A nurse caring for a client with COVID-19 is about to perform endotracheal suctioning (an aerosol-generating procedure). Which PPE is required?

• Surgical mask, gown, gloves
• N95 respirator (or higher), eye protection, gown, and gloves in an airborne-capable room
• Face shield only
• Gloves only with hand hygiene

Correct Answer: N95 respirator (or higher), eye protection, gown, and gloves in an airborne-capable room

Q21. After providing care to a client with norovirus, the nurse should ensure which environmental cleaning approach?

• Alcohol-based wipes for high-touch surfaces
• Sporicidal disinfectant approved for norovirus
• Steam cleaning only
• Water rinse followed by drying

Correct Answer: Sporicidal disinfectant approved for norovirus

Q22. A nurse receives a needlestick injury after drawing blood from a client on contact precautions. What is the priority first action?

• Complete an incident report before washing the area
• Wash the puncture site with soap and water immediately
• Notify the supervisor at the end of the shift
• Apply alcohol gel and continue working

Correct Answer: Wash the puncture site with soap and water immediately

Q23. Which client should be assigned to the most experienced nurse due to high transmission risk?

• Client with influenza on droplet precautions
• Client with C. difficile on contact precautions with fecal incontinence
• Client with healed shingles and no open lesions
• Client on standard precautions awaiting routine labs

Correct Answer: Client with C. difficile on contact precautions with fecal incontinence

Q24. Which action by the nurse prevents transmission when removing a soiled gown after contact care?

• Untie the gown and pull it over the head
• Roll the gown inside out away from the body and discard
• Remove the mask first, then the gown
• Shake the gown to remove debris before discarding

Correct Answer: Roll the gown inside out away from the body and discard

Q25. A pediatric client with scarlet fever has received penicillin for 24 hours. What isolation is now appropriate?

• Discontinue all precautions; standard only
• Maintain droplet precautions until afebrile and clinically improved
• Start airborne precautions for 48 hours
• Switch to contact precautions only

Correct Answer: Maintain droplet precautions until afebrile and clinically improved

Q26. Which statement about shingles requires correction by the student nurse?

• “Disseminated shingles requires airborne plus contact precautions.”
• “If lesions are localized and covered in an immunocompetent client, standard precautions may be sufficient.”
• “A non-immune pregnant nurse can safely care for disseminated shingles if wearing a gown and gloves.”
• “Clients with shingles should have lesions covered to reduce transmission.”

Correct Answer: “A non-immune pregnant nurse can safely care for disseminated shingles if wearing a gown and gloves.”

Q27. The nurse prepares to collect sputum from a client with active TB in a negative-pressure room. Which is correct?

• Wear a surgical mask, gown, and gloves
• Wear an N95 respirator and gloves; provide tissue disposal and hand hygiene supplies
• Only gloves are required if the client is masked
• Remove the client’s mask to improve cough strength and no PPE needed

Correct Answer: Wear an N95 respirator and gloves; provide tissue disposal and hand hygiene supplies

Q28. A client with scabies is admitted. Which precautions are necessary until effective treatment has occurred?

• Airborne precautions
• Contact precautions with gown and gloves for all contact
• Droplet precautions
• Standard precautions only

Correct Answer: Contact precautions with gown and gloves for all contact

Q29. Which instruction is most appropriate for visitors of a client on droplet precautions for influenza?

• Wear a surgical mask upon entry; perform hand hygiene before and after the visit
• Wear an N95 respirator and shoe covers only
• No mask is needed if the visit is under 5 minutes
• Gloves only are required unless the client is coughing

Correct Answer: Wear a surgical mask upon entry; perform hand hygiene before and after the visit

Q30. The nurse is caring for two clients: one with C. difficile and one with VRE. Which statement reflects correct isolation management?

• These clients can be roomed together since both require contact precautions
• They cannot be cohorted because they have different pathogens
• They can share noncritical equipment if wiped with alcohol
• Droplet masks are required for both clients at all times

Correct Answer: They cannot be cohorted because they have different pathogens

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