Infectious Disease & Sepsis for the NCLEX-RN Exam

Common failure modes

These are the patterns that cause most candidates to lose marks on this topic. Recognising them in advance is half the work.

• !Drawing blood cultures AFTER starting antibiotics — cultures must come first
• !Mixing up contact (gown + gloves) with droplet (mask within 3–6 ft) and airborne (N95, negative-pressure room)
• !Treating SIRS as sepsis without confirming infection source
• !Missing the lactate trend — a rising lactate indicates worsening tissue hypoperfusion

Study tips

• 1Memorize the Hour-1 sepsis bundle: lactate, blood cultures (before abx), broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension or lactate ≥ 4.
• 2Drill isolation precautions by pathogen: TB, varicella, measles → airborne; influenza, pertussis → droplet; C. diff, MRSA → contact; COVID-19 → contact + airborne for AGPs.
• 3Know the central-line-associated bloodstream infection (CLABSI) bundle: hand hygiene, max barrier, chlorhexidine prep, optimal site, daily review of necessity.
• 4C. diff: soap-and-water hand hygiene (alcohol does not kill spores), bleach surface cleaning, contact precautions.

Sample NCLEX-RN Infectious Disease & Sepsis questions

These sample items mirror the format and difficulty of real NCLEX-RN questions. Practice with thousands more on the free Koydo question bank.

1. 1

   A client is admitted with suspected pulmonary tuberculosis. Which isolation precautions should the nurse implement?

   • AStandard precautions only
   • BContact precautions (gown and gloves)
   • CDroplet precautions (surgical mask within 3 feet)
   • DAirborne precautions (N95 respirator, negative-pressure room)Correct
   Why this answer?

   Tuberculosis requires airborne precautions: a fit-tested N95 respirator and a negative-pressure (AIIR) room with at least 6–12 air changes per hour. The patient should wear a surgical mask during transport. Other airborne pathogens include varicella and measles.