Know which bug gets which precautions and you will pick up easy points in Safety and Infection Prevention and Control. Follow CDC and facility policy in practice.
Isolation precautions chart
| Type | Key PPE and room | Common NCLEX examples |
|---|---|---|
| Standard | Hand hygiene; gloves, gown, eye protection based on expected exposure | Every client |
| Contact | Gown and gloves; private room or cohort; dedicated equipment | MRSA, VRE, C. diff (soap and water), norovirus, rotavirus, scabies, lice, RSV, draining wounds |
| Droplet | Surgical mask; private room or cohort; client wears a mask for transport | Influenza, pertussis, meningococcal meningitis, mumps, rubella, Mycoplasma pneumonia, strep pharyngitis (first 24 hours of antibiotics) |
| Airborne | N95 respirator; negative-pressure room with the door closed; client wears a surgical mask for transport | Tuberculosis, measles, chickenpox (plus contact), disseminated shingles (plus contact) |
| Protective (reverse) | Private room (positive pressure for some transplant clients); strict hand hygiene; no fresh flowers or plants; sick staff and visitors stay out | Neutropenic clients, chemotherapy, stem cell transplant |
Memory tricks
- Airborne, "MTV": Measles, TB, Varicella (chickenpox and disseminated zoster).
- Droplet: think anything spread by a cough or sneeze within about 6 feet: flu, pertussis, meningococcal meningitis, mumps, rubella.
- Contact: anything you touch: resistant bacteria, GI bugs, skin and wound infections, lice, scabies.
- C. diff: soap and water only. Alcohol does not kill spores.
Quick answers to common searches
| TB | Airborne |
| Measles | Airborne |
| Chickenpox | Airborne + contact |
| Shingles, localized, healthy immune system | Standard (cover lesions) |
| Shingles, disseminated or immunocompromised | Airborne + contact |
| MRSA | Contact |
| C. diff | Contact (soap and water) |
| RSV | Contact (per CDC; many facilities add droplet) |
| Influenza | Droplet |
| Pertussis | Droplet |
| Meningococcal meningitis | Droplet (first 24 hours of antibiotics) |
PPE order
- Donning: gown, mask or N95, goggles or face shield, gloves.
- Doffing: gloves, goggles or face shield, gown, mask or N95 (outside the room for N95), then hand hygiene.
Practice questions
A client is admitted with suspected pulmonary tuberculosis. Which precautions should the nurse implement?
Rationale: TB spreads by airborne droplet nuclei. The client needs a negative-pressure (airborne infection isolation) room, and staff wear a fit-tested N95 respirator.
A client has Clostridioides difficile infection. Which action by the nurse is correct?
Rationale: C. difficile spores are not reliably killed by alcohol-based hand rub. Soap and water physically remove spores, and contact (enteric) precautions with a gown and gloves prevent spread.
A child is admitted with suspected measles. Which room assignment is most appropriate?
Rationale: Measles is spread by the airborne route. The child needs a negative-pressure room with the door closed, and staff wear N95 respirators.
A client is diagnosed with pertussis. Which personal protective equipment should the nurse wear when entering the room?
Rationale: Pertussis is spread by respiratory droplets, so droplet precautions apply: a surgical mask when entering the room, plus standard precautions.
More: free NCLEX practice questions.
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Frequently asked questions
What are the types of isolation precautions?
Standard precautions apply to every client. Transmission-based precautions add contact, droplet, or airborne precautions. Protective (reverse) isolation protects immunocompromised clients.
What precautions are used for TB?
Airborne precautions: an airborne infection isolation room with negative pressure and a fit-tested N95 respirator.
What precautions are used for shingles?
Localized shingles in a client with a healthy immune system needs standard precautions with the lesions covered. Disseminated shingles, or shingles in an immunocompromised client, needs airborne and contact precautions until ruled out or crusted.
What is the order for putting on PPE?
Gown, mask or respirator, goggles or face shield, then gloves. Remove in this order: gloves, goggles or face shield, gown, then mask or respirator, with hand hygiene after.