PPE donning and doffing: the CDC order

Doffing is not donning in reverse, and that single fact is the whole question. The gown goes on first and the gloves last; the gloves come off first, but the gown does not come off last. “Just reverse it” swaps the gown and the mask.

Questions and answers, explained

All 11 questions above, with the correct answer and why it is correct. Everything here is on ppe donning and doffing: the cdc order.

1. A medical assistant removes gloves after changing a dressing. The hands appear clean and are not visibly soiled. What should the medical assistant do next?

   • APerform hand hygiene with an alcohol-based hand rubCorrect
   • BApply new gloves immediately; hand hygiene is unnecessary because gloves were worn
   • CRinse the hands with water only
   • DWipe the hands with a dry paper towel

   Why: CDC lists hand hygiene immediately after glove removal as a required indication, because gloves can have unnoticed micro-perforations and hands are readily contaminated during removal. Choice B is the most common student misconception: gloves reduce but never eliminate hand contamination and are never a substitute for hand hygiene.

   Reference Domain 3C (k101, k102); CDC hand hygiene in healthcare settings

2. While removing gloves after a venipuncture, a medical assistant gets a visible smear of blood on the back of one hand. What is the correct action?

   • AApply an alcohol-based hand rub and rub until dry
   • BWipe the blood off with an alcohol pad and continue working
   • CRinse the hand under running water for 10 seconds
   • DWash the hands with soap and running water for at least 20 secondsCorrect

   Why: CDC requires soap and running water whenever hands are visibly soiled with blood or other body fluids, scrubbing for at least 20 seconds, because organic material inactivates alcohol and blocks contact with the skin. Choice A fails for exactly that reason: alcohol-based rub is not designed to work through visible soil and does not physically remove it.

   Reference Domain 3C (k101, k102); CDC hand hygiene for healthcare workers

3. A medical assistant is helping the provider with a patient who has an infected sacral wound and a clean surgical incision on the abdomen. After assisting with the sacral wound, the medical assistant must help with the abdominal dressing. What should the medical assistant do?

   • AContinue with the same gloves because it is the same patient
   • BRemove the gloves, perform hand hygiene, and don clean gloves before moving to the clean siteCorrect
   • CWipe the gloves with an alcohol-based hand rub and continue
   • DDon a second pair of gloves over the contaminated pair

   Why: CDC requires changing gloves and performing hand hygiene when moving from a contaminated body site to a clean body site on the same patient, to prevent self-inoculation of the clean site. Choice C is unsafe and is never acceptable: gloves are single-use items and disinfecting them degrades the glove material and does not reliably decontaminate it.

   Reference Domain 3C (k100, k101); CDC standard precautions - glove use

4. Using the CDC sequence, in what order should a medical assistant put on personal protective equipment?

   • AGown, then mask or respirator, then goggles or face shield, then glovesCorrect
   • BGloves, then gown, then mask or respirator, then goggles or face shield
   • CMask or respirator, then gloves, then gown, then goggles or face shield
   • DGoggles or face shield, then gloves, then gown, then mask or respirator

   Why: The CDC donning sequence is gown, mask or respirator, goggles or face shield, then gloves, with the gloves pulled over the cuffs of the gown last. Any option that places gloves before the gown or mask (B, C, D) is wrong because the gloved hands would then contaminate clean PPE while it is being adjusted on the face and body.

   Reference Domain 3C (k100); CDC PPE sequence

5. Using the CDC sequence, in what order should a medical assistant remove PPE after caring for a patient while wearing a gown, gloves, goggles, and a mask?

   • AGown, gloves, mask or respirator, goggles or face shield
   • BGloves, goggles or face shield, gown, mask or respiratorCorrect
   • CMask or respirator, goggles or face shield, gloves, gown
   • DGoggles or face shield, gown, mask or respirator, gloves

   Why: The CDC removal sequence is gloves, goggles or face shield, gown, then mask or respirator, followed immediately by hand hygiene; the mask or respirator is removed after leaving the patient room. Choice D is wrong because removing gloves last means contaminated gloves would be used to handle the face and head straps of the other PPE.

   Reference Domain 3C (k100); CDC PPE sequence

6. A medical assistant is removing PPE after caring for a patient on contact precautions. Why are gloves removed first?

   • AGloves are the least expensive item of PPE and the easiest one to replace afterward
   • BGloves interfere with untying the gown at the neck and waist
   • CGloves are the most contaminated item, so removing them first prevents spreadCorrect
   • DGlove removal must be documented in the chart before other PPE is removed

   Why: The CDC doffing order is built entirely around contamination level: gloves have the heaviest bioburden, so they come off first, and the mask or respirator, which is closest to the face and least contaminated on the straps, comes off last. Choice B describes a convenience issue, not the infection-control rationale that drives the sequence.

   Reference Domain 3C (k100); CDC PPE sequence

7. During a wound irrigation the medical assistant notices a small tear in one glove. Irrigation fluid has not yet contacted the hand. What should the medical assistant do?

   • ACover the tear with tape and finish the procedure
   • BPull a second glove over the torn one and finish the procedure
   • CFinish the procedure and change gloves before the next patient
   • DStop as soon as it is safe to do so, remove both gloves, perform hand hygiene, and don new glovesCorrect

   Why: A torn glove is no longer a barrier, so CDC standard precautions require stopping at the first safe moment, removing the gloves, performing hand hygiene, and re-gloving before continuing. Choice C is wrong because the exposure risk is immediate and to the medical assistant, not deferred to the next patient encounter.

   Reference Domain 3C (k100); CDC standard precautions - glove use

8. A medical assistant must wear an N95 filtering facepiece respirator to room a patient with suspected pulmonary tuberculosis. Which requirement must be met?

   • AThe assistant must be fit-tested for that model and do a seal check each timeCorrect
   • BA surgical facemask may be substituted whenever no N95 respirator is available
   • CFit testing is needed only once at hire, and seal checks are optional
   • DFacial hair at the seal surface is acceptable if the straps are tightened

   Why: CDC and OSHA require a respiratory protection program with fit testing for the specific make and model plus a user seal check every time the respirator is donned, because an unsealed respirator provides no airborne protection. Choice B is unsafe: a surgical facemask is not a respirator and does not filter the small droplet nuclei that carry M. tuberculosis.

   Reference Domain 3C (k96, k100); CDC airborne precautions; OSHA respiratory protection

9. How should a medical assistant remove a contaminated isolation gown?

   • APull it over the head without unfastening it, keeping the outside surface facing outward
   • BUnfasten the ties and shake the gown to loosen it before removing it
   • CUnfasten the ties, pull the gown away from the neck and shoulders touching only the inside, turn it inside out, and roll it into a bundleCorrect
   • DRemove the gown before the gloves so the sleeves are not contaminated

   Why: CDC teaches that the gown front and sleeves are contaminated, so the gown is unfastened, pulled away from the body touching only the inside, turned inside out, and rolled into a bundle before disposal. Choice B is wrong because shaking a contaminated gown aerosolizes pathogens and skin squames into the room air.

   Reference Domain 3C (k100); CDC PPE sequence

10. A provider asks the medical assistant to assist with incision and drainage of an abscess that is likely to spray purulent fluid. In addition to gloves, which PPE is most appropriate?

    • AA surgical facemask alone
    • BA fluid-resistant gown plus a facemask with a face shield or gogglesCorrect
    • CGoggles alone, because a gown is needed only for contact precautions
    • DAn N95 respirator alone

    Why: Under CDC standard precautions, PPE is selected by anticipated exposure: a procedure likely to generate sprays or splashes of body fluid requires eye protection, mouth and nose protection, and a fluid-resistant gown. Choice C is wrong because gown use is not limited to contact precautions; standard precautions require a gown whenever clothing or skin is likely to be soiled.

    Reference Domain 3C (k100); CDC standard precautions - PPE selection

11. A tube of blood breaks on the exam room floor. After donning gloves and other appropriate PPE, what is the correct process?

    • ACover with absorbent material, collect the glass with forceps into a sharps container, disinfectCorrect
    • BPick up the glass with gloved hands, wipe the area with an alcohol pad, and discard it in the trash
    • CMop the spill with water and detergent, then apply alcohol to the wet floor area
    • DCover the spill with paper towels and notify the housekeeping staff at the end of the day

    Why: CDC recommends decontaminating a large blood spill with an EPA-registered tuberculocidal disinfectant or a 1:10 final-concentration dilution of household bleach, after the bulk of the spill is absorbed and any broken glass is removed mechanically into a sharps container. Choice B violates OSHA sharps handling: contaminated broken glass is never picked up by hand, even gloved, and must be handled with tongs, forceps, or a brush and dustpan.

    Reference Domain 3C (k105, k107, k108); CDC environmental services; OSHA 29 CFR 1910.1030

Drill the whole domain

• Infection Control and Safety (10%)

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