Standard & transmission-based precautions NCLEX-RN Practice Questions

Standard & transmission-based precautions NCLEX-RN Practice Questions help you master essential infection control decisions you’ll face at the bedside. This topic-wise set targets the Safety & Infection Control domain on the NCLEX-RN and focuses on when to apply standard, contact, droplet, airborne, and protective precautions; the correct use and sequence of PPE; transport and cohorting rules; and prevention of occupational exposures. Designed for M. Pharma students preparing for the NCLEX-RN, these questions emphasize real-world prioritization, isolation logistics, and evidence-based CDC guidance for high-risk pathogens like TB, measles, C. difficile, MRSA, RSV, and COVID-19. Use these questions to refine clinical judgment, reduce transmission risk, and ensure safe nursing practice across care settings.

Q1. Which patient requires airborne precautions in addition to contact precautions?

• Infant with RSV bronchiolitis
• Client with scabies
• Client with disseminated herpes zoster (shingles)
• Client with localized shingles with lesions fully covered

Correct Answer: Client with disseminated herpes zoster (shingles)

Q2. The nurse is preparing to enter a room of a patient on airborne precautions for pulmonary TB. What is the correct donning sequence?

• Hand hygiene → Gloves → Gown → N95 respirator → Goggles/face shield
• Hand hygiene → Gown → N95 respirator → Goggles/face shield → Gloves
• Gown → Hand hygiene → Gloves → Goggles/face shield → N95 respirator
• Hand hygiene → N95 respirator → Gloves → Gown → Goggles/face shield

Correct Answer: Hand hygiene → Gown → N95 respirator → Goggles/face shield → Gloves

Q3. After providing care in an airborne isolation room for a patient with TB, which doffing sequence best minimizes self-contamination?

• Gown → Gloves → Hand hygiene → Remove N95 in the room → Hand hygiene → Exit room
• Gloves → Gown → Hand hygiene → Exit room and close door → Remove face shield/goggles → Remove N95 respirator → Hand hygiene
• Gloves → Face shield/goggles → N95 → Gown → Hand hygiene → Exit room
• Face shield/goggles → Gown → Gloves → Hand hygiene → Remove N95 in hallway → Hand hygiene

Correct Answer: Gloves → Gown → Hand hygiene → Exit room and close door → Remove face shield/goggles → Remove N95 respirator → Hand hygiene

Q4. A patient has confirmed Clostridioides difficile infection. Which action is most important to prevent transmission?

• Use alcohol-based hand rub after removing gloves
• Perform hand hygiene with soap and water after patient contact
• Place the patient on droplet precautions
• Use a standard disinfectant without bleach on high-touch surfaces

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

Q5. A patient with suspected pulmonary TB needs a CT scan. What is the priority action prior to transport?

• Have staff wear N95 respirators during transport
• Apply a surgical mask to the patient
• Place a HEPA filter on the CT machine
• Administer a dose of antibiotics before transport

Correct Answer: Apply a surgical mask to the patient

Q6. A client with suspected meningococcal meningitis is admitted. Which isolation is appropriate?

• Standard precautions only
• Airborne precautions with N95 respirator
• Contact precautions with gown and gloves only
• Droplet precautions with a surgical mask upon entry

Correct Answer: Droplet precautions with a surgical mask upon entry

Q7. The nurse must assign a roommate for an infant with RSV bronchiolitis on contact and droplet precautions. Which is the best choice?

• Another infant with confirmed RSV
• A child with neutropenia post-chemotherapy
• A post-op child 24 hours after tonsillectomy
• A child awaiting renal transplant evaluation

Correct Answer: Another infant with confirmed RSV

Q8. After giving a subcutaneous injection, what is the safest action regarding the needle?

• Use a two-handed recap technique and dispose in regular trash
• Leave the needle uncapped on the bedside tray for later disposal
• Activate the safety device and discard immediately into a sharps container
• Break the needle using a clamp before disposal

Correct Answer: Activate the safety device and discard immediately into a sharps container

Q9. Which patient must be placed in a negative-pressure airborne isolation room?

• Patient with influenza A
• Patient with pulmonary tuberculosis and productive cough
• Patient with MRSA wound infection
• Patient with pertussis

Correct Answer: Patient with pulmonary tuberculosis and productive cough

Q10. A nurse without documented immunity to varicella is assigned to a patient with active chickenpox. What is the appropriate action?

• Wear a surgical mask and proceed with care
• Provide care using a gown and gloves only
• Reassign the nurse; non-immune staff should not care for varicella patients
• Administer antibiotics prior to entering the room

Correct Answer: Reassign the nurse; non-immune staff should not care for varicella patients

Q11. When implementing contact precautions, what should be available at the doorway?

• Only hand sanitizer
• PPE cart with gowns and gloves and signage indicating contact precautions
• Only a surgical mask box
• A sharps container only

Correct Answer: PPE cart with gowns and gloves and signage indicating contact precautions

Q12. The nurse’s hands are visibly soiled with blood after removing gloves. What is the best hand hygiene method?

• Alcohol-based hand rub for 20 seconds
• Soap and water for at least 20 seconds
• Wipe with sterile normal saline gauze
• Put on a clean pair of gloves without hand hygiene

Correct Answer: Soap and water for at least 20 seconds

Q13. During a central venous catheter dressing change, which aseptic technique is required?

• Clean technique with nonsterile gloves only
• Sterile technique with sterile gloves, mask, and sterile field
• No gloves required if using chlorhexidine
• Standard precautions using only hand hygiene

Correct Answer: Sterile technique with sterile gloves, mask, and sterile field

Q14. A patient with an absolute neutrophil count of 400/mm³ is placed on protective precautions. Which instruction is most appropriate?

• Visitors with mild colds may enter if masked
• Fresh flowers and raw fruits are allowed
• Patient should wear a mask when leaving the room
• Door should remain open to promote airflow

Correct Answer: Patient should wear a mask when leaving the room

Q15. A nurse sustains a needlestick from a needle used on a patient with unknown HIV status. What is the first action?

• Report to employee health at the end of the shift
• Vigorously squeeze the wound to promote bleeding
• Wash the area immediately with soap and water
• Apply bleach directly to the puncture site

Correct Answer: Wash the area immediately with soap and water

Q16. Which statement reflects correct principles of environmental cleaning to reduce infection risk?

• Clean from dirty to clean to avoid missing contaminated areas
• Clean from top to bottom and from clean to dirty areas
• Start with the floor and finish with high-touch surfaces
• Use the same cloth for all surfaces to maximize disinfectant contact time

Correct Answer: Clean from top to bottom and from clean to dirty areas

Q17. A patient on droplet precautions must go to radiology. Which statement by the new nurse indicates correct understanding?

• “I will have the patient wear a surgical mask during transport.”
• “I will place an N95 respirator on the patient for transport.”
• “No mask is needed for the patient during transport.”
• “I will transport the patient without notifying radiology.”

Correct Answer: “I will have the patient wear a surgical mask during transport.”

Q18. A resident has crusted scabies. Which isolation is appropriate?

• Airborne precautions
• Contact precautions with gown and gloves
• Droplet precautions
• Standard precautions only

Correct Answer: Contact precautions with gown and gloves

Q19. A patient is colonized with MRSA in the nares and has chronic wounds. Which action is appropriate?

• Implement contact precautions and use dedicated equipment
• Place on droplet precautions only
• No isolation is necessary for colonization
• Use airborne isolation due to high transmission risk

Correct Answer: Implement contact precautions and use dedicated equipment

Q20. Which PPE best protects the nurse’s mucous membranes from splashes during suctioning a droplet isolation patient?

• Surgical mask only
• N95 respirator only
• Face shield or goggles
• Shoe covers

Correct Answer: Face shield or goggles

Q21. When taking vital signs for a patient on contact precautions for a draining wound, which approach is best?

• Use dedicated blood pressure cuff and stethoscope kept in the room
• Use unit equipment and wipe with water after use
• Borrow another patient’s stethoscope if clean
• Use disposable gloves only; no need for equipment cleaning

Correct Answer: Use dedicated blood pressure cuff and stethoscope kept in the room

Q22. Which item requires disposal in a red biohazard bag?

• A small gauze with a few dried blood spots
• A large abdominal pad saturated and dripping with blood
• Empty IV bags without visible blood
• Used nasal cannula

Correct Answer: A large abdominal pad saturated and dripping with blood

Q23. Which action primarily interrupts the chain of infection at the portal of exit?

• Administering antibiotics
• Applying a mask to a coughing patient
• Ensuring host vaccination
• Using sterile gloves for all procedures

Correct Answer: Applying a mask to a coughing patient

Q24. A nurse has not been fit-tested for an N95 respirator but is assigned to a patient with active TB. What is the appropriate action?

• Wear a surgical mask and proceed
• Use a powered air-purifying respirator (PAPR) or request reassignment until fit-tested
• Open the window to improve ventilation and enter without a mask
• Wear two surgical masks to substitute for an N95

Correct Answer: Use a powered air-purifying respirator (PAPR) or request reassignment until fit-tested

Q25. A hospitalized patient with COVID-19 is undergoing an aerosol-generating procedure (e.g., intubation). Which PPE is required?

• Surgical mask, gloves only
• N95 (or higher) respirator, eye protection, gown, and gloves in a negative-pressure room
• Face shield only
• Gown and gloves only

Correct Answer: N95 (or higher) respirator, eye protection, gown, and gloves in a negative-pressure room

Q26. Which precaution is indicated for an incontinent adult with acute hepatitis A?

• Airborne precautions
• Droplet precautions
• Contact precautions in addition to standard
• Standard precautions only

Correct Answer: Contact precautions in addition to standard

Q27. The nurse collects a sputum specimen from a patient with suspected TB. What is the correct specimen handling?

• Place the unlabeled container on the lab counter for labeling later
• Carry the open container to the lab immediately to avoid delays
• Label at bedside, then place the closed container into a biohazard transport bag for delivery
• Refrigerate in the unit medication fridge until pickup

Correct Answer: Label at bedside, then place the closed container into a biohazard transport bag for delivery

Q28. Which cohorting decision is most appropriate when single rooms are unavailable?

• Pair a patient with influenza A with a neutropenic patient
• Place two patients with confirmed influenza A together
• Room a patient with C. difficile with a patient post-hip surgery
• Pair a varicella patient with a nonimmune adult

Correct Answer: Place two patients with confirmed influenza A together

Q29. While performing tracheal suctioning on a patient with droplet precautions for influenza, what additional PPE should the nurse wear?

• Shoe covers
• Hair cover only
• Goggles or face shield to protect eyes
• No additional PPE is required beyond gloves

Correct Answer: Goggles or face shield to protect eyes

Q30. A patient with active varicella must be transported emergently to the OR. Which action is appropriate?

• Transport without a mask to save time
• Place a surgical mask on the patient and cover lesions with a clean sheet before transport
• Have the patient wear an N95 respirator
• Delay transport until all lesions crust

Correct Answer: Place a surgical mask on the patient and cover lesions with a clean sheet before transport

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