NCLEX Isolation Precautions Quiz and Chart
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Name the precaution
For each condition, decide the precaution category before you check. The PPE follows from the category, so the category is the thing to get right.
Pulmonary tuberculosis
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Airborne precautions
PPE. N95 respirator, negative-pressure room
Continue until three consecutive negative sputum smears.
Measles (rubeola)
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Airborne precautions
PPE. N95 respirator, negative-pressure room
Highly contagious before the rash appears.
Varicella (chickenpox)
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Airborne_contact precautions
PPE. N95, gown and gloves, negative-pressure room
Needs both airborne and contact precautions.
Disseminated herpes zoster
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Airborne_contact precautions
PPE. N95, gown and gloves
Localised zoster in an immunocompetent client needs contact precautions only.
Influenza
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Droplet precautions
PPE. Surgical mask within two metres
Client wears a mask during transport.
Pertussis
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Droplet precautions
PPE. Surgical mask
Precautions continue for five days of effective therapy.
Neisseria meningitidis meningitis
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Droplet precautions
PPE. Surgical mask
Close contacts require prophylaxis.
Mumps
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Droplet precautions
PPE. Surgical mask
Parotid swelling is the classic finding.
Rubella
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Droplet precautions
PPE. Surgical mask
Keep pregnant staff and visitors away.
Bacterial pneumonia in an infant
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Droplet precautions
PPE. Surgical mask
Add contact precautions if the organism warrants it.
Clostridioides difficile
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Contact precautions
PPE. Gown and gloves; soap and water hand hygiene
Alcohol rub does not kill the spores. Bleach-based surface cleaning.
Methicillin-resistant Staphylococcus aureus
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Contact precautions
PPE. Gown and gloves
Dedicated equipment; private room preferred.
Vancomycin-resistant Enterococcus
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Contact precautions
PPE. Gown and gloves
Cohorting is acceptable with the same organism.
Respiratory syncytial virus
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Contact precautions
PPE. Gown and gloves
Common in infants; add droplet precautions per facility policy.
Scabies
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Contact precautions
PPE. Gown and gloves
Treat all close contacts and launder linens in hot water.
Impetigo
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Contact precautions
PPE. Gown and gloves
Honey-coloured crusted lesions.
Draining wound not contained by a dressing
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Contact precautions
PPE. Gown and gloves
Contain the drainage where possible.
Pediculosis (head lice)
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Contact precautions
PPE. Gown and gloves
Check close contacts.
Viral conjunctivitis
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Contact precautions
PPE. Gown and gloves
Highly transmissible on hands and equipment.
Severe neutropenia after chemotherapy
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Protective precautions
PPE. Positive-pressure HEPA-filtered room
No fresh flowers, raw produce, standing water or sick visitors.
Stem cell transplant recipient
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Protective precautions
PPE. Positive-pressure HEPA-filtered room
The precautions protect the client from the environment.
Uncomplicated urinary tract infection
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Standard precautions
PPE. Standard precautions
No transmission-based precautions needed unless a resistant organism is identified.
Hepatitis B
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Standard precautions
PPE. Standard precautions with attention to sharps
Bloodborne, so standard precautions are sufficient.
HIV infection
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Standard precautions
PPE. Standard precautions
Additional precautions only for opportunistic infections such as tuberculosis.
Localised herpes zoster in an immunocompetent client
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Contact precautions
PPE. Gown and gloves, cover the lesions
Becomes airborne and contact if disseminated.
Full precautions chart
| Condition | Precaution | PPE and room | Nursing note |
|---|---|---|---|
| Pulmonary tuberculosis | airborne | N95 respirator, negative-pressure room | Continue until three consecutive negative sputum smears. |
| Measles (rubeola) | airborne | N95 respirator, negative-pressure room | Highly contagious before the rash appears. |
| Varicella (chickenpox) | airborne_contact | N95, gown and gloves, negative-pressure room | Needs both airborne and contact precautions. |
| Disseminated herpes zoster | airborne_contact | N95, gown and gloves | Localised zoster in an immunocompetent client needs contact precautions only. |
| Influenza | droplet | Surgical mask within two metres | Client wears a mask during transport. |
| Pertussis | droplet | Surgical mask | Precautions continue for five days of effective therapy. |
| Neisseria meningitidis meningitis | droplet | Surgical mask | Close contacts require prophylaxis. |
| Mumps | droplet | Surgical mask | Parotid swelling is the classic finding. |
| Rubella | droplet | Surgical mask | Keep pregnant staff and visitors away. |
| Bacterial pneumonia in an infant | droplet | Surgical mask | Add contact precautions if the organism warrants it. |
| Clostridioides difficile | contact | Gown and gloves; soap and water hand hygiene | Alcohol rub does not kill the spores. Bleach-based surface cleaning. |
| Methicillin-resistant Staphylococcus aureus | contact | Gown and gloves | Dedicated equipment; private room preferred. |
| Vancomycin-resistant Enterococcus | contact | Gown and gloves | Cohorting is acceptable with the same organism. |
| Respiratory syncytial virus | contact | Gown and gloves | Common in infants; add droplet precautions per facility policy. |
| Scabies | contact | Gown and gloves | Treat all close contacts and launder linens in hot water. |
| Impetigo | contact | Gown and gloves | Honey-coloured crusted lesions. |
| Draining wound not contained by a dressing | contact | Gown and gloves | Contain the drainage where possible. |
| Pediculosis (head lice) | contact | Gown and gloves | Check close contacts. |
| Viral conjunctivitis | contact | Gown and gloves | Highly transmissible on hands and equipment. |
| Severe neutropenia after chemotherapy | protective | Positive-pressure HEPA-filtered room | No fresh flowers, raw produce, standing water or sick visitors. |
| Stem cell transplant recipient | protective | Positive-pressure HEPA-filtered room | The precautions protect the client from the environment. |
| Uncomplicated urinary tract infection | standard | Standard precautions | No transmission-based precautions needed unless a resistant organism is identified. |
| Hepatitis B | standard | Standard precautions with attention to sharps | Bloodborne, so standard precautions are sufficient. |
| HIV infection | standard | Standard precautions | Additional precautions only for opportunistic infections such as tuberculosis. |
| Localised herpes zoster in an immunocompetent client | contact | Gown and gloves, cover the lesions | Becomes airborne and contact if disseminated. |
Grouped by precaution type
Airborne precautions
- Pulmonary tuberculosis — N95 respirator, negative-pressure room
- Measles (rubeola) — N95 respirator, negative-pressure room
Airborne_contact precautions
- Varicella (chickenpox) — N95, gown and gloves, negative-pressure room
- Disseminated herpes zoster — N95, gown and gloves
Droplet precautions
- Influenza — Surgical mask within two metres
- Pertussis — Surgical mask
- Neisseria meningitidis meningitis — Surgical mask
- Mumps — Surgical mask
- Rubella — Surgical mask
- Bacterial pneumonia in an infant — Surgical mask
Contact precautions
- Clostridioides difficile — Gown and gloves; soap and water hand hygiene
- Methicillin-resistant Staphylococcus aureus — Gown and gloves
- Vancomycin-resistant Enterococcus — Gown and gloves
- Respiratory syncytial virus — Gown and gloves
- Scabies — Gown and gloves
- Impetigo — Gown and gloves
- Draining wound not contained by a dressing — Gown and gloves
- Pediculosis (head lice) — Gown and gloves
- Viral conjunctivitis — Gown and gloves
- Localised herpes zoster in an immunocompetent client — Gown and gloves, cover the lesions
Protective precautions
- Severe neutropenia after chemotherapy — Positive-pressure HEPA-filtered room
- Stem cell transplant recipient — Positive-pressure HEPA-filtered room
Standard precautions
- Uncomplicated urinary tract infection — Standard precautions
- Hepatitis B — Standard precautions with attention to sharps
- HIV infection — Standard precautions
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