PPE Donning And Doffing Sequence

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NCLEX-RN › PPE Donning And Doffing Sequence

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1

A nurse in a long-term care facility is leaving the room of a resident on droplet precautions for a productive cough. The nurse wore gloves, a gown, a surgical mask, and eye protection. What is the proper order for doffing PPE after providing care?

Remove gloves, remove eye protection, remove surgical mask, remove gown, perform hand hygiene

Remove gloves, remove gown, remove eye protection, remove surgical mask, perform hand hygiene

Remove surgical mask, remove eye protection, remove gown, remove gloves, perform hand hygiene

Remove gown, remove gloves, remove surgical mask, remove eye protection, perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use during doffing after droplet precaution care. The correct sequence for doffing PPE is: remove gloves, remove gown, remove eye protection, remove surgical mask, then perform hand hygiene (answer A). This follows the best practice for infection control because it removes items from most to least contaminated - gloves (highest contamination from direct contact), gown (body contamination), eye protection (potential droplet contamination), mask (respiratory protection removed last to maintain protection during doffing), ending with hand hygiene. Answer B removes mask and eye protection before the contaminated gown and gloves; answer C removes gown before gloves; answer D removes eye protection and mask in the wrong order. The principle is to maintain respiratory protection as long as possible while removing contaminated items first. Remember the doffing sequence 'GGEMH': Gloves, Gown, Eye protection, Mask, Hands - protecting yourself throughout the process.

2

In the emergency department, a nurse has completed care for a trauma client with active bleeding and risk of blood exposure. The nurse wore gloves, a gown, a surgical mask, and a face shield for splash protection. What is the proper order for doffing PPE after providing care?

Remove face shield, remove mask, remove gown, remove gloves, perform hand hygiene

Remove gloves, remove gown, remove face shield, remove mask, perform hand hygiene

Remove gown, remove gloves, remove mask, remove face shield, perform hand hygiene

Remove gloves, remove face shield, remove gown, remove mask, perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use during doffing procedures. The correct sequence for doffing PPE is: remove gloves, remove gown, remove face shield, remove mask, then perform hand hygiene (answer D). This follows the best practice for infection control because it removes the most contaminated items first (gloves and gown that directly contacted the patient/environment), then removes face protection in order of contamination risk, and ends with hand hygiene to remove any microorganisms acquired during doffing. Answer A removes gloves first but then incorrectly removes face shield before gown; answer B removes face shield and mask before the heavily contaminated gown and gloves; answer C removes gown before gloves, risking contamination of hands and arms. The principle is to remove PPE from most to least contaminated, minimizing self-contamination during the process. Remember 'GGFMH' for doffing: Gloves, Gown, Face shield, Mask, Hands - removing dirty items first and ending clean.

3

In a hospital, a nurse has finished changing linens for a client with a draining wound on contact precautions. The nurse wore a gown and gloves to reduce the risk of transferring microorganisms from contaminated surfaces. What is the proper order for doffing PPE after providing care?

Perform hand hygiene, remove gloves, remove gown, perform hand hygiene

Remove gloves, perform hand hygiene, remove gown, perform hand hygiene

Remove gloves, remove gown, perform hand hygiene

Remove gown, remove gloves, perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use for basic contact precautions. The correct sequence for doffing PPE is: remove gloves, remove gown, then perform hand hygiene (answer D). This follows the best practice for infection control because it removes the contaminated gloves first (as they directly contacted surfaces), then removes the gown (which may have contacted the environment), and concludes with hand hygiene to eliminate any microorganisms acquired during patient care or doffing. Answer A incorrectly adds an extra hand hygiene step between gloves and gown removal; answer B removes the gown before gloves, risking contamination of hands and arms; answer C begins with hand hygiene before removing contaminated PPE, which is illogical and wasteful. The principle is to follow a simple, efficient sequence that minimizes contamination risk without unnecessary steps. Remember 'GGH' for basic doffing: Gloves, Gown, Hands - a streamlined approach for contact precautions.

4

A nurse in a hospital exits the room of a client on droplet precautions for respiratory syncytial virus. The nurse wore gloves, a gown, a surgical mask, and eye protection during care. Which PPE item should be removed FIRST after exiting the client area?

Eye protection (goggles or face shield)

Surgical mask

Gown

Gloves

Explanation

This question tests infection control and safe practice in PPE use, specifically identifying which item to remove first during doffing. The first PPE item to remove is always gloves (answer D). This follows the best practice for infection control because gloves are typically the most contaminated PPE item, having directly contacted the patient and environmental surfaces, and removing them first prevents spreading contamination to other PPE or clean areas during the doffing process. Answer A (surgical mask), answer B (eye protection), and answer C (gown) are all incorrect because these items are less contaminated than gloves and removing them first would require touching them with contaminated gloves, increasing the risk of self-contamination. The fundamental principle is that doffing begins with the dirtiest items to minimize contamination spread. A key strategy is to always think 'gloves first' when doffing - they're your most contaminated barrier and must be removed before touching any other PPE.

5

A nurse in a hospital is preparing to enter the room of an adult client with Clostridioides difficile infection on contact precautions to administer oral medications. The nurse will wear a gown and gloves to prevent transmission via contaminated surfaces. What is the correct sequence for donning PPE before entering the client's room?

Perform hand hygiene, don gown, don gloves

Don gown, perform hand hygiene, don gloves

Don gloves, don gown, perform hand hygiene

Perform hand hygiene, don gloves, don gown

Explanation

This question tests infection control and safe practice in PPE use for contact precautions. The correct sequence for donning PPE is: perform hand hygiene, don gown, then don gloves (answer C). This follows the best practice for infection control because hand hygiene removes transient microorganisms before PPE application, the gown is applied next to cover clothing and exposed skin, and gloves are donned last to cover the cuffs of the gown and maintain a continuous barrier. Answer A incorrectly places gloves before the gown, preventing proper cuff coverage; answer B delays hand hygiene until after gown application, risking contamination; and answer D performs hand hygiene last, which defeats the purpose of clean hands before PPE. The decision-making principle is to work from cleanest to most contaminated areas, ensuring each layer properly covers the previous one. A helpful mnemonic for donning is 'Hands, Gown, Gloves' (HGG) - always start clean and work outward to create protective barriers.

6

In an outpatient clinic, a nurse is preparing to irrigate a draining wound for a client with methicillin-resistant Staphylococcus aureus (MRSA) requiring contact precautions. The nurse will wear a gown, gloves, a mask, and a face shield because splashing is likely. What is the correct sequence for donning PPE before beginning the procedure?

Perform hand hygiene, don gown, don mask, don face shield, don gloves

Perform hand hygiene, don mask, don face shield, don gown, don gloves

Perform hand hygiene, don gloves, don gown, don mask, don face shield

Don gown, don gloves, don mask, don face shield, perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use when splash protection is needed. The correct sequence for donning PPE is: perform hand hygiene, don gown, don mask, don face shield, then don gloves (answer B). This follows the best practice for infection control because it starts with clean hands, protects the body and clothing with the gown, adds respiratory and mucous membrane protection with mask and face shield (working from nose/mouth outward), and finishes with gloves to cover gown cuffs and protect hands. Answer A incorrectly places mask and face shield before the gown; answer C omits initial hand hygiene and reverses the proper sequence; answer D places gloves too early, preventing proper coverage of gown cuffs. The principle is to build protection from the inside out, ensuring each layer properly interfaces with the next. A helpful memory aid is 'HGMFG': Hands, Gown, Mask, Face shield, Gloves - creating a systematic barrier from core to periphery.

7

In a long-term care facility, the nurse assists a client with suspected meningococcal infection on droplet precautions and wears gloves, gown, surgical mask, and face shield due to coughing. After providing care and leaving the room, what should the nurse do LAST when doffing PPE?

Remove gown

Remove mask

Remove gloves

Perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use. The correct sequence for doffing PPE is to remove gloves, remove the gown, perform hand hygiene, remove the face shield, remove the mask, and perform hand hygiene last. Option C follows the best practice for infection control by ending with hand hygiene to ensure all potential contaminants are removed after doffing. Options A, B, and D involve removal steps that would occur earlier in the sequence, not last. A key decision-making principle is to conclude doffing with hand hygiene to prevent pathogen transmission. The infection control rationale is to protect against droplet-spread infections like meningococcus. A transferable strategy is to think of doffing as 'reverse layering' with hygiene bookends, or use a checklist ending with 'Final hand hygiene'.

8

In a hospital setting, the nurse is preparing to enter the room of a client on contact precautions for scabies. The nurse will use gown and gloves. What is the correct sequence for donning PPE before entering the room?

Hand hygiene, don gloves, then don gown

Hand hygiene, don gown, then don gloves

Don gown, don gloves, then perform hand hygiene

Don gloves, don gown, then perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use. The correct sequence for donning PPE (gown and gloves only) is to perform hand hygiene, don the gown, then don the gloves. Option C follows the best practice for infection control by starting with hygiene and donning gown before gloves to ensure proper cuff overlap. Options A and B place gloves first or after hygiene incorrectly; option D starts with gloves without hygiene. A key decision-making principle is to prepare clean surfaces before applying barriers. The infection control rationale is to prevent skin parasite transmission like scabies. A transferable strategy is to remember 'Hygiene Gown Gloves' or use a simple three-step checklist.

9

In a long-term care facility, the nurse is doffing PPE after caring for a client on droplet precautions and wore gown, gloves, mask, and face shield. Which sequence is correct for removing the respiratory and eye protection portion at the end of doffing (after gloves and gown are removed and hand hygiene is done)?

Remove mask, perform hand hygiene, then remove face shield

Remove face shield and mask together by touching the front surfaces

Remove mask first, then remove face shield

Remove face shield first, then remove mask

Explanation

This question tests infection control and safe practice in PPE use. The correct sequence for removing respiratory and eye protection in doffing is to remove the face shield first, then the mask. Option B follows the best practice for infection control by avoiding contact with the mask while removing the shield. Option A reverses order; option C touches fronts; option D inserts hygiene midway. A key decision-making principle is to remove overlying items first. The infection control rationale is to contain droplets safely. A transferable strategy is to use 'Shield off, Mask off' or demonstrate in training sessions.

10

In a hospital setting, the nurse dons full PPE (gown, gloves, mask, face shield) to provide care for a client on contact precautions with copious wound drainage. After leaving the room, which sequence correctly completes doffing after gloves and gown have been removed and hand hygiene has been performed?

Remove face shield and mask together by grasping the front, then perform hand hygiene

Remove face shield, remove mask, then perform hand hygiene

Perform hand hygiene, remove face shield, remove mask

Remove mask, remove face shield, then perform hand hygiene

Explanation

This question tests infection control and safe practice in PPE use. The correct sequence for doffing PPE after gloves, gown, and initial hygiene is to remove the face shield, remove the mask, then perform final hand hygiene. Option B follows the best practice for infection control by removing eye protection before the mask to avoid disturbing contaminants. Option A reverses the order; option C inserts unnecessary hygiene; option D touches contaminated fronts. A key decision-making principle is to handle from clean back areas. The infection control rationale is to manage drainage in contact precautions. A transferable strategy is to remember 'Shield then Mask' post-hygiene or use video-guided practice.

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