A nurse is caring for a client newly admitted with suspected methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Which actions are required by Contact and Droplet Precautions? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
MRSA pneumonia requires both Contact Precautions (private/cohort room, gloves and gown for all contact) and Droplet Precautions (surgical mask within 3-6 ft / when entering the room). N95 respirators are required for AIRBORNE precautions (TB, measles, varicella) — MRSA is droplet, not airborne. Visitors are not blanket-restricted; they receive PPE education and follow the same precautions. During transport, the client must wear a surgical mask to contain droplets even if other PPE is removed.
Clinical Judgment The core of this question is identifying the transmission route → selecting the appropriate isolation level. MRSA pneumonia is transmitted via large droplets (>5μm) from respiratory secretions, so the standard is Droplet + Contact simultaneously. Using the NCJMM: Recognize Cues (MRSA pneumonia) → Analyze (droplet + contact route) → Generate Solutions (PPE, isolation room, mask) → Take Action (select options 1, 2, and 3 simultaneously).
Memory Tip My Chicken Has TB = 4 Airborne diseases (Measles, Chickenpox, Herpes zoster disseminated, TB). Most other respiratory infections are Droplet (influenza, pertussis, meningococcal, MRSA pneumonia, COVID-19). N95 is for Airborne only!
KR vs US In Korean clinical practice, the perception that "respiratory infection = N95" is common, but the NCLEX strictly differentiates Droplet and Airborne according to CDC guidelines. MRSA pneumonia is Droplet (surgical mask), while TB and measles are Airborne (N95 + negative pressure room) — this is tested very frequently.
Clinical Practice GuideCDC 2007 guidelines + 2022 update: Droplet precautions require a surgical mask for activities within 1m (3ft), a private room or cohorting, and a mask on the patient during transport. Contact precautions require gloves and gown for all patient contact, a private room or cohorting, and enhanced cleaning of environmental surfaces.
CautionIn SATA, "select all that apply" but selecting an extra incorrect option results in a penalty (plus-minus scoring). The NCLEX does not tell you the number of correct answers, so judge each option independently as True/False. Options 1, 2, and 3 are the 3 basic elements of Contact + Droplet standard precautions.
MRSA (Methicillin-Resistant Staphylococcus aureus, 메티실린 내성 황색포도알균) — 베타락탐계 항생제(메티실린 등) 내성을 가진 황색포도알균. 병원 내(HA-MRSA)·지역사회(CA-MRSA) 모두 발생. 폐렴·균혈증·수술부위 감염의 주요 원인이며 vancomycin·linezolid가 1차 치료.
Droplet Precautions (비말 예방조치) — 5μm 초과 큰 비말로 전파되는 감염병(인플루엔자, 백일해, 수막구균, MRSA 폐렴 등) 차단. 외과 마스크, 1인실 또는 코호트, 환자에게도 이송 시 마스크 필수. N95는 불필요.
Airborne Precautions (공기매개 예방조치) — 5μm 이하 미세 비말핵으로 공기 중 장기 부유하는 병원체(결핵, 홍역, 수두, 파종성 대상포진) 차단. 음압 격리실(AIIR) + N95 호흡기. MRSA에는 적용하지 않음.