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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