A client who is taking warfarin has an international normalized ratio (INR) of 0.8. Which question should a nurse ask to further evaluate the client?

Self-determination. Self-determination is the ethical principle that respects the right of a person to make their own decisions. When a nurse respects the decision of a client who refuses a blood transfusion, the nurse is upholding this principle by acknowledging and protecting the client’s autonomy.

Choice A is wrong because beneficence is the ethical principle that involves actively seeking benefits or the promotion of good.

While a blood transfusion may be beneficial for the client, it is not the nurse’s role to impose their own judgment on the client’s choice.

Choice C is wrong because justice is the ethical principle that involves fairness and the just distribution of resources.

A blood transfusion is not a scarce resource that needs to be allocated among competing demands.

Choice D is wrong because fidelity is the ethical principle that involves keeping promises and being faithful to one’s commitments.

A blood transfusion is not a promise or a commitment that the nurse has made to the client.

Remove gloves, wash hands, remove face shield, gown, mask, and wash hands again. This is because gloves are the most contaminated piece of PPE and should be removed first to avoid touching other parts of the body or environment with them. Washing hands after removing gloves is also important to reduce the risk of infection. Face shields, gowns, and masks should be removed in that order, as they are less contaminated than gloves and can be handled with clean hands. Washing hands again after removing all PPE is the final step to ensure hygiene.

Choice A is wrong because it does not include washing hands after removing gloves, which is a crucial step to prevent contamination. It also removes the gown before the gloves, which can cause the gown to touch the face or hair and contaminate them.

Choice B is wrong because it does not include washing hands between removing gloves and gown, which can transfer germs from the gloves to the gown and then to the face or hair when removing the face shield and mask.

Choice D is wrong because it does not include washing hands between removing gloves and gown, which can transfer germs from the gloves to the gown and then to the face or hair when removing the face shield and mask. It also removes the gown before the face shield, which can cause the gown to touch the face or hair and contaminate it.

Normal ranges for PPE removal are not applicable as different types of PPE may require different methods of removal. However, some general principles are to remove PPE in a way that minimizes contact with contaminated surfaces, perform hand hygiene frequently, and dispose of PPE properly.