# An infection-prevention nurse assigns initial transmission-based precautions in addition to Standard Precautions. Diagnoses below are confirmed or strongly suspected as stated. Use one complete category per record: Contact, Droplet, Airborne, or Airborne plus Contact. Assign each record once; categories accept multiple records and have no quotas. Consider lesion extent, immune status and the ability to contain secretions or drainage. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=en > language: en > subject: Standard/Transmission-Based Precautions/Surgical Asepsis > category: SIPC ## Question An infection-prevention nurse assigns initial transmission-based precautions in addition to Standard Precautions. Diagnoses below are confirmed or strongly suspected as stated. Use one complete category per record: Contact, Droplet, Airborne, or Airborne plus Contact. Assign each record once; categories accept multiple records and have no quotas. Consider lesion extent, immune status and the ability to contain secretions or drainage. **1.** An unvaccinated adult has laboratory-confirmed measles with cough and a generalized rash; there is no separate contact-transmitted infection. Select a category Contact Droplet Airborne Airborne plus Contact **2.** A transplant recipient has new vesicles in several nonadjacent dermatomes and scattered lesions on the trunk; disseminated zoster is diagnosed. Select a category Contact Droplet Airborne Airborne plus Contact **3.** A young adult has suspected meningococcal meningitis and has not yet received effective antimicrobial therapy. Select a category Contact Droplet Airborne Airborne plus Contact **4.** After antibiotic exposure, an adult has frequent uncontained diarrhea and a positive test supporting symptomatic Clostridioides difficile infection. Select a category Contact Droplet Airborne Airborne plus Contact **5.** An adult with cavitary pulmonary disease has sputum testing confirming infectious pulmonary tuberculosis and no other isolation indication. Select a category Contact Droplet Airborne Airborne plus Contact **6.** An adult with fever and lesions in successive stages is diagnosed with varicella; several vesicles remain uncrusted. Select a category Contact Droplet Airborne Airborne plus Contact **7.** An adult has laboratory-confirmed influenza with active cough; no aerosol-generating procedure is being performed and no other infection is suspected. Select a category Contact Droplet Airborne Airborne plus Contact **8.** A large infected surgical wound produces drainage that repeatedly escapes the dressing; no airborne or droplet pathogen is identified. Select a category Contact Droplet Airborne Airborne plus Contact ## Explanation Contact: symptomatic C. difficile and uncontained major wound drainage. Droplet: meningococcal meningitis and influenza. Airborne: measles and pulmonary TB. Airborne plus Contact: disseminated zoster and varicella. Some pathogens require a combined category. Measles requires Airborne plus Standard, whereas varicella and disseminated zoster require Airborne plus Contact plus Standard. The extent and containment of lesions or drainage changes the relevant contact risk. ## In-depth explanation Correct answer Contact: symptomatic C. difficile and uncontained major wound drainage. Droplet: meningococcal meningitis and influenza. Airborne: measles and pulmonary TB. Airborne plus Contact: disseminated zoster and varicella. Why this is correct Some pathogens require a combined category. Measles requires Airborne plus Standard, whereas varicella and disseminated zoster require Airborne plus Contact plus Standard. The extent and containment of lesions or drainage changes the relevant contact risk. Clinical picture Transmission-based precautions are added to Standard Precautions. Implementation includes the appropriate room, protective equipment and local infection-prevention procedures; classification alone does not specify every operational detail. Memory hook One record, one complete precaution package. A combined package is a distinct answer, not permission to omit one of its components. NCLEX decision rule Use pathogen-specific recommendations and the stated clinical modifiers. Do not infer that all viral rashes require the same combination, or that a covered localized lesion behaves like disseminated disease. Why the alternatives are wrong Record 1 requires Airborne, not the combined category solely because a rash exists. Record 2 describes disseminated disease in an immunocompromised host, supporting Airborne plus Contact. Record 3 requires Droplet at the stated untreated stage. Record 4 has active symptomatic uncontained enteric infection requiring Contact. Record 5 requires Airborne for infectious pulmonary disease. Record 6 has active uncrusted varicella requiring both routes of precaution. Record 7 uses routine influenza care without an aerosol-generating procedure, supporting Droplet. Record 8 is major uncontained drainage, not a minor wound reliably covered by a dressing. Equal counts happen in this set but are not supplied as response capacities. Sources CDC isolation precautions Appendix A ## Clinical scenario Practice transfer: Transmission-based precautions are added to Standard Precautions. Implementation includes the appropriate room, protective equipment and local infection-prevention procedures; classification alone does not specify every operational detail. ## Key concepts - **Transmission-based precautions** — Additional precautions selected for an infectious agent and route of spread. - **Disseminated zoster** — Zoster with spread beyond a localized distribution. - **Containment** — Reliable restriction of infectious drainage or secretions at their source. ## Related questions - [A nurse is caring for a client newly admitted with suspected methicillin-resistant Staphyl…](https://mymerci.kr/pages/nclex_q.php?qn_id=360517&lang=en) - [A nurse is about to enter the room of a client with Clostridioides difficile infection dur…](https://mymerci.kr/pages/nclex_q.php?qn_id=361226&lang=en) - [A 22-year-old female client presents to the emergency department with a 4-week history of …](https://mymerci.kr/pages/nclex_q.php?qn_id=361677&lang=en) - [A 65-year-old client admitted to the medical ICU with sepsis and acute delirium has just p…](https://mymerci.kr/pages/nclex_q.php?qn_id=361679&lang=en) - [A new graduate registered nurse (RN) on a medical unit just hung an intravenous antibiotic…](https://mymerci.kr/pages/nclex_q.php?qn_id=361710&lang=en) - [A nurse is caring for a client newly admitted with active Clostridioides difficile infecti…](https://mymerci.kr/pages/nclex_q.php?qn_id=363996&lang=en) - [A nurse is caring for an adult client newly admitted with suspected active pulmonary tuber…](https://mymerci.kr/pages/nclex_q.php?qn_id=366306&lang=en) - [A nurse cares for a client newly admitted with a positive surveillance culture for vancomy…](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=569398&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._