PPE Donning And Doffing - NCLEX Pn

1. What is the first action to take immediately before donning any PPE for patient care?

   Perform hand hygiene. Hand hygiene removes transient microorganisms from hands, preventing their transfer to PPE and subsequent patient contamination during care.

2. What should you do immediately after removing all PPE to reduce transmission risk?

   Perform hand hygiene. Hand hygiene eliminates any residual microorganisms that may have transferred during doffing, reducing the risk of pathogen transmission.

3. What is the key purpose of gloves in PPE use during patient care?

   Protect hands from contact with blood/body fluids and contaminants. Gloves create a protective barrier against pathogens in blood, body fluids, or on surfaces, preventing direct hand exposure during procedures.

4. Which option is correct: remove PPE inside the patient room or after leaving for contact precautions?

   Remove PPE inside the room (before exit), then perform hand hygiene. Removing PPE inside confines contamination to the isolation area, with hand hygiene afterward eliminating any residual microbes.

5. What is the correct sequence for doffing PPE when gloves, goggles, gown, and mask are worn?

   Gloves → goggles/face shield → gown → mask/respirator. This sequence starts with the most contaminated items to reduce self-contamination, ending with the mask to maintain respiratory protection until the end.

6. Which isolation category requires a fit-tested N95 (or higher) rather than a surgical mask?

   Airborne precautions. Airborne precautions involve pathogens that remain suspended in air, requiring a respirator to filter small particles, unlike larger droplets blocked by surgical masks.

7. Which PPE item is removed first during doffing because it is usually the most contaminated?

   Gloves. Gloves are typically the most contaminated due to direct contact with patients and surfaces, so removing them first minimizes spreading pathogens to other PPE or skin.

8. What additional PPE is typically required for droplet precautions beyond standard precautions?

   Surgical mask (plus eye protection if splash risk). Droplet precautions target large particles from coughs or sneezes, with a mask providing respiratory protection and eye wear added for potential fluid splashes.

9. Which option is correct: don gloves before or after securing the gown at neck and waist?

   After securing the gown. Securing the gown first ensures full coverage before gloves are donned to overlap and seal the cuffs, maintaining a continuous barrier.

10. Identify the correct action if you must adjust goggles after donning gloves and gown.

    Avoid touching face; if adjustment needed, perform hand hygiene and re-glove. Touching the face with gloved hands risks contamination, so hygiene and re-gloving ensure clean adjustment without breaching PPE integrity.

11. What additional PPE is added for contact precautions beyond standard precautions?

    Gown and gloves upon room entry. Contact precautions prevent transmission via direct touch or contaminated surfaces, necessitating barriers like gown and gloves for all room entries.

12. What is the correct way to remove a mask or respirator to avoid contaminating hands?

    Handle only the ties/ear loops; do not touch the front. The front is considered contaminated, so handling only clean ties or loops prevents transferring pathogens to hands.

13. What is the correct sequence for donning PPE when gown, mask/respirator, goggles, and gloves are needed?

    Gown → mask/respirator → goggles/face shield → gloves. This order ensures the gown covers clothing first, followed by respiratory protection, eye coverage, and finally gloves to seal over gown cuffs, minimizing contamination risks.

14. What should you do if your hands become visibly soiled after removing PPE?

    Wash with soap and water. Visible soil requires mechanical removal with soap and water, as alcohol-based sanitizers are ineffective against certain pathogens like C. difficile spores.

15. Which option is correct for N95 use: place respirator on before or after the gown during donning?

    After the gown and before eye protection and gloves. Placing the respirator after the gown but before other items allows proper fit and sealing without interference from eye protection or gloves.

16. What is the key purpose of eye protection (goggles/face shield) in PPE use?

    Protect mucous membranes of eyes from splashes and sprays. Eye protection shields the conjunctiva from infectious droplets or sprays generated during patient care activities like suctioning.

17. Identify the correct action if you touch the front of your mask while doffing PPE.

    Perform hand hygiene immediately. The front of the mask is contaminated, so touching it requires immediate hygiene to remove transferred pathogens and prevent self-inoculation.

18. What is the correct way to remove goggles or a face shield to avoid contamination?

    Handle only the strap/arms; do not touch the front surface. The front surface is potentially contaminated from splashes, so touching only clean straps or arms avoids hand contamination.

19. What is the correct technique to remove gloves to avoid contaminating bare hands?

    Glove-in-glove removal (peel off, then slide fingers under cuff). This method contains contaminants inside the gloves by inverting them during removal, preventing contact with bare skin.

20. What is the key purpose of a gown in PPE use during patient care?

    Protect skin and clothing from contamination. Gowns act as a barrier against microorganisms and body fluids, preventing their adherence to underlying skin or clothing during close patient contact.

21. What is the correct technique to remove a gown to prevent contaminating scrubs or skin?

    Unfasten ties, pull away from neck/shoulders, turn inside out, roll. This technique contains contaminants on the inside of the gown by turning it outward while rolling, avoiding contact with underlying clothing or skin.

22. Which type of mask is appropriate for droplet precautions when no aerosol-generating procedure is occurring?

    Surgical mask. Droplet precautions protect against large respiratory particles, which a surgical mask effectively blocks without needing the higher filtration of an N95.

23. Identify the correct action if a glove tears during patient care while using PPE.

    Stop task, remove gloves, perform hand hygiene, don new gloves. A tear compromises the barrier, requiring immediate replacement after hygiene to prevent pathogen exposure and maintain asepsis.

24. What is the correct action if you must re-enter an isolation room shortly after doffing PPE?

    Don a new set of PPE; do not reuse disposable PPE. Disposable PPE is single-use to prevent cross-contamination, requiring fresh items for each entry to maintain infection control standards.

25. Which PPE item is removed last during doffing to reduce inhalation exposure risk?

    Mask or respirator. Removing the mask last maintains respiratory protection during the doffing process when aerosolized particles may still be present.

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