Standard Precautions-Transmission-Based Precautions Practice Test 1
Standard Precautions-Transmission-Based Precautions NCLEX Practice Test
Standard Precautions-Transmission-Based Precautions is a key topic within the NCLEX test plan, located under Safe and Effective Care Environment → Safety and Infection Control → Standard Precautions-Transmission-Based Precautions. This section reinforces hand hygiene and correct isolation techniques to stop pathogen spread. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 1st part of the Standard Precautions-Transmission-Based Precautions series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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Standard Precautions-Transmission-Based Precautions Practice Test 1
What is the most important aspect of aseptic techniques?
- Hand washing techniques
- Gown techniques
- Mask use
- Gloves
Explanation: Answer reason: Hand hygiene is the single most effective and prioritized measure for preventing the transmission of microorganisms, making it the key element of aseptic technique.
A client with neutropenia is in protective or reverse isolation. The family asks why the client is in this type of isolation. Which of the following explanations by the nurse is the best response?
- To protect other clients on the unit from infection.
- To protect the client from environmental sources of infection.
- To protect the client from his own bacteria.
- To protect the staff from infection by the client.
Explanation: Answer reason: Neutropenic clients are immunocompromised and at high risk of acquiring infections from the environment and other people. Protective (reverse) isolation is used to shield the client from external sources of infection, not to protect others from the client.
How is coronavirus transmitted?
- When a person coughs or sneezes, droplets spread through the air or fall on the ground and nearby surfaces.
- If another person is nearby and inhales the droplets or touches these surfaces and then touches his or her face, eyes, or mouth, he or she can become infected.
- If the distance is less than 1 meter from the infected person.
- All of the above are correct.
Explanation: Answer reason: SARS-CoV-2 spreads via respiratory droplets, contact with contaminated surfaces followed by touching mucous membranes, and close proximity (about 1 meter). Therefore, all statements A–C are correct.
Which of the following pediatric clients is at greatest risk for a latex allergy?
- The child with a myelomeningocele.
- The child with epispadias.
- The child with coxa plana.
- The child with rheumatic fever.
Explanation: Answer reason: Children with myelomeningocele (spina bifida) have a very high latex sensitivity due to repeated early exposure during surgeries and catheterizations. The other conditions are not classically linked to a high risk of latex allergy.
What are the precautions that need to be taken to protect against the coronavirus?
- Cover your nose and mouth when sneezing.
- Add more garlic to your diet.
- Visit your doctor for antibiotic treatment.
- Wash your hands every hour.
Explanation: Answer reason: Hand hygiene is a primary measure to prevent the transmission of respiratory viruses like the coronavirus. Garlic has no proven protective effect, and antibiotics do not treat viral infections. Covering sneezes helps, but frequent handwashing is the key precaution.
Which action is appropriate when a nurse is administering an injection?
- Wearing gloves
- Recapping the needle
- Administer the injection into the area of redness
- Injecting quickly
Explanation: Answer reason: Gloves are part of standard precautions to prevent exposure to blood and body fluids during injections. Needles should not be recapped; injections should avoid inflamed or red areas; and medication should be injected slowly after a quick needle insertion.
An educational program is being conducted on standard precautions. The nurse understands that a primary purpose of standard precautions for all clients is?
- To prevent nosocomial infections.
- To protect clients from AIDS.
- To protect employees from HIV and HBV.
- To replace other isolation requirements.
Explanation: Answer reason: Standard precautions treat all blood and body fluids as potentially infectious to prevent occupational exposure and the transmission of blood-borne pathogens, especially HIV and HBV, to healthcare workers. They do not replace other isolation measures and are not primarily intended to protect clients from AIDS.
A client has been placed in blood-and-body-fluid isolation. The nurse is instructing auxiliary personnel on the correct procedures. Which statement by the nursing assistant indicates the best understanding of the correct protocol for blood-and-body-fluid isolation?
- Masks should be worn during all client contact.
- Gloves should be worn for contact with non-intact skin, mucous membranes, or soiled items.
- Isolation gowns are not needed.
- A private room is always indicated.
Explanation: Answer reason: Standard precautions for blood and body fluids require gloves when touching blood, body fluids, non-intact skin, mucous membranes, or contaminated items. Masks are used only when there is a risk of splash or spray; gowns are used when soiling is likely, and a private room is not always required.
Which action by the novice nurse indicates a need for further teaching?
- The nurse fails to wear gloves when removing a dressing.
- The nurse applies an oxygen saturation monitor to the earlobe.
- The nurse elevates the head of the bed to check the blood pressure.
- The nurse places the extremity in a dependent position to acquire a peripheral blood sample.
Explanation: Answer reason: Contact with wound drainage poses an infection risk; gloves are essential to prevent transmission of pathogens and protect both nurse and client. Failure to use gloves violates basic standard precautions and indicates a knowledge deficit in infection control.
What is the oldest control measure for communicable diseases?
- Quarantine
- Isolation
- Health education
Explanation: Answer reason: Isolation—the separation of sick individuals—has been practiced since ancient times (e.g., leprosy), predating the later development of quarantine in the Middle Ages.
Which pathogen causes a disease that is spread by exposure to an open wound or sore of an infected individual?
- Blood-borne
- Infectious
- Universal
- Airborne
Explanation: Answer reason: Exposure of nonintact skin or open sores to infected blood or body fluids transmits bloodborne pathogens (e.g., HBV, HCV, HIV).
While on your night rounds, you notice two nursing aides placing bed sheets that they picked up from the floor. What is the proper nursing action?
- Confront them and call for private counseling.
- Continue the rounds; they are liable for their actions.
- Remind them of the principle of medical asepsis.
- Provide a clothes basket for them.
Explanation: Answer reason: Linens that come into contact with the floor are considered contaminated and should not be used on a bed. The nurse should immediately correct the aides and teach them by reinforcing medical asepsis and standard precautions.
What does respiratory isolation include?
- Use of a gown
- Use of a mask
- Hand washing
- All of the above.
Explanation: Answer reason: Respiratory isolation uses transmission-based precautions: mask use to prevent inhalation of infectious droplets/airborne particles, gown as indicated for close contact, and strict hand hygiene. Thus all listed measures apply.
The nurse is caring for a client with Hepatitis A. Which of the following would be appropriate in planning care for this client?
- Wear masks and/or goggles during procedures.
- Observe stool and needle precautions.
- Wear a gown and gloves during client contact.
- Report this case of Hepatitis A to the local health department.
Explanation: Answer reason: Hepatitis A is spread primarily via the fecal–oral route; contact precautions are indicated. Wearing gown and gloves during client contact prevents transmission. Masks/goggles are only needed for splash risk, and reporting is not a direct care-planning intervention.
Which action by the healthcare worker indicates a need for further teaching?
- The nursing assistant wears gloves while giving the client a bath.
- The nurse wears goggles while drawing blood from the client.
- The doctor washes his hands before examining the client.
- The nurse wears gloves to take the client's vital signs.
Explanation: Answer reason: Gloves are not required for routine vital signs when there is no anticipated contact with blood or body fluids; hand hygiene is sufficient. Gloves during bathing and goggles during procedures with possible splash, and handwashing before exam are appropriate.
How is HIV transmitted?
- Blood
- Body fluids
- semen
- All
Explanation: Answer reason: HIV is transmitted through blood and specific body fluids such as semen, vaginal fluids, rectal fluids, and breast milk; therefore all listed routes apply.
A severe acute respiratory syndrome (SARS) epidemic is suspected in a community of 10,000 people. As clients with SARS are admitted to the hospital, what types of precautions should the nurse institute?
- Enteric precautions.
- Handwashing precautions.
- Reverse isolation.
- Standard precautions.
Explanation: Answer reason: SARS is a contagious respiratory illness. The universal starting point for all patients is standard precautions; other options are incorrect (enteric applies to GI pathogens, hand-washing alone is not a precaution category, and reverse isolation protects immunocompromised patients).
Hand hygiene is to be used in the following situations by imaging professionals in the workplace?
- Before caring for a patient.
- After caring for a patient.
- When preparing for an invasive procedure.
- 1, 2, and 3
Explanation: Answer reason: Hand hygiene is indicated before and after patient contact and prior to an aseptic or invasive procedure; therefore, all three situations apply.
A newly admitted client with streptococcal pharyngitis (tonsillitis) has been placed on droplet precautions. Which of the following statements indicates the best understanding of this type of isolation?
- The client can be placed in a room with another client who has measles (rubeola).
- A special mask (N95) should be worn when working with the client.
- Must maintain a distance of 3 feet.
- Gloves should only be worn when giving direct care.
Explanation: Answer reason: Droplet precautions require maintaining at least 3 feet (1 meter) distance, wearing a surgical mask when within that range, and using gloves/gown as needed for contact with secretions.
Touching infectious lesions or sexual intercourse?
- Direct contact
- Indirect contact
- Droplets transmission
- Vector born
Explanation: Answer reason: Physical touching of lesions or sexual intercourse involves direct person-to-person contact, which is direct contact transmission.
Isolation period of a child with bacterial meningitis?
- 12 hours after starting antibiotics
- 24 hours after starting antibiotics
- Till antibiotic course completion
- Till culture negative
Explanation: Answer reason: For bacterial meningitis, droplet precautions are required until the patient has received effective antibiotics for 24 hours, after which infectivity falls markedly.
You are the nurse performing education for a patient with AIDS at the community clinic. Which of the following statements is an example of appropriate teaching?
- Do not wash your dishes with your roommate's dishes.
- Clean all utensils and dishes before reusing them.
- Do not use the same shower or toilet as your roommate.
- Hand sanitizer is not necessary unless you plan on touching someone else.
Explanation: Answer reason: HIV is not transmitted through casual household contact such as shared dishes, showers, or toilets. Appropriate teaching emphasizes routine hygiene and standard precautions; cleaning dishes and utensils before reuse is correct.
To maintain cleanliness of the bag and its contents, what must the nurse do?
- Wash his/her hands before and after providing nursing care to family members
- In care of family members, as much as possible, use only articles taken from the bag
- Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag
- At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside
Explanation: Answer reason: Using only supplies from the nursing bag maintains a controlled clean source and prevents contamination from household items. Options C and D describe techniques that would contaminate items, and A focuses on hand hygiene rather than bag cleanliness specifically.
Which statements by a client diagnosed with TB indicate understanding of how to avoid spreading the disease to family members?
- I will need to dispose of old clothing when I return home.
- I should always cover my mouth and nose when sneezing.
- It is important that I isolate myself from family when possible.
- I should use paper tissues to cough in and dispose of them properly.
- I can use regular plates and utensils whenever I eat.
Explanation: Answer reason: TB is spread via airborne droplets from coughing/sneezing. Covering the mouth and nose is a key cough-etiquette measure to prevent transmission. Disposing of clothing is unnecessary; isolation from family is not required beyond respiratory hygiene; regular plates/utensils are safe.
The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus (MRSA). Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
- The nurse leaves the stethoscope in the client's room for future use.
- The nurse cleans the stethoscope with alcohol and returns it to the exam room.
- The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
- The nurse cleans the stethoscope with water, dries it, and returns it to the nurse's station.
Explanation: Answer reason: MRSA requires contact precautions with dedicated patient equipment to prevent cross-contamination; leaving the stethoscope in the room is correct.
The most important aspect of hand washing is?
- Time
- Soap
- Water
- Friction
Explanation: Answer reason: Mechanical rubbing creates friction that dislodges and removes microorganisms from the skin; soap, water, and time support this, but friction is the critical element.
What is the most important instruction a nurse should give to a caregiver of a client diagnosed with AIDS to prevent infection?
- Cover your nose and mouth when you sneeze or cough.
- Get rid of all pets in the home.
- Wash your hands frequently.
- Wash the client's dishes separately.
Explanation: Answer reason: Hand hygiene is the single most effective measure to prevent transmission of pathogens to an immunocompromised client. Removing pets and separate dishes are unnecessary; covering cough protects others rather than primarily preventing infection in the client.
Which personal protective equipment (PPE) should the nurse apply when caring for a client with disseminated herpes zoster?
- N95 gown
- N95 mask, goggles, and gloves
- N95 mask, gown and gloves
- Surgical mask, face shield, gown, gloves
Explanation: Answer reason: Disseminated herpes zoster requires airborne plus contact precautions. Use an N95 respirator for airborne protection and gown and gloves for contact.
A nurse is completing discharge teaching with a client who has a new diagnosis of AIDS. Which of the following statements by the nurse indicates an understanding of the teaching?
- I will increase the amount of fresh veggies
- I will wipe up areas soiled with body fluids with alcohol and immediately dispose of the trash
- I will need to take my clothes to the dry cleaners to sterilize them
- I will be sure to wear gloves and wash my hands when I change my cat's litter box
Explanation: Answer reason: Clients with AIDS are immunocompromised; exposure to cat feces can transmit Toxoplasma. Using gloves and hand hygiene when changing the litter reduces infection risk. The other options reflect incorrect infection-control practices (no need for dry cleaning, avoid or carefully wash raw produce, and surfaces soiled with body fluids should be cleaned with a bleach solution rather than alcohol).
What precautions should be taken to protect from the coronavirus?
- Cover your nose and mouth when sneezing.
- Add more garlic into your diet.
- Visit your doctor for antibiotics treatment.
- Wash your hands after every hour.
Explanation: Answer reason: Covering the nose and mouth when sneezing follows respiratory hygiene to reduce droplet transmission. Garlic has no proven protective effect; antibiotics do not treat viral infections; washing specifically every hour is not evidence-based compared to performing hand hygiene as needed.
All the flowing are essential standard precautions used in the care of all patients irrespective of whether they are diagnosed infectious or not, except one?
- Hand hygiene
- Improper sharps and waste disposal
- Personal protective equipment
- Aseptic techniques
Explanation: Answer reason: Standard precautions include hand hygiene, use of PPE, aseptic technique, and proper sharps and waste disposal. "Improper" sharps and waste disposal is unsafe and therefore the exception.
In which direction should a thermometer be cleaned after taking a temperature?
- Bulb to stem
- Stem to bulb
- Midway between stem and bulb
- Bulb to bulb
Explanation: Answer reason: The bulb is the most contaminated part; wiping from the stem (cleaner) toward the bulb (dirtier) prevents transferring microorganisms to the clean handle.
The nurse in charge is evaluating the infection control procedures on the unit. Which finding indicates a break in technique and the need for education of staff?
- The nurse aide is not wearing gloves when feeding an elderly client.
- A client with active tuberculosis is asked to wear a mask when he leaves his room to go to another department for testing.
- A nurse with open, weeping lesions of the hands puts on gloves before giving direct client care.
- The nurse puts on a mask, a gown, and gloves before entering the room of a client on strict isolation.
Explanation: Answer reason: Open, weeping hand lesions are an infection risk; the nurse should be restricted from direct client care or lesions must be fully covered. Gloves alone are not adequate. The other options reflect appropriate practices (no gloves needed for routine feeding, TB client wears a mask during transport, full PPE for strict isolation).
Which of the following does NOT reflect routine practices?
- Were once known as universal precautions
- Used independent of transmission-based precautions
- Used in conjunction of transmission-based precautions
- Used to protect the health care professionals and patients
- Used when working with high risk groups and infected patients
Explanation: Answer reason: Routine practices (standard precautions) are applied to all patients at all times and used together with transmission-based precautions when indicated. They are not limited to high-risk or infected patients, so option E does not reflect routine practices.
A client has an infection that is spread through droplets. Which of the following is essential for the nurse to use when taking this client's temperature?
- Gloves
- Goggles
- A gown
- A mask
Explanation: Answer reason: Droplet precautions require wearing a surgical mask when within close proximity to the patient; taking a temperature involves close contact. Gloves, goggles, and gowns are not routinely required for droplet transmission unless contact with secretions is expected.
A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is MOST appropriate for this client?
- Reverse isolation
- Respiratory isolation
- Standard precautions
- Contact isolation
Explanation: Answer reason: MRSA is primarily transmitted by direct contact with contaminated surfaces or secretions. Use contact precautions (gloves and gown). Reverse isolation is for immunocompromised clients; respiratory isolation is for airborne diseases like TB; standard precautions alone are insufficient.
A client is admitted with suspected meningitis. What isolation precautions should the nurse implement?
- Contact precautions
- Droplet precautions
- Airborne precautions
- Standard precautions
Explanation: Answer reason: Common causes of meningitis (e.g., Neisseria meningitidis, H. influenzae) spread via respiratory droplets. Implement droplet precautions until at least 24 hours after effective antibiotics.
A client is admitted with suspected tuberculosis. What is the priority nursing intervention?
- Administering an antipyretic
- Initiating airborne precautions
- Encouraging increased fluid intake
- Administering a bronchodilator
Explanation: Answer reason: For suspected TB, the priority is to prevent transmission by initiating airborne precautions (negative-pressure room, N95). The other actions are not immediate priorities for infection control.
What is the primary mode of transmission for scabies mites?
- Close contact
- Airborne droplets
- Contaminated food
- Vector-borne transmission
Explanation: Answer reason: Scabies primarily spreads through prolonged skin-to-skin contact; airborne, foodborne, and vector-borne routes are not typical for this infestation.
A client diagnosed with tuberculosis asks the nurse when he can return to work. The nurse should tell the client that?
- He can return to work when he has three negative sputum cultures.
- He can return to work as soon as he feels well enough.
- He can return to work after a week of being on the medication.
- He should think about applying for disability because he will no longer be able to work.
Explanation: Answer reason: Return to work is appropriate when the client is no longer infectious, typically evidenced by three consecutive negative sputum results after effective therapy. Feeling better or one week of treatment is insufficient; disability is not indicated.
The nurse working the organ transplant unit is caring for a client with a white blood cell count of 450. During evening visitation, a visitor brings a basket of fruit. What action should the nurse take?
- Allow the client to keep the fruit
- Place the fruit next to the bed for easy access by the client
- Offer to wash the fruit for the client
- Ask the family members to take the fruit home
Explanation: Answer reason: WBC 450 indicates severe neutropenia in an immunosuppressed transplant client. Fresh fruit can carry microorganisms; neutropenic precautions restrict raw fruits/flowers. The safest action is to have the family take the fruit home.
Which action by the healthcare worker indicates a need for further teaching?
- The nursing assistant ambulates the elderly client using a gait belt.
- The nurse wears goggles while performing a venopuncture.
- The nurse washes his hands after changing a dressing.
- The nurse wears gloves to monitor the IV infusion rate.
Explanation: Answer reason: Gloves are required when contact with blood or body fluids is anticipated. Simply monitoring the IV infusion rate does not involve such contact, so wearing gloves indicates misunderstanding. The other actions reflect appropriate safety and hygiene practices.
The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?
- The client with methcillin resistant-staphylococcus aureas (MRSA)
- The client with diabetes
- The client with pancreatitis
- The client with Addison's disease
Explanation: Answer reason: MRSA requires contact precautions and preferably a private room to prevent transmission. Diabetes, pancreatitis, and Addison's disease are not contagious and do not require isolation.
Which action by the nurse indicates understanding of herpes zoster?
- The nurse covers the lesions with a sterile dressing.
- The nurse wears gloves when providing care.
- The nurse administers a prescribed antibiotic.
- The nurse administers oxygen.
Explanation: Answer reason: Herpes zoster lesions contain varicella virus; contact with vesicle fluid can spread infection. Using gloves during care reflects appropriate standard/contact precautions. Antibiotics are ineffective for this viral infection, oxygen is unrelated, and a sterile dressing is not specifically required.
A client hospitalized with MRSA is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact?
- The client should be placed in a room with negative pressure.
- Infection Requires close contact; therefore, the door may remain open.
- Transmission is highly likely, so the client should wear a mask at all times.
- Infection Requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.
Explanation: Answer reason: MRSA is spread by contact; prevention requires hand hygiene plus gloves and gown. Negative pressure and masks are for airborne precautions, and the emphasis on close contact/door open aligns with droplet, not contact, transmission.
Which client should be assigned to the pregnant nurse?
- The client with HIV
- The client with a radium implant for cervical cancer
- The client with RSV
- The client with cytomegalovirus
Explanation: Answer reason: HIV poses no special risk to pregnant healthcare workers when standard precautions are used. RSV and CMV present higher risk to the fetus. Radium implant exposure is contraindicated due to radiation risk.
What is the primary mode of transmission of hepatitis A virus?
- Blood product
- Infected food and water
- Airborne
- None of the above
Explanation: Answer reason: Hepatitis A is spread via the fecal–oral route, most commonly through contaminated (infected) food and water, not by blood products or airborne transmission.
Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to?
- The client with ulcerative colitis
- The client with neutropenia
- The client with cholecystitis
- The client with polycythemia vera
Explanation: Answer reason: Clients with neutropenia are severely immunocompromised and require a private room for protective isolation to reduce exposure to pathogens. The other conditions are not infectious and do not require private isolation.
Hepatitis A is an acute viral disease of the liver that is essentially transmitted through which route?
- Droplet
- Blood
- Skin
- Fecal-oral
Explanation: Answer reason: Hepatitis A is primarily spread via the fecal-oral route, typically through contaminated food or water, not by droplets, blood exposure, or skin contact.
Which of the following procedures requires a nurse to wear gloves?
- Back massage
- Providing passive exercise
- Feeding
- Providing oral hygiene
Explanation: Answer reason: Gloves are required when contact with mucous membranes or body fluids is anticipated; oral hygiene involves saliva and the oral mucosa. Massage, passive exercise, and feeding generally do not require gloves if skin is intact and no secretions are handled.
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