Infection Control
Infection control questions test your knowledge of standard precautions, transmission-based precautions, isolation types, personal protective equipment (PPE), sterile technique, and strategies to prevent healthcare-associated infections. These questions require you to match the correct isolation category to specific diseases and know the correct order for donning and doffing PPE. Infection control is a foundational nursing concept tested heavily on the NCLEX.
Strategy
Organize your knowledge around the three transmission-based precaution categories: airborne, droplet, and contact. Airborne precautions require a negative-pressure room and N95 respirator (tuberculosis, measles, varicella, disseminated zoster). Droplet precautions require a surgical mask within 3 feet (influenza, pertussis, meningococcal meningitis, mumps, rubella). Contact precautions require gown and gloves for any client interaction (MRSA, C. difficile, scabies, RSV). Remember that standard precautions apply to ALL clients regardless of diagnosis. For PPE questions, know the order: don gown first, then mask, then goggles, then gloves; doff gloves first, then goggles, then gown, then mask.
Key Tips
- ✓Remember 'My Chicken Hez TB' for airborne precautions: Measles, Chickenpox (Varicella), Herpes Zoster (disseminated), Tuberculosis
- ✓Droplet precautions require a surgical mask and 3-foot distance but NOT a negative-pressure room
- ✓C. difficile requires soap and water hand hygiene because alcohol-based sanitizer does not kill spores
- ✓For sterile technique, a 1-inch border around a sterile field is considered contaminated
- ✓Standard precautions apply to all body fluids except sweat, regardless of the client's infection status
Example Question
A nurse is assigned to care for a client with active pulmonary tuberculosis. Which precautions should the nurse implement?
Rationale
Active pulmonary tuberculosis is transmitted via airborne nuclei that remain suspended in the air for prolonged periods. Airborne precautions require a private negative-pressure room (which filters air and prevents organisms from escaping into the hallway), and the nurse must wear a fit-tested N95 respirator. A standard surgical mask (A, B) does not filter airborne particles smaller than 5 microns. Contact precautions (D) are for organisms transmitted by direct or indirect contact, not airborne transmission.
Common Mistakes
- ✗Confusing droplet and airborne precautions, particularly using a surgical mask when an N95 respirator is required for airborne diseases
- ✗Using alcohol-based hand sanitizer for C. difficile when only soap and water effectively removes spores
- ✗Breaking sterile technique by reaching over a sterile field, turning your back to it, or allowing items to fall below waist level
- ✗Forgetting that standard precautions apply to every client, not just those with known infections
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Common questions about infection control
Airborne precautions are for organisms that travel on tiny particles (less than 5 microns) that remain suspended in the air for long periods, such as TB, measles, and varicella. They require an N95 respirator and a negative-pressure room. Droplet precautions are for organisms that travel on larger respiratory droplets (greater than 5 microns) that fall to the ground within 3 feet, such as influenza and pertussis. They require a surgical mask but not a negative-pressure room.
Donning order (putting on): gown, mask or respirator, goggles or face shield, then gloves. Doffing order (removing): gloves first (most contaminated), then goggles or face shield, then gown, then mask or respirator. The mask is removed last during doffing because it protects your airway. Always perform hand hygiene after removing all PPE.