Infection control is one of the highest-yield areas on the NCLEX because it is testable in a single sentence: a client has X, which room and what do you put on? There is no reasoning to construct — either you know which category the organism belongs to, or you do not. That makes it unusually cheap to master.
The four levels
| Level | PPE | Room |
|---|---|---|
| Standard | Gloves; add gown, mask and eye protection when splash is likely | Any — used with every client, every time |
| Contact | Gown + gloves | Private room preferred; dedicated equipment |
| Droplet | Surgical mask within about 6 feet (many facilities mask on entry) | Private room; door may stay open |
| Airborne | N95 respirator (fit-tested) | Negative-pressure room, door closed |
Who goes where
Airborne — the short list, and the one worth memorising cold: Measles, Tuberculosis, Varicella (chickenpox), and disseminated herpes zoster. My Tiny Vehicle. These are the only ones needing a negative-pressure room and an N95.
Droplet — influenza, pertussis, mumps, rubella, Neisseria meningitidis, group A streptococcus, and most common respiratory viruses. Travels a short distance and falls; a surgical mask is enough.
Contact — C. difficile, MRSA, VRE, RSV, scabies, impetigo, and draining wounds. Anything spread by touching the client or their surroundings.
The exceptions the exam loves
- C. difficile: alcohol gel does not kill the spores. Soap and water, and bleach-based cleaning of surfaces. This is asked constantly.
- Varicella and disseminated zoster: airborne and contact together.
- Localised shingles on an immunocompetent client: contact only, if it can be covered.
- Meningococcal meningitis: droplet for the first 24 hours of effective antibiotics, then off.
- Neutropenic (protective) isolation is the reverse problem — you are protecting the client from the world. No fresh flowers, no raw fruit or vegetables, no visitors who are unwell.
The order matters, and it is asked
Putting on: gown → mask/respirator → goggles → gloves.
Taking off: gloves → goggles → gown → mask/respirator — with the mask removed outside the room for airborne precautions.
The logic is worth holding rather than the list: gloves are the dirtiest thing on you, so they come off first; the respirator protects you from air you are still standing in, so it comes off last.
Cheat sheets: airborne · droplet · contact · chemotherapy. Then drill it: safety and infection control questions.