# A nurse orients a new graduate to CDC standard precautions versus transmission-based precautions. Which statements about standard precautions are correct? Select all that apply.

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> subject: NCLEX-RN  
> category: SIPC

## Question

A nurse orients a new graduate to CDC standard precautions versus transmission-based precautions. Which statements about standard precautions are correct? Select all that apply.

1

Standard precautions apply to the care of every patient regardless of suspected or confirmed diagnosis.

2

Standard precautions include hand hygiene, personal protective equipment based on the anticipated exposure, respiratory hygiene/cough etiquette, safe injection practices, and safe handling of contaminated equipment and environmental surfaces.

3

Standard precautions assume that every patient may be infected or colonized with a transmissible organism that could be present in blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes.

4

Transmission-based precautions are added to (not substituted for) standard precautions when an organism with a defined transmission route is suspected or confirmed.

5

Transmission-based precautions (contact, droplet, airborne) should be used instead of standard precautions when a patient is suspected of having an infection with a known transmission route.

## Explanation

Standard precautions are the foundation of infection prevention and apply universally — every patient, every encounter — based on the assumption that any patient may carry an infectious organism. Components: hand hygiene, PPE based on the anticipated exposure, respiratory hygiene, safe injection practices, safe equipment and environmental handling. Body fluid coverage applies to blood, secretions, excretions (except sweat), non-intact skin, mucous membranes. Transmission-based precautions (contact for MRSA/VRE/C. diff, droplet for influenza/Neisseria meningitidis, airborne for TB/measles/varicella) are ADDED to (not substituted for) standard precautions when a defined transmission route applies. Choice 5 is incorrect — transmission-based precautions are layered on top of standard precautions, never replace them.

## In-depth explanation

Standard precautions are the floor of every patient encounter, applied universally regardless of suspected or confirmed infection status. They include hand hygiene, PPE based on the anticipated exposure, respiratory hygiene and cough etiquette, safe injection practices, and safe handling of contaminated equipment and environmental surfaces. The fluid scope covers blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes. Transmission-based precautions are added on top of standard precautions when a specific route applies — contact for MRSA, VRE, and C. difficile; droplet for influenza, pertussis, Neisseria meningitidis, and bacterial meningitis; airborne for tuberculosis, measles, and varicella. The standard precautions framework persists even when transmission-based precautions are layered, never being replaced.

## Clinical scenario

A nurse orients a **new graduate** to **CDC standard precautions versus transmission-based precautions**. The new graduate evaluates statements about standard precautions.

## Key concepts

- **Standard Precautions** — Universal precautions applied to every patient. Components: hand hygiene, PPE for anticipated exposure, respiratory hygiene/cough etiquette, safe injection practices, safe equipment and environmental handling. Fluid scope: blood, body fluids, secretions, excretions (except sweat), non-intact skin, mucous membranes.
- **Transmission-Based Precautions** — Added to standard precautions for specific pathogens. Contact: MRSA, VRE, C. difficile, RSV — gown and gloves, dedicated equipment. Droplet: influenza, pertussis, meningococcus — surgical mask within 6 ft. Airborne: TB, measles, varicella — N95 respirator, negative-pressure room.
- **Layering Principle** — Transmission-based precautions are added to (never substituted for) standard precautions. The standard precaution framework — hand hygiene, environment, sharps safety — persists at every encounter, with the transmission-based layer changing the additional PPE and isolation environment.

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