# A nurse is leaving an airborne-isolation room after suctioning a client with pulmonary tuberculosis. Complete CDC Example 1 for removing the worn PPE.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393377&lang=en  
> language: en  
> subject: Standard/Transmission-Based Precautions/Surgical Asepsis  
> category: SIPC

## Question

A nurse is leaving an airborne-isolation room after suctioning a client with pulmonary tuberculosis. Complete CDC Example 1 for removing the worn PPE.

The nurse should first ::선택::remove the contaminated gloves using a technique that protects bare skinremove the N95 respirator by touching its frontcarry all worn PPE into the hallwayclean the goggles while still wearing the contaminated gloves. Before leaving the room, ::선택::remove only the respirator and keep the other PPE onremove the goggles and gown, performing hand hygiene if contamination occursopen the door while still wearing contaminated glovesskip hand hygiene because gloves were worn. After leaving and closing the door, ::선택::put on a second pair of gloves over the first pairreenter the room to remove the gownremove the respirator by its straps and perform final hand hygienetouch the front of the respirator to check for contamination.

## 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.

## In-depth explanation

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

## Clinical scenario

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.

## Key concepts

- **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.

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