A nurse is preparing to exit the room of a client who has a draining wound that contains methicillin-resistant Staphylococcus aureus (MRSA) and requires contact precautions. Identify the sequence the nurse should follow to remove personal protective equipment (PPE) after caring for this client.

Choice A rationale In the standard sequence for removing personal protective equipment, gloves are removed first because they are considered the most heavily contaminated items. Handling other equipment or skin with soiled gloves increases the risk of cross-contamination and the spread of MRSA. Removing them properly by peeling them off inside out ensures that the nurse's bare hands do not touch the outside of the glove, maintaining hand hygiene before touching the face or head. Choice B rationale Eyewear or goggles are removed after gloves. Since the outside of the eyewear may be contaminated by splashes or droplets during wound care, it is handled by the clean ear pieces or head band. By removing eyewear second, the nurse clears the field of vision and removes a potential source of environmental contamination before proceeding to larger items like the gown. This chronological step prevents the transfer of pathogens from the face to the clothing. Choice C rationale The gown is removed after the gloves and eyewear. The nurse should unfasten the ties and pull the gown away from the neck and shoulders, touching only the inside of the gown. By folding or rolling it into a bundle with the contaminated outside facing inward, the nurse minimizes the dispersal of MRSA into the air or onto their uniform. This step-by-step containment is vital for maintaining contact precautions and protecting the healthcare environment. Choice D rationale The mask or respirator is the final item removed. This is done to ensure that the nurse remains protected from any aerosolized particles or droplets that might have been disturbed during the removal of the gown and other equipment. The mask should be handled only by the ties or elastic bands to avoid touching the front surface, which is considered contaminated. Following this removal, the nurse must immediately perform thorough hand hygiene to ensure safety.