RML MAINS 2025
Applied Microbiology & Infection control (E5)
Easy
What type of isolation is recommended for a patient with chickenpox (Varicella)?
Appeared in: RML MAINS 2025
Explanation
- Chickenpox (Varicella) is caused by the varicella-zoster virus, which spreads through small airborne droplet nuclei.
- These infectious particles are smaller than 5 microns and can remain suspended in the air for extended periods, traveling long distances.
- Airborne precautions are therefore required to prevent transmission via inhalation.
- This involves placing the patient in a negative-pressure room and requiring healthcare workers to wear an N95 respirator.
- While contact with skin lesions also transmits the virus (requiring contact precautions), airborne isolation is the primary and most critical measure.
Why Other Options Were Wrong
- Option B: Contact isolation alone is insufficient as it does not prevent the spread of the virus through the air. Chickenpox is highly transmissible via respiratory droplets.
- Option C: Droplet precautions are for pathogens transmitted by large droplets (greater than 5 microns) that do not remain suspended in the air and travel only short distances. Chickenpox is transmitted by smaller, airborne particles.
- Option D: Reverse isolation (or protective environment) is designed to protect the patient from the environment, not to protect others from the patient's infection.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Transmission-based precautions for infectious diseases to guide bedside assessment, documentation, and the next nursing action.
- Correctly identifying and implementing isolation precautions is a fundamental nursing responsibility to prevent healthcare-associated infections (HAIs) and protect patients, staff, and visitors.
- For chickenpox, it is critical to remember that both airborne and contact precautions are necessary. This is referred to as 'strict isolation' in some contexts.
- A patient with chickenpox should be placed in an Airborne Infection Isolation Room (AIIR) immediately upon suspicion of the diagnosis to prevent nosocomial outbreaks.
How to Approach the Question
- First, identify the key terms in the question: 'chickenpox (Varicella)' and 'type of isolation'.
- Recall the mode of transmission for chickenpox. The varicella-zoster virus is spread primarily through respiratory droplets that become aerosolized (airborne). It can also be spread by contact with lesions.
- Consider the different types of isolation precautions and their corresponding transmission routes.
- Match the primary mode of transmission (airborne) to the correct precaution. Airborne precautions are specifically for diseases transmitted by small particles that remain suspended in the air.
- Evaluate the other options. Contact precautions are also used but are not the primary type for preventing respiratory spread. Droplet precautions are for larger particles. Reverse isolation is for protecting the patient, not others.
- Conclude that Airborne isolation is the most appropriate and critical precaution.
Concept Tested & Keywords
- Concept Tested: Transmission-based precautions for infectious diseases
- Stem keywords: isolation, chickenpox, Varicella
- Lead-in keywords: What type
- Negative lead-in flag: false
Question ID
QsjbOutlsm3CL_0joqGVYd
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 43-45
E6 Microbiology Applied AnjuDhir 3e Part 2 pp. 144-146, 143-145
Practise the full RML MAINS 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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