Isolation Precautions Cheat Sheet for the NCLEX
Airborne vs droplet vs contact on one page: which diseases, which PPE, and the trap pairs the NCLEX loves.
One page, three categories, and the trap pairs that decide most isolation questions.
Airborne
Diseases: TB, measles (rubeola), varicella, disseminated herpes zoster. Mnemonic: My Tuberculosis Vaccine. PPE: N95 respirator, negative-pressure room, door closed. Patient wears a surgical mask (not an N95) during transport. Varicella and disseminated zoster take airborne PLUS contact.
Droplet
Diseases: influenza, pertussis, mumps, rubella, meningococcal meningitis, pharyngeal diphtheria, epiglottitis, group A strep (first 24h of antibiotics). PPE: surgical mask within 3 feet. Private room or cohort. No negative pressure needed. Mask the patient for transport.
Contact
Diseases: C. diff, MRSA, VRE, RSV, scabies, lice, rotavirus, norovirus, impetigo. PPE: gown and gloves for every room entry. Dedicated equipment (stethoscope, BP cuff stays in the room). C. diff and norovirus: wash hands with soap and water. Alcohol gel does not kill the spores.
The trap pairs
These pairs are where the points are: Rubeola (measles) is airborne. Rubella is droplet. Similar names, different masks. Localized zoster in an immunocompetent patient: standard precautions with the lesions covered. Disseminated zoster: airborne plus contact. Pertussis is droplet, not airborne, despite the violent cough. Meningitis: meningococcal gets droplet; viral meningitis gets standard. The organism decides, not the diagnosis. C. diff: contact plus soap and water. An option that says "use alcohol-based hand rub" is the planted wrong answer.
PPE order, since they test it
Donning: gown, mask, goggles, gloves. Doffing: gloves, goggles, gown, mask. Hand hygiene after doffing, always. Gloves come off first because they are the dirtiest item.
Frequently asked
What does the patient wear during transport?
A surgical mask for both airborne and droplet transport. The N95 is for staff, not the patient.
Does TB need contact precautions too?
No, airborne alone for pulmonary TB. The airborne-plus-contact combos are varicella and disseminated zoster.
When do standard precautions apply?
Every patient, every time, regardless of diagnosis. The other categories add to standard, they never replace it.
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