A nurse is leaving an airborne-isolation room after suctioning a client with pulmonary tuberculosis. Complete CDC Example 1 for removing the worn PPE.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
Using CDC Example 1, remove the contaminated gloves first without touching bare skin, then remove goggles and the gown before leaving the room. Perform hand hygiene if the hands become contaminated during removal. After leaving and closing the door, remove the respirator by the straps without touching the front and perform final hand hygiene. The sequence limits self-contamination while preserving respiratory protection until the nurse is outside the airborne-isolation room.
Correct Answer Remove gloves first, remove goggles and gown before exit with hand hygiene if contamination occurs, then remove the respirator outside after closing the door and perform final hand hygiene.
Why It Fits The most contaminated PPE comes off early, while respiratory protection stays on until the nurse is outside the airborne environment.
Clinical Picture Technique matters as much as order: avoid touching contaminated fronts, use straps or ties, and clean the hands whenever contamination occurs.
Memory Link Dirty hands first; room PPE before exit; respirator after the door; clean hands last.
NCLEX Rule Follow the facility's CDC-based sequence and perform immediate hand hygiene whenever the hands become contaminated during removal.
Why the Alternatives Fail Removing the respirator inside ends airborne protection too early. Leaving gloves on while handling eye protection spreads contamination, and skipping hand hygiene leaves the sequence incomplete.
Sources
1CDC PPE Removal Sequence
22026 NCLEX-RN Test Plan
The nurse wore gloves, a gown, goggles, and a fit-tested N95 respirator. The gloves are visibly contaminated. All PPE except the respirator is removed before leaving; the respirator is removed after leaving and closing the door.
CDC PPE Doffing Sequence — Gloves → goggles or face shield → gown → mask or N95 → final hand hygiene. Hand hygiene between each step. Doffing is the high-risk side of PPE because contamination is greatest during removal.
Why Gloves First and Mask Last — Gloves are most contaminated and must come off first to avoid spreading contamination to other items. Mask or N95 is removed last because it covers the airway; removing it while the gown or gloves are still on exposes the respiratory tract to remaining contamination on those items.
Doffing Safety Aids — CDC recommends a trained observer or a mirror for high-risk pathogen doffing (Ebola, COVID variants). The observer guides each step and confirms hand hygiene between steps. Most exposures occur during doffing — the observer is the single most effective safeguard.