🎯 High-Yield Points
- Standard precautions apply to ALL patients with ALL body fluids
- Airborne: TB, measles, varicella — negative pressure room, N95 respirator
- Droplet: influenza, meningitis, pertussis — surgical mask, private room
- Contact: MRSA, C. diff, VRE — gown and gloves, private room or cohort
- Hand hygiene with soap and water (not hand sanitiser) required for C. diff
[Concept Map: Infection Control NCLEX Questions — Clinical Manifestations, Nursing Interventions, Priority Actions]
Practice Questions
Question 1
A nurse is caring for a client with active pulmonary tuberculosis. Which PPE is required when entering the room?
✓ Correct: N95 respirator and gloves
Tuberculosis requires AIRBORNE precautions: N95 respirator (fit-tested), negative pressure private room, door closed at all times. A surgical mask is insufficient for TB because TB droplet nuclei are small enough to pass through standard masks. N95 respirators filter at least 95% of airborne particles. Gloves are also standard when contact with body fluids is anticipated.
Tuberculosis requires AIRBORNE precautions: N95 respirator (fit-tested), negative pressure private room, door closed at all times. A surgical mask is insufficient for TB because TB droplet nuclei are small enough to pass through standard masks. N95 respirators filter at least 95% of airborne particles. Gloves are also standard when contact with body fluids is anticipated.
Question 2
A client with Clostridium difficile (C. diff) diarrhoea is admitted. Which infection control measure is MOST important?
✓ Correct: Wash hands with soap and water after removing gloves
C. diff spores are NOT killed by alcohol-based hand sanitisers. The only effective hand hygiene for C. diff is washing with soap and water, which physically removes spores. This is a critical distinction — failing to use soap and water can spread C. diff to other patients. Contact precautions (gown and gloves) are also required, but soap-and-water hand hygiene is the key differentiator.
C. diff spores are NOT killed by alcohol-based hand sanitisers. The only effective hand hygiene for C. diff is washing with soap and water, which physically removes spores. This is a critical distinction — failing to use soap and water can spread C. diff to other patients. Contact precautions (gown and gloves) are also required, but soap-and-water hand hygiene is the key differentiator.
Question 3
Which type of isolation precautions are required for a child with chickenpox (varicella)?
✓ Correct: Airborne and contact precautions
Varicella (chickenpox) requires BOTH airborne and contact precautions. Varicella spreads via airborne droplet nuclei (requires N95 and negative pressure room) AND direct contact with lesion fluid (requires gown and gloves). Only immune or vaccinated staff should care for varicella patients. This dual-precaution requirement makes varicella an exception from purely contact or airborne diseases.
Varicella (chickenpox) requires BOTH airborne and contact precautions. Varicella spreads via airborne droplet nuclei (requires N95 and negative pressure room) AND direct contact with lesion fluid (requires gown and gloves). Only immune or vaccinated staff should care for varicella patients. This dual-precaution requirement makes varicella an exception from purely contact or airborne diseases.
Question 4
A nurse is preparing to insert a peripheral IV catheter. Which action BEST prevents catheter-related bloodstream infection?
✓ Correct: Clean the insertion site with chlorhexidine and allow to dry completely
Chlorhexidine gluconate is the preferred antiseptic for peripheral IV insertion sites. Allowing it to air dry completely is essential — the antiseptic action occurs during the drying process. Using clean (not sterile) gloves is acceptable for peripheral IVs with proper technique. Daily dressing changes are not standard unless soiled. Antibiotic ointment is not recommended as it can promote resistant organisms.
Chlorhexidine gluconate is the preferred antiseptic for peripheral IV insertion sites. Allowing it to air dry completely is essential — the antiseptic action occurs during the drying process. Using clean (not sterile) gloves is acceptable for peripheral IVs with proper technique. Daily dressing changes are not standard unless soiled. Antibiotic ointment is not recommended as it can promote resistant organisms.
Question 5
Which client should be placed in a negative pressure isolation room?
✓ Correct: A client with new diagnosis of tuberculosis
Negative pressure rooms are required for AIRBORNE diseases — tuberculosis, measles, and varicella. The negative pressure prevents contaminated air from escaping the room. MRSA and VRE require contact precautions (private room or cohorting, gown and gloves, but not negative pressure). Influenza requires droplet precautions (surgical mask, private room, but not negative pressure).
Negative pressure rooms are required for AIRBORNE diseases — tuberculosis, measles, and varicella. The negative pressure prevents contaminated air from escaping the room. MRSA and VRE require contact precautions (private room or cohorting, gown and gloves, but not negative pressure). Influenza requires droplet precautions (surgical mask, private room, but not negative pressure).
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