PPE Donning And Doffing
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NCLEX-PN › PPE Donning And Doffing
A nurse must quickly respond to a client in a private room with suspected meningococcal infection who is actively coughing; droplet precautions are posted, and PPE available includes gown, gloves, surgical mask, and face shield. Which PPE item should the nurse don FIRST?
Don the surgical mask and secure it over the nose and mouth
Don the face shield over the eyes and face
Don gloves, extending them to cover the wrists
Don the gown and fasten at the neck and waist
Explanation
This question tests safety and infection prevention through PPE usage in urgent droplet precaution situations. The correct PPE donning sequence remains critical even in urgent situations to ensure healthcare worker protection from respiratory droplets. The gown (D) should be donned first as it provides the foundation layer and must be properly secured before applying other PPE items. The surgical mask (A) is applied after the gown to protect from respiratory droplets, followed by face shield (B) for additional eye protection, with gloves (C) always being the last item applied. This sequence follows the principle of establishing clean protective barriers in the correct order, even when responding quickly to patient needs. Healthcare workers should practice the standard donning sequence regularly so it becomes automatic even in urgent situations, remembering 'GMEG' (Gown, Mask, Eye protection, Gloves).
A nurse exits a droplet isolation room after administering nebulized medication to a client with influenza; the nurse wore gloves, gown, surgical mask, and a face shield. What is the correct sequence for doffing PPE?
Gloves, face shield, gown, mask, then hand hygiene
Face shield, mask, gown, gloves, then hand hygiene
Mask, face shield, gloves, gown, then hand hygiene
Gloves, gown, face shield, mask, then hand hygiene
Explanation
This question tests safety and infection prevention through PPE usage during doffing after aerosol-generating procedures. The correct PPE doffing sequence is especially critical after exposure to respiratory aerosols to prevent self-contamination during removal. The correct sequence (B) removes gloves first as the most contaminated items, followed by gown, then face shield, mask, and finally hand hygiene. Options A and D incorrectly remove facial PPE before more contaminated items, while option C removes the face shield before the gown, potentially contaminating the face shield straps. The principle of infection prevention requires removing PPE from most to least contaminated, with special attention after aerosol-generating procedures where all PPE may have higher contamination levels. Healthcare workers should remember that the standard doffing sequence (gloves, gown, eye protection, mask, hand hygiene) provides maximum protection regardless of the type of precautions or procedures performed.
A nurse is assisting with a sterile bedside procedure (central line dressing change) for a client; there is risk of blood splash, and the nurse will wear gloves, a gown, a surgical mask, and eye protection. Which PPE item should the nurse don FIRST?
Don the gown
Don eye protection
Don sterile gloves
Don the surgical mask
Explanation
This question tests safety and infection prevention through PPE usage during sterile procedures. The correct PPE donning sequence for sterile procedures follows the same principles as standard precautions, with the gown being donned first to establish the foundation layer. The gown (C) should be donned first, followed by the surgical mask (B) and eye protection (D), with sterile gloves (A) always being donned last to maintain their sterility. Donning sterile gloves before other PPE would contaminate them, while donning the mask or eye protection first would leave the clothing unprotected during application. The principle of infection prevention during sterile procedures requires maintaining both a protective barrier and sterile technique throughout the process. Healthcare workers should remember that the donning sequence remains consistent whether using clean or sterile gloves, with gloves always being the final item applied.
A nurse is preparing to enter an isolation room to administer oral medications to a client with a contagious respiratory infection requiring droplet precautions; the nurse plans to wear gloves, gown, surgical mask, and eye protection. The nurse should QUESTION which PPE practice?
Performing hand hygiene before donning any PPE
Placing eye protection after the mask is secured
Donning gloves before the gown to save time
Ensuring the gown fully covers the torso and ties are secured
Explanation
This question tests safety and infection prevention through PPE usage by identifying incorrect donning practices. The correct PPE donning sequence requires that each item be applied in the proper order to maintain the integrity of the protective barrier. The nurse should question donning gloves before the gown (B) because gloves must always be donned last and pulled over the gown cuffs to create a continuous barrier. Performing hand hygiene before donning PPE (A) is correct practice, placing eye protection after the mask (C) follows proper sequence, and ensuring proper gown coverage (D) is essential for protection. The principle of infection prevention requires maintaining an unbroken protective barrier by ensuring gloves overlap gown cuffs, preventing exposure of skin or clothing. Healthcare workers should remember that gloves are always the last item donned to avoid contaminating other PPE during application.
After providing routine care for a client on contact precautions for Clostridioides difficile infection, the nurse removes PPE at the doorway; the nurse wore gloves, gown, surgical mask, and eye protection due to possible splash during hygiene care. What is the correct sequence for doffing PPE?
Gloves, gown, eye protection, mask, then hand hygiene
Gown, gloves, mask, eye protection, then hand hygiene
Gloves, gown, mask, eye protection, then hand hygiene
Eye protection, mask, gown, gloves, then hand hygiene
Explanation
This question tests safety and infection prevention through PPE usage during the doffing process for contact precautions. The correct PPE doffing sequence prevents self-contamination by removing items from most to least contaminated, with special attention to the order of facial PPE removal. The correct sequence (C) removes gloves first as the most contaminated item, then gown, followed by eye protection, mask, and finally hand hygiene. Options A and B incorrectly place mask removal before eye protection, while option D removes eye protection and mask in the wrong order relative to more contaminated items. The principle of infection prevention requires removing PPE that contacts the patient first, then items protecting the face in order from furthest to closest to the respiratory tract. Healthcare workers should remember to remove eye protection before the mask to avoid contaminating the face when reaching behind the head for mask ties or loops.
A nurse is preparing to enter an isolation room to reposition a client with a contagious respiratory infection; required PPE includes gloves, gown, surgical mask, and eye protection. The nurse should QUESTION which PPE practice?
Pulling the gown off by the sleeves and rolling it inside out
Removing the mask by the ear loops or ties without touching the front
Wearing the same eye protection into the next client room without cleaning it
Performing hand hygiene after all PPE is removed
Explanation
This question tests safety and infection prevention through PPE usage by identifying unsafe practices. The correct use of PPE requires following proper techniques for both donning and doffing, as well as appropriate handling between uses. The nurse should question wearing the same eye protection into the next client room without cleaning it (D), as this would spread pathogens between patients and violates infection control principles. Removing the mask by ear loops without touching the front (A) is correct technique, performing hand hygiene after PPE removal (B) is required practice, and pulling the gown off by the sleeves while rolling inside out (C) is an acceptable alternative to the standard shoulder-pull method. The principle of infection prevention requires that reusable PPE be properly cleaned and disinfected between patients to prevent cross-contamination. Healthcare workers should remember that all PPE must be either disposed of or properly disinfected between patient encounters to maintain safety standards.
A nurse is preparing to enter an airborne isolation room to assess a client with suspected tuberculosis who is coughing frequently; the anteroom contains a gown, gloves, an N95 respirator, and a face shield. Which PPE item should the nurse don FIRST before entering the room?
Put on the face shield over the eyes and face
Put on gloves, extending them over the gown cuffs
Put on the gown and tie it at the neck and waist
Put on the N95 respirator and complete a seal check
Explanation
This question tests safety and infection prevention through PPE usage in airborne isolation settings. The correct PPE donning sequence is critical to prevent self-contamination and ensure proper protection, with the standard order being gown, mask/respirator, eye protection, then gloves. The gown (B) should be donned first as it provides the foundation layer of protection and must be secured before other PPE items are applied. The N95 respirator (A) is donned after the gown, followed by face shield (D), with gloves (C) always being the last item to prevent contaminating other PPE during application. This sequence follows the principle of working from least to most contaminated areas, establishing clean barriers before handling potentially contaminated surfaces. Healthcare workers should remember the donning sequence as 'GMEG' (Gown, Mask, Eye protection, Gloves) to ensure consistent safety practices.
A nurse has completed suctioning for a client in droplet isolation for influenza; the nurse is wearing gloves, gown, surgical mask, and goggles. What is the correct sequence for doffing PPE to reduce self-contamination?
Goggles, mask, gown, gloves, then hand hygiene
Mask, goggles, gloves, gown, then hand hygiene
Gloves, goggles, gown, mask, then hand hygiene
Gloves, gown, goggles, mask, then hand hygiene
Explanation
This question tests safety and infection prevention through PPE usage during the doffing process. The correct PPE doffing sequence is crucial to prevent self-contamination when removing potentially contaminated equipment, following the principle of removing the most contaminated items first. Gloves (C) are removed first as they are the most contaminated, followed by gown, then goggles, and finally the mask, with hand hygiene performed last. Option A incorrectly removes goggles before more contaminated items, option B removes goggles too early in the sequence, and option D removes the mask before eye protection, which could lead to contamination. The principle of infection prevention requires removing PPE in order from most to least contaminated, working from the outside in toward the respiratory tract. Healthcare workers can remember the doffing sequence as removing items that touch the patient first, then working toward items protecting the airways.
A nurse is leaving a contact isolation room after changing a wound dressing for a client with methicillin-resistant Staphylococcus aureus (MRSA); the nurse is wearing gloves, gown, surgical mask, and eye protection due to splash risk. Which step should the nurse take IMMEDIATELY after removing gloves?
Remove eye protection by handling the front of the goggles
Perform hand hygiene
Remove the gown by breaking the ties and rolling it inside out
Remove the surgical mask by pulling the front away from the face
Explanation
This question tests safety and infection prevention through PPE usage, specifically focusing on hand hygiene during the doffing sequence. The importance of correct PPE doffing sequence includes performing hand hygiene at critical points to prevent cross-contamination between PPE items. Hand hygiene (B) should be performed immediately after removing gloves because gloves are the most contaminated PPE item and hands may have become contaminated during removal. Removing the gown (A) without first performing hand hygiene could contaminate the gown ties, while removing eye protection (C) or mask (D) by touching contaminated areas would spread pathogens to the face. The principle of infection prevention requires hand hygiene after removing each contaminated PPE item, especially gloves, to break the chain of transmission. Healthcare workers should remember to perform hand hygiene immediately after glove removal and again after all PPE is removed to ensure complete decontamination.
A nurse is doffing PPE after collecting a nasopharyngeal swab from a client with a contagious respiratory infection; the nurse is wearing gloves, gown, surgical mask, and goggles. Which step should the nurse take IMMEDIATELY after removing gloves?
Perform hand hygiene
Remove goggles by touching the front surface to lift them away
Remove the surgical mask by pulling the front off the face
Put on a clean pair of gloves before removing the gown
Explanation
This question tests safety and infection prevention through PPE usage, emphasizing critical hand hygiene points during doffing. The importance of correct PPE doffing sequence includes performing hand hygiene at specific intervals to prevent cross-contamination between PPE items and self-contamination. Hand hygiene (B) must be performed immediately after removing gloves because hands may have become contaminated during the removal process and before touching any other PPE. Removing goggles by touching the front (A) would contaminate hands with pathogens, removing the mask by the front (C) spreads contamination, and putting on clean gloves (D) before removing the gown is unnecessary and wasteful. The principle of infection prevention requires hand hygiene after removing the most contaminated items (gloves and gown) to prevent spreading pathogens when removing facial PPE. Healthcare workers should remember that hand hygiene is required immediately after glove removal and again after all PPE is removed.