Question 1

A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should?

Accepted Answer

Answer reason: With neutropenia, protective isolation aims to minimize exposure to microorganisms; sealed single-serving foods reduce contamination risk. The client need not wear a mask for visitors (visitors should be screened), disposable utensils are unnecessary if dishwashing is adequate, and IV sites should be prepped with antiseptics like chlorhexidine rather than mild soap and water.

Question 2

The nurse on oncology is caring for a client with a white blood count of 600. During evening visitation, a visitor brings a potted plant. What action should the nurse take?

Accepted Answer

Answer reason: A WBC of 600 indicates severe neutropenia; fresh flowers and potted plants harbor organisms in soil and water that increase infection risk. The safest action is to have the family take the plant home.

Question 3

The nurse recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?

Accepted Answer

Answer reason: A coughing client represents a droplet-spread risk; a mask is required.

Question 4

A client with a femoral popliteal bypass graft is assigned to a semiprivate room. The most suitable roommate for this client is the client with?

Accepted Answer

Answer reason: Post-op vascular graft clients must avoid infectious exposures. Hypothyroidism is noninfectious, whereas diabetic ulcers may be colonized/infected, ulcerative colitis involves diarrhea (potential contact precautions), and pneumonia is infectious.

Question 5

What is the most efficient way to break the chain of infection?

Accepted Answer

Answer reason: Hand hygiene is the single most effective standard precaution to interrupt transmission of pathogens and break the chain of infection across all settings.

Question 6

The nurse is supervising care given to a group of patients on the unit. The nurse observes a staff member entering a patient's room wearing gown and gloves. The nurse knows that the staff member is caring for which of the following patients?

Accepted Answer

Answer reason: RSV in infants requires contact precautions; staff should wear gown and gloves. Kawasaki disease is noninfectious, Lyme disease is not person-to-person, and mononucleosis typically requires standard precautions only.

Question 7

A 28-year-old client is admitted to the hospital unit with hepatitis A. The nurse knows that the client's overall care during hospitalization should include which of the following?

Accepted Answer

Answer reason: Hepatitis A spreads via the fecal–oral route; routine standard precautions are sufficient for hospitalized adults. Airborne, droplet, or protective isolation are not indicated.

Question 8

A nurse is teaching a new nursing assistant about ways to prevent the spread of infection. Included in the instruction would be that the cycle of the infectious process must be broken, which may be accomplished primarily through?

Accepted Answer

Answer reason: Hand hygiene is the single most effective and primary method to break the chain of infection and prevent transmission.

Question 9

A nurse discusses the procedure for protective isolation with the husband of a client who is receiving chemotherapy and has been hospitalized for neutropenia. Which statement made by the husband indicates the teaching was effective?

Accepted Answer

Answer reason: Protective (reverse) isolation for neutropenia is intended to protect the immunocompromised patient from microorganisms in the external environment. The other options describe preventing transmission from the patient to others or unnecessary sterilization steps.

Question 10

The nurse must assign a room to a client with scabies. Which of the following options would be the best choice for this client?

Accepted Answer

Answer reason: Scabies is spread by direct contact; use contact precautions. The preferred placement is a private room to prevent transmission. Negative-pressure rooms are for airborne diseases, and cohorting is acceptable only if a private room is unavailable.

Question 11

A nurse is caring for a client with a respiratory infection. Which of the following is the most important action by the nurse to prevent the transmission of infection?

Accepted Answer

Answer reason: Hand hygiene is the single most effective way to prevent transmission. Hands can be contaminated during glove removal; therefore washing after removing soiled gloves is essential. Gloves and gowns are adjuncts, and washing after donning gloves is inappropriate.

Question 12

After establishing a sterile field to insert a Foley catheter, the nurse must don sterile gloves. Place these actions in the proper sequence?

Accepted Answer

Answer reason: Correct sterile gloving sequence: 5 → 2 → 4 → 3 → 1. Use the non-dominant hand to grasp the inside of the dominant glove cuff (maintains sterility), pull glove over dominant hand, then with the gloved dominant hand slip fingers under the cuff of the second glove on the sterile side, don the non-dominant glove, and finally interlock fingers to adjust fit.

Question 13

The nurse is caring for a client with Hepatitis A. What action puts the nurse at highest risk for being exposed to Hepatitis A?

Accepted Answer

Answer reason: Hepatitis A is transmitted via the fecal–oral route; contact with feces poses the highest exposure risk. Handling/testing stool is highest risk, whereas coughing, suctioning, or casual touch are not primary transmission routes.

Question 14

The nurse must auscultate the lungs of a client in isolation. Which of the following is the best way to prevent the spread of microorganisms to other clients?

Accepted Answer

Answer reason: Use dedicated equipment for clients under isolation to prevent cross-contamination. Detaching needles is unsafe, double-bagging equipment is less effective than dedicating equipment, and PPE should be removed before leaving the room per isolation protocols.

Question 15

The nurse is finished caring for a client in an isolation room. The nurse begins to remove personal protective equipment. Put the following items in order beginning with what the nurse would remove first?

Accepted Answer

Answer reason: Correct doffing order to minimize contamination is: Gloves (most contaminated) → Goggles/Face shield → Gown → Mask/Respirator. Sequence: 1, 2, 3, 4.

Question 16

A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which of the following nursing measures should the nurse do FIRST?

Accepted Answer

Answer reason: Meningococcal meningitis is transmitted via respiratory droplets; the priority is to implement droplet (respiratory) isolation to prevent transmission before other assessments or interventions.

Question 17

Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which of the following medical conditions?

Accepted Answer

Answer reason: A positive PPD combined with an abnormal chest x-ray indicates suspected active tuberculosis. Tuberculosis is transmitted via airborne particles and requires airborne precautions (negative-pressure room, N95 respirator). AIDS with CMV requires standard precautions, viral pneumonia typically requires droplet precautions depending on the pathogen, and lung cancer does not require isolation precautions.

Question 18

Which of the following is the FIRST priority in preventing infections when providing care for a client?

Accepted Answer

Answer reason: Hand hygiene is the primary and most effective first-line measure for preventing infection; PPE and barriers are adjuncts and situation-dependent.

Question 19

An adult woman is admitted to an isolation unit in the hospital after tuberculosis was detected during a pre-employment physical. Although frightened about her diagnosis, she is anxious to cooperate with the therapeutic regimen. The teaching plan includes information regarding the most common means of transmitting the tubercle bacillus from one individual to another. Which contamination is usually responsible?

Accepted Answer

Answer reason: Mycobacterium tuberculosis is spread primarily via airborne droplet nuclei generated when an infected person coughs, sneezes, or speaks. Hands, eating utensils, and milk products are not the usual mode of person-to-person transmission.

Question 20

The charge nurse observes a new staff nurse who is changing a dressing on a surgical wound. After carefully washing her hands the nurse dons sterile gloves to remove the old dressing. After removing the dirty dressing, the nurse removes the gloves and dons a new pair of sterile gloves in preparation for cleaning and redressing the wound. The most appropriate action for the charge nurse is to?

Accepted Answer

Answer reason: Hand hygiene is required after removing soiled gloves and before donning new sterile gloves to prevent contaminating the wound. While sterile gloves aren’t necessary to remove the old dressing, the priority is to stop and require handwashing now.

Question 21

A client has been placed in blood and body fluid isolation. The nurse is instructing auxiliary personnel in the correct procedures. Which statement by the nursing assistant indicates the best understanding of the correct protocol for blood and body fluid isolation?

Accepted Answer

Answer reason: Blood/body fluid (standard) precautions require gloves for contact with blood, body fluids, nonintact skin, mucous membranes, or contaminated items. Masks and gowns are used only if splash or soiling is likely, and a private room is not routinely required.

Question 22

The nurse is training a group of Certified Nursing Assistants (CNAs) about hand hygiene. Which of the following statements indicate that CNAs need further instructions from the nurse?

Accepted Answer

Answer reason: Gloves do not replace hand hygiene; hands must be cleaned before and after glove use. Statement A shows a misunderstanding.

Question 23

The nurse is evaluating whether nonprofessional staff understand how to prevent transmission of HIV. Which of the following behaviors indicates correct application of universal precautions?

Accepted Answer

Answer reason: Suctioning produces splash and aerosol risk; mask and eye protection align with universal precautions.

Question 24

Parents of a 7 year-old child call the clinic nurse because their daughter was sent home from school because of a rash. The child had been seen the day before by the practitioner and diagnosed with Fifth Disease (erythema infectiosum) and is otherwise in good health. The MOST appropriate action by the nurse would be to?

Accepted Answer

Answer reason: In fifth disease, the child is typically contagious before the rash appears; once the rash erupts, the illness is not considered contagious and isolation is unnecessary. The nurse should reassure the parents and school accordingly.

Question 25

A client is admitted with a right upper lobe infiltrate, and also to rule out tuberculosis. The isolation precautions the nurse would institute include?

Accepted Answer

Answer reason: Suspected TB requires airborne precautions, including a fit-tested particulate respirator (N95). Positive pressure is contraindicated; gown/gloves or generic barrier precautions alone are insufficient for airborne transmission.

Question 26

Which body fluid has the highest concentration of HIV virus?

Accepted Answer

Answer reason: HIV viral load is highest in blood, making blood exposures the most infectious; semen and CSF contain virus but at lower concentrations, and saliva has very low levels.

Question 27

Which hepatitis is spread by contact with infected blood or body fluids?

Accepted Answer

Answer reason: Hepatitis B is transmitted via exposure to infected blood and body fluids, including through sexual contact, perinatal exposure, and percutaneous injuries or needle sharing. Hepatitis A and E are primarily spread by the fecal–oral route. While hepatitis D is also blood-borne, it requires coinfection with hepatitis B and is not the typical single best answer for this question. Therefore, hepatitis B best fits the described transmission route.

Question 28

Hepatitis C is mainly transmitted through?

Accepted Answer

Answer reason: Hepatitis C virus is primarily spread via blood-to-blood contact, such as sharing needles, transfusions before screening was implemented, or occupational needlestick injuries. Sexual and perinatal transmission occur but are much less efficient. It is not spread through air, food, or water. Therefore, blood is the main route of transmission.

Question 29

Safe social distance is?

Accepted Answer

Answer reason: For droplet-spread infections, particles typically travel short distances before settling, with most transmission occurring within about 1 meter (3 feet). The WHO recommends maintaining at least 1 meter of distance to reduce risk, with some jurisdictions adopting larger buffers when feasible. Therefore, 1 meter is the minimum safe social distance standard commonly cited.

Question 30

Diphtheria spreads through?

Accepted Answer

Answer reason: Corynebacterium diphtheriae is transmitted primarily via respiratory droplets during close person-to-person contact. It can also spread by contact with respiratory secretions or skin lesions, but bloodborne, foodborne, and vector-borne transmission are not typical routes. Therefore, droplet transmission is the correct mechanism guiding droplet precautions in clinical settings.

Question 31

Indirect transmission includes which of the following?

Accepted Answer

Answer reason: Indirect transmission occurs when pathogens are passed via an intermediate object or material rather than person-to-person contact. Doorknobs and toilet seats are fomites that can carry microorganisms and transmit infection indirectly. In contrast, droplet spread is a form of direct transmission over short distances. Therefore, the best answer is the fomite example.

Question 32

Which of the following fluids does NOT transmit HIV?

Accepted Answer

Answer reason: HIV is transmitted through certain body fluids, primarily blood, semen, vaginal fluids, rectal fluids, and breast milk. Saliva contains very low levels of virus and has innate inhibitory enzymes, so it does not transmit HIV in typical exposures such as kissing. In contrast, semen, vaginal fluid, and blood are well-documented transmission sources. Therefore, saliva is the fluid that does not transmit HIV.

Question 33

What is the main mode of transmission of TB?

Accepted Answer

Answer reason: Mycobacterium tuberculosis is spread primarily via inhalation of airborne droplet nuclei generated when an infected person coughs, sneezes, or speaks. These fine particles remain suspended and reach the alveoli to establish infection. Fecal-oral, direct skin contact, and vector-borne transmission are not typical routes for TB.

Question 34

A nurse should wear sterile gloves when?

Accepted Answer

Answer reason: Sterile gloves are required for procedures that must remain sterile to prevent introducing microorganisms into vulnerable tissues. Wound dressing changes are performed using surgical asepsis to reduce infection risk in open tissue. Feeding, giving oral medications, and checking blood pressure do not require sterile technique; clean gloves are used only as needed for contact with body fluids.

Question 35

Negative-pressure room isolation is required for?

Accepted Answer

Answer reason: Negative-pressure rooms are used for airborne precautions to prevent spread of small droplet nuclei to other areas. Tuberculosis, including laryngeal TB, is transmitted via the airborne route and requires an airborne infection isolation room and N95 respirators. Herpes simplex and impetigo are managed with contact precautions, and Mycoplasma pneumonia requires droplet precautions, not airborne isolation.

Question 36

What is the primary mode of transmission for mumps?

Accepted Answer

Answer reason: Mumps is a paramyxovirus transmitted primarily via respiratory droplets and saliva from an infected person, especially during close contact. Droplet precautions are recommended during the infectious period. Fomite transmission is less common, and it is not spread by the fecal-oral route or vectors. Therefore, airborne droplet spread is the principal mode.

Question 37

Ebola virus disease mainly spreads through?

Accepted Answer

Answer reason: Ebola is transmitted through direct contact with blood, secretions, or other body fluids of a symptomatic infected person or through contaminated objects and remains. It is not spread by mosquitoes and is not waterborne. Airborne transmission does not occur under routine conditions, though droplets may pose risk during close contact with bodily fluid exposure. Therefore, direct contact with body fluids is the primary route.

Question 38

Transmission of COVID-19 occurs mainly through?

Accepted Answer

Answer reason: SARS-CoV-2 spreads primarily via respiratory droplets and aerosols generated when an infected person coughs, sneezes, talks, or breathes, particularly at close range. Food and water are not recognized routes of transmission for COVID-19 in typical circumstances. Mosquitoes do not transmit coronaviruses. Hence the main mode is respiratory droplets.

Question 39

Appropriate actions for a client with suspected pulmonary TB?

Accepted Answer

Answer reason: Pulmonary tuberculosis requires airborne precautions to prevent spread of droplet nuclei. The immediate priority is to place the client in a negative-pressure room, which contains and exhausts contaminated air to the outside. Additional correct measures (not all selectable here) include staff use of fit-tested N95 respirators, having the client wear a surgical mask during transport, keeping the door closed, and limiting visitors. Droplet precautions or a surgical mask alone are insufficient for TB.

Question 40

Using the principles of standard precautions, the nurse would wear gloves in what nursing interventions?

Accepted Answer

Answer reason: Standard precautions require gloves whenever there is potential contact with blood, body fluids, mucous membranes, or nonintact skin. Providing oral hygiene involves direct contact with the oral mucosa and saliva, which are body fluids, so gloves are indicated. Back massage, feeding, and hair care do not typically involve exposure to body fluids or mucous membranes unless other risk factors are present.

Question 41

Hepatitis B is transmitted mainly through?

Accepted Answer

Answer reason: Hepatitis B virus is transmitted via exposure to infected blood and body fluids, including through sexual contact and perinatal transmission from mother to infant. It is not spread by airborne routes. Food and water transmission are characteristic of fecal–oral viruses like hepatitis A and E, not hepatitis B.

Question 42

Using gloves is absolutely mandatory in which of the following patient care activity?

Accepted Answer

Answer reason: Gloves are mandatory when there is anticipated contact with blood, body fluids, mucous membranes, or non-intact skin as part of Standard Precautions. Postpartum perineal care involves exposure to lochia and perineal secretions and contact with mucous membranes, creating a clear contamination risk. Therefore, gloves are required to protect both the patient and the healthcare worker and to prevent cross-transmission. The other activities may not inherently require gloves unless there is expected exposure to body fluids or the patient is on specific precautions.

Question 43

How to prevent NSI (Needle stick injury) during phlebotomy?

Accepted Answer

Answer reason: All listed actions are evidence-based components of preventing needlestick injuries during phlebotomy: using safety-engineered devices (e.g., safety vacutainer needles), immediate disposal in sharps containers, and never recapping reduce exposure risk. Eliminating or reducing needle use when possible further decreases the chance of injury. Consistent universal/standard precautions help prevent bloodborne pathogen transmission if an exposure occurs, so the best answer is that all apply.

Question 44

Which isolation precaution is used for tuberculosis?

Accepted Answer

Answer reason: Tuberculosis is transmitted via airborne droplet nuclei that can remain suspended in air and be inhaled over distances. Therefore, patients with suspected or confirmed pulmonary TB require airborne precautions, including placement in a negative-pressure room and staff use of a fit-tested N95 respirator (or higher-level protection). Droplet precautions are insufficient because they target larger, short-range respiratory droplets rather than airborne particles.

Question 45

Which infection requires airborne precautions?

Accepted Answer

Answer reason: Tuberculosis is transmitted via airborne droplet nuclei that can remain suspended in the air and be inhaled, so it requires airborne precautions. Airborne precautions include placement in a negative-pressure room and use of a fit-tested N95 respirator (or higher) by staff. Influenza requires droplet precautions, MRSA typically requires contact precautions, and rotavirus requires contact precautions due to fecal-oral spread.

Question 46

Which type of isolation precaution is required for a patient with tuberculosis (TB)?

Accepted Answer

Answer reason: Tuberculosis is transmitted via airborne droplet nuclei that can remain suspended in the air, so transmission-based airborne precautions are required. This includes placing the patient in a negative-pressure room and using a fit-tested N95 respirator (or higher-level respirator) for staff. Contact precautions are for organisms spread by direct contact, and droplet precautions apply to larger respiratory droplets that travel short distances. Standard precautions are used for all patients but are not sufficient alone for suspected or confirmed active TB.

Question 47

Which disease would NOT require airborne precautions?

Accepted Answer

Answer reason: Measles (rubeola), varicella (chickenpox), and tuberculosis are classic conditions requiring airborne precautions due to transmission via droplet nuclei/aerosolized particles. Pertussis (whooping cough) is transmitted primarily by respiratory droplets, so it requires droplet precautions (and standard precautions), not airborne. Therefore, pertussis is the disease that would NOT require airborne precautions among the options.

Question 48

Which PPE should be removed first to prevent contamination?

Accepted Answer

Answer reason: Gloves are removed first because they are considered the most contaminated PPE after patient contact. Removing them early reduces the risk of transferring organisms to other PPE or to the wearer’s skin while doffing. Standard doffing sequence commonly begins with gloves, then goggles/face shield, then gown, and mask/respirator last after leaving the room (if indicated). Hand hygiene is performed immediately after glove removal and again at the end of doffing.

Question 49

8 year-old man is diagnosed with tuberculosis (TB) and negative pressure room. Which of the following should wear a facemask?

Accepted Answer

Answer reason: Active pulmonary TB requires airborne precautions in a negative-pressure room. Everyone entering the room (staff and visitors) must wear appropriate respiratory protection (typically a fit-tested N95 or higher-level respirator) to prevent inhalation of droplet nuclei. Limiting masking only to healthcare providers, close contacts, or certain family members is incomplete and unsafe because any entrant is at risk during exposure in the room. Therefore the best answer is that all people who enter the patient’s room should wear a mask/respirator.

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