A nurse caring for a client who requires isolation has just finished a care procedure. Which of the following pieces of personal protective equipment (PPE) should the nurse remove last?

Choice A rationale Eyewear or goggles are considered contaminated on the outside but are generally removed early in the sequence to prevent the transfer of pathogens to the face. The removal of eyewear typically follows the removal of gloves and the gown in many protocols, or it is removed before the mask. This ensures that the nurse does not inadvertently touch their eyes or face while still wearing contaminated gloves or before the airway is protected. Choice B rationale The mask or respirator is removed last in the personal protective equipment sequence because it protects the nurse's airway from airborne or droplet pathogens. Removing the mask after all other contaminated items ensures that the nurse does not inhale infectious particles that might be disturbed during the removal of the gown or gloves. This sequence is critical in maintaining the integrity of the respiratory protection until the nurse has exited the contaminated environment. Choice C rationale The gown is often removed simultaneously with or after the gloves because the front and sleeves are highly contaminated. The nurse unfastens the ties and pulls the gown away from the body, touching only the inside of the garment. Removing the gown before the mask is essential to ensure that any dust or droplets released during the movement are not inhaled, as the mask remains in place to provide a barrier for the nurse. Choice D rationale Gloves are typically the most contaminated piece of personal protective equipment and are therefore removed first to prevent the spread of microorganisms to other items or the nurse's skin. The nurse uses a glove-to-glove and skin-to-skin technique to ensure the outside of the glove does not touch the wrist. Once the gloves are removed, hand hygiene is performed before continuing with the removal of the remaining protective equipment like the mask.