Master NCLEX-RN® Infection Control Questions

• NCLEX-RN® infection control questions assess your knowledge of how to prevent the spread of infections.
• You’ll be tested on both standard and transmission-based precautions.
• Programs like Slone NCLEX include infection control in its question bank.

Infection control is an essential part of your nursing practice and key to preventing infection transmission and protecting clients, visitors, and personnel.  

Effective infection control practices lower the risk of illness for clients, healthcare workers, and the wider community. These practices also contribute to global health by combating antibiotic resistance and preventing the spread of infections beyond healthcare facilities. Ultimately, infection control is a fundamental aspect of delivering quality healthcare. 

You can expect to encounter many infection control questions on the NCLEX-RN® because of its significance in providing quality care. 

NCLEX-RN® infection control questions focus on essential topics, including standard precautions, transmission-based precautions (such as airborne, droplet, and contact precautions), proper use of personal protective equipment (PPE), client room assignments, hand hygiene, aseptic techniques, safe handling of sharps, and an understanding of diseases that require specific isolation procedures. Essentially, these questions assess your knowledge of how to prevent the spread of infections in healthcare settings by adhering to appropriate protocols. 

NCLEX-RN® Infection Control Tips: Standard vs. Transmission-Based Precautions 

There are two main types of precautions: standard precautions and transmission-based precautions.  

To choose the right type, identify the interventions you are performing and assess the client’s potential infectious disease. If the client has an infectious disease, determine the appropriate precaution (e.g., airborne for tuberculosis or droplet for influenza).

There’s also a specific precaution type to protect clients who are immunosuppressed and at risk of infection. This is called protective or neutropenic precautions.   

Standard Precautions  

Standard precautions are based on the principle that all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes may contain infectious agents. These practices apply to all patients in any healthcare setting and include: 

• Hand hygiene. 
• Use of gloves, gowns, masks, and eye protection based on anticipated exposure. 
• Safe injection practices. 

Specific precautions vary depending on the procedure being performed and the anticipated level of exposure. For instance, inserting an IV may only require gloves, while more invasive procedures like intubation require gloves, gowns, masks, and eye protection. Standard precautions are crucial for protecting clients, as they ensure that healthcare personnel do not transfer infectious agents to clients through their hands or with the equipment used during client care. 

Transmission-Based Precautions 

There are three categories of transmission-based precautions: Contact Precautions, Droplet Precautions, and Airborne Precautions. These are implemented when standard precautions alone don’t completely interrupt the routes of transmission.  

For certain diseases that have multiple transmission routes, such as SARS, more than one category of transmission-based precaution may be necessary. Whether used individually or in combination, these precautions are always applied in addition to standard precautions. 

• Contact Precautions: 
  • Contact precautions help prevent the spread of infectious agents through direct or indirect contact. They are particularly important in cases of excessive wound drainage, fecal incontinence, or other bodily discharges that could contaminate the environment. 
  • A single-client room is preferred for clients requiring contact precautions. If unavailable, consult infection control personnel to assess risks of other placement options. 
  • Always wear a gown and gloves during any interaction that may involve contact with the client or potentially contaminated areas in the client’s environment. Put on personal protective equipment (PPE) upon entering the room and remove it before leaving the patient’s room. This practice helps contain pathogens, particularly those known to be transmitted through environmental contamination. 
• Droplet Precautions: 
  • Droplet precautions are used to prevent the spread of pathogens transmitted through close respiratory contact or mucous membrane exposure to respiratory secretions. These pathogens, which include Bordetella pertussis, influenza virus, adenovirus, rhinovirus, Neisseria meningitidis, and group A streptococcus (during the first 24 hours of antimicrobial therapy), do not remain infectious over long distances, so specialized air handling and ventilation are not necessary. 
  • A single client room is preferred for clients requiring droplet precautions. If unavailable, consult infection control personnel about alternative options. When sharing a room, the nurse should maintain a distance of at least 3 feet and draw the curtain between clients to minimize infection risk. 
  • Healthcare personnel should wear a mask (not a respirator) during close contact with infectious patients, usually before entering the room. Patients on droplet precautions being transported outside should wear a mask if possible and follow respiratory hygiene and cough etiquette. 
  • The CDC states that respiratory hygiene and cough etiquette are practices meant to reduce the spread of respiratory illnesses like the flu and common cold. This includes covering your mouth and nose with a tissue when coughing or sneezing, disposing of it properly, and washing your hands afterward to prevent the spread of respiratory droplets. 
• Airborne Precautions: 
  • Airborne precautions are implemented to prevent the spread of infectious agents that can remain viable over long distances while suspended in the air, such as the rubeola virus (measles), varicella virus (chickenpox), Mycobacterium tuberculosis, and possibly SARS-CoV. 
  • Clients requiring airborne precautions are placed in an airborne infection isolation room (AIIR). An AIIR is a single-client room designed with specialized air handling and ventilation systems. 
  • Healthcare personnel caring for clients with airborne illnesses must wear an N95 mask or respirator, based on specific disease recommendations, which should be donned prior to entering the room. 

Neutropenic Precautions: “Protective Precautions” 

Neutropenia is a condition with low levels of neutrophils, leading to increased vulnerability to infections. “Protective precautions” involve measures to limit germ exposure, such as strict hand hygiene, wearing gloves and gowns, avoiding unnecessary procedures, and monitoring for infection signs. Clients should also maintain good personal hygiene and avoid contact with sick individuals.  

These precautions include: 

• Hand Hygiene: Healthcare workers must wash their hands with soap and water before and after entering a client’s room.  
• Protective Gear: Wear gloves, gowns, and masks when in the client’s room to prevent infection.  
• Dedicated Equipment: Use client-specific medical tools to avoid cross-contamination.  
• Visitor Restrictions: Limit visitors who are sick or recently vaccinated with a live vaccine.  
• Dietary Restrictions: Avoid raw foods, unwashed fruits and vegetables, and unpasteurized dairy to reduce bacterial exposure.  
• Environmental Cleaning: Regularly disinfect surfaces and equipment in the room.  
• Infection Monitoring: Monitor the client’s temperature, white blood cell count, and infection screening tools (e.g., SIRS and SOFA) closely and report any fever immediately.

Personal Protective Equipment 

Donning and doffing PPE refers to the processes of putting on and taking off the gear. These steps are essential for protecting the wearer from infectious materials and minimizing self-contamination risks. For the NCLEX-RN®, you will need to know when and how to properly wear and remove PPE like gloves, gowns, masks, and eye protection based on the isolation precaution required. 

• Donning  
  • Wash hands 
  • Put on gown 
  • Put on mask 
  • Put on eye protection 
  • Put on gloves 
  • Perform a PPE check 
• Doffing  
  • Remove gloves 
  • Remove gown 
  • Remove eye protection 
  • Remove mask or respirator 
  • Wash hands or use hand sanitizer 
  • Dispose of PPE in an appropriate waste container 
• PPE Tips 
  • Put on your PPE before entering a room or meeting someone.
  • Avoid touching the front of your mask or respirator.
  • Peel off your gloves by turning them inside out.
  • Wash or sanitize your hands after removing PPE.

Sterile technique: 

Sterile technique in nursing involves practice to maintain a germ-free environment during patient care. This includes using sterile gowns, gloves, masks, and instruments to prevent infections during invasive procedures, like surgeries. The goal is to eliminate microorganisms from the work area. 

Sterile techniques are utilized in the following areas: during surgery, when inserting catheters (such as urinary or central venous), during wound care for open wounds, and when accessing sterile body cavities, like during a lumbar puncture. 

Examples of NCLEX-RN® infection control questions  

1. When should you perform hand hygiene?

(Before and after patient contact, after touching bodily fluids, etc.) 

2. What personal protective equipment (PPE) is necessary when caring for a client with a suspected airborne infection?  

(Mask, gown, gloves, eye protection.) 

3. How should you dispose of a used needle?  

(In a sharps container.) 

4. Which type of client should be placed in a private room with negative airflow?  

(A patient with a highly contagious airborne infection.) 

5. What are the key components of standard precautions?  

(Hand hygiene, wearing gloves when appropriate, and wearing a mask when necessary.)