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NCLEX-RN Standard and transmission-based precautions practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Standard and transmission-based precautions sits inside the Safety and Infection Control category of the NCLEX-RN. Our bank holds 44 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Standard and transmission-based precautions sample questions

Question 1

A nurse is caring for a client with a productive cough and a temperature of 101.2°F. The client is suspected of having pulmonary tuberculosis. Which type of transmission-based precaution should the nurse implement?

  1. A Droplet precautions with a surgical mask worn by the client during transport.
  2. B Standard precautions only, since the diagnosis is not confirmed.
  3. C Contact precautions with a private room and dedicated equipment.
  4. D Airborne precautions with an N95 respirator worn by the nurse.
Show the answer and explanation

Correct answer: D

Tuberculosis spreads by tiny airborne droplet nuclei. A client with suspected TB needs airborne precautions right away: an airborne infection isolation room and an N95 respirator for staff.

Why the other options are wrong:
A: Droplet precautions protect against large droplets and are inadequate for airborne TB.
B: Precautions must begin as soon as TB is suspected, not after confirmation.
C: Contact precautions address spread by touch, not inhaled droplet nuclei.

Question 2

A 45-year-old client is admitted with suspected pulmonary tuberculosis. The client has a productive cough and a chest X-ray shows cavitary lesions in the upper lobes. Which type of transmission-based precaution should the nurse implement?

  1. A Airborne precautions with a N95 respirator and negative pressure room.
  2. B Standard precautions only, because the diagnosis is not yet confirmed.
  3. C Droplet precautions with a surgical mask within 3 feet of the client.
  4. D Contact precautions with a gown and gloves for all interactions.
Show the answer and explanation

Correct answer: A

Cavitary upper-lobe lesions with a productive cough strongly suggest active pulmonary TB, which spreads by airborne droplet nuclei. Airborne precautions require a negative-pressure isolation room and an N95 respirator.

Why the other options are wrong:
B: Precautions start when TB is suspected, not after confirmation.
C: Droplet precautions do not protect against airborne droplet nuclei.
D: Contact precautions address spread by touch, not inhalation.

Question 3

A nurse is caring for a 28-year-old client diagnosed with scabies. Which precaution should the nurse implement when providing direct care?

  1. A Place the client in a negative pressure room with an N95 respirator for staff.
  2. B Wear a gown and gloves for all contact with the client or the client's environment.
  3. C Wear a surgical mask and eye protection when within 3 feet of the client.
  4. D Use standard precautions only, because scabies is not transmitted via blood or body fluids.
Show the answer and explanation

Correct answer: B

Scabies spreads through direct skin contact and through contaminated linens and clothing, so contact precautions with a gown and gloves are used for client care and for contact with the environment.

Why the other options are wrong:
A: Negative pressure rooms and N95 respirators are for airborne diseases, not scabies.
C: Masks and eye protection are droplet precautions, which do not prevent mite transmission.
D: Standard precautions alone are not enough because mites spread by skin and fabric contact, not by blood.

Question 4

A 58-year-old client in the medical unit has a productive cough, fever of 38.9°C, and a chest X-ray showing a cavitary lesion in the right upper lobe. Sputum culture is pending. The nurse is preparing to enter the room. Which personal protective equipment should the nurse apply before entering?

  1. A N95 respirator, gown, and gloves
  2. B Surgical mask, face shield, and gloves
  3. C Gown, gloves, and eye protection
  4. D Surgical mask and gloves only
Show the answer and explanation

Correct answer: A

The client's symptoms and cavitary lesion suggest possible pulmonary tuberculosis, which requires airborne precautions. An N95 respirator is necessary for airborne precautions, along with a gown and gloves if contact with respiratory secretions is anticipated. A surgical mask and face shield (the option "Surgical mask, face shield, and gloves" are used for droplet precautions, which are not adequate for tuberculosis. Gown, gloves, and eye protection (the option "Gown, gloves, and eye protection" are for contact or splash risks, not airborne. Surgical mask and gloves only (the option "Surgical mask and gloves only" do not protect against airborne transmission.

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