# For each condition, select the transmission-based precautions required for routine inpatient care beyond Standard Precautions. Select all that apply in each row.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393398&lang=en  
> language: en  
> subject: Standard/Transmission-Based Precautions/Surgical Asepsis  
> category: SIPC

## Question

For each condition, select the transmission-based precautions required for routine inpatient care beyond Standard Precautions. Select all that apply in each row.

|  | Airborne infection isolation room and fit-tested N95 or higher respirator | Droplet Precautions with a medical mask on room entry | Contact Precautions with gown and gloves on room entry | Dedicated or appropriately disinfected patient-care equipment |
| --- | --- | --- | --- | --- |
| Suspected infectious pulmonary tuberculosis |  |  |  |  |
| Suspected or confirmed seasonal influenza during routine care |  |  |  |  |
| Clostridioides difficile diarrhea |  |  |  |  |
| MRSA wound infection in an acute-care inpatient |  |  |  |  |

## Explanation

Suspected infectious pulmonary tuberculosis requires Airborne Precautions with an airborne infection isolation room and a fit-tested N95 or higher respirator. Seasonal influenza requires Droplet Precautions with a medical mask on room entry for routine care. Clostridioides difficile diarrhea and inpatient MRSA require Contact Precautions with gown and gloves; use dedicated or appropriately disinfected equipment. For C. difficile, clean the environment with a sporicidal agent. Current CDC hand-hygiene guidance does not make soap and water an absolute in every C. difficile encounter: use soap and water when hands are visibly soiled and follow outbreak and facility policy; otherwise alcohol-based hand sanitizer remains preferred in most clinical situations.

## In-depth explanation

Correct Answer
Tuberculosis: airborne infection isolation room plus a fit-tested N95 or higher respirator. Seasonal influenza: Droplet Precautions with a medical mask on room entry. C. difficile and MRSA: Contact Precautions with gown and gloves plus dedicated or appropriately disinfected equipment.

Why It Fits
Transmission-Based Precautions are added to Standard Precautions according to how the organism spreads. Airborne, droplet, and contact controls are not interchangeable.

Clinical Picture
Tuberculosis can remain suspended in air and requires respiratory protection and an airborne infection isolation room. Influenza is managed with Droplet Precautions for routine care. C. difficile spores and MRSA can spread through direct contact and contaminated equipment or surfaces.

Memory Link
TB: air. Flu: droplets. C. diff and MRSA: contact.

NCLEX Rule
Apply Standard Precautions to all clients, then add only the transmission-based controls supported by the organism and activity. Do not rely on a fixed distance phrase when current guidance says to don a mask on room entry for Droplet Precautions.

Why the Alternatives Fail
A medical mask alone does not protect staff from infectious pulmonary tuberculosis. An airborne room is not routinely required for seasonal influenza, C. difficile, or MRSA. Contact organisms also require attention to equipment and environmental cleaning, not PPE alone.

Source
1CDC: Precautions to Prevent Transmission
2CDC: C. difficile Infection Prevention
3CDC: Clinical Safety and Hand Hygiene
4CDC: MRSA Infection Control

## Clinical scenario

An infection prevention nurse is orienting acute-care staff. The scenarios involve routine care, not an aerosol-generating procedure. Apply Standard Precautions to every client, then add the indicated transmission-based precautions.

## Key concepts

- **Airborne Precautions** — Place the client in an airborne infection isolation room. Healthcare personnel use a fit-tested NIOSH-approved N95 or higher respirator when required for the pathogen and activity.
- **Droplet Precautions** — Use a medical mask, generally donned on room entry, for routine care of a client with a droplet-transmitted infection such as seasonal influenza. Special air handling is not routinely required.
- **Contact Precautions** — Wear gown and gloves on room entry and use dedicated or appropriately disinfected equipment. Apply organism-appropriate environmental cleaning and current hand-hygiene guidance, including soap and water when hands are visibly soiled and outbreak or facility policy when applicable.

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