Place the following actions in the correct order for a nurse caring for a hospitalized client with new-onset unexplained diarrhea and suspected Clostridioides difficile infection.

Quick answer
The correct order is: 1) Move the client to a private room and initiate contact precautions; 2) Don gown and gloves, then assess the client for signs of severe disease and confirm the stool is unformed; 3) Collect a fresh unformed stool specimen and label it; 4) Notify the receiving department and arrange transport of the specimen; 5) Perform hand hygiene with soap and water after removing PPE.

Why this is correct
Isolation and contact precautions are the first priority to prevent transmission of C. difficile spores. Assessment and confirmation of testing appropriateness precede specimen collection to avoid unnecessary testing. Specimen collection follows assessment. Communication and transport of the specimen occur after collection. Hand hygiene with soap and water is performed after doffing PPE to remove spores from hands.

Clinical picture
C. difficile infection is a healthcare-associated infection spread via spores that can survive on surfaces for months. Contact precautions include a private room, gown and gloves for all room entry, and dedicated equipment. Testing should be performed only on unformed stool from symptomatic patients. Hand hygiene with soap and water is preferred over alcohol-based hand rubs because alcohol does not kill spores.

Memory hook
The sequence follows the nursing process: first ensure safety (isolation), then assess, then intervene (collect specimen), then communicate, then perform final hygiene. Remember: isolate before you investigate.

NCLEX decision rule
Follow the CDC 2026 acute-care guidance: isolate symptomatic patients with unexplained diarrhea immediately; do not wait for test results. Use gown and gloves for all contact with the patient or environment. Collect stool specimen only if unformed. Use soap and water for hand hygiene after caring for patients with suspected C. difficile.

Why the alternatives are wrong
If the client were already in a private room with contact precautions in place, the first action would be to don PPE and assess. If the stool were formed, testing would not be indicated and the nurse would reassess for other causes. If the client had severe disease (e.g., hypotension, ileus), the nurse would prioritize hemodynamic support and notify the provider before specimen collection.