A client has a valid advance directive stating no cardiopulmonary resuscitation. The family tells the nurse, "Do everything if the heart stops." Which action should the nurse take?

A valid advance directive communicates the client wishes and guides care when the client cannot speak for self. The nurse should advocate for the client, follow the directive according to policy, and notify the provider about the family concern. Family distress should be addressed respectfully, but it does not automatically override the client documented decision.

In-depth explanation

<span class='merci-scenario-label'>Clinical Judgment</span><br>Client autonomy remains central when valid documents express the client wishes.<br><br><span class='merci-scenario-label'>Memory Tip</span><br>Advance directive equals client voice when the client cannot speak.<br><br><span class='merci-scenario-label'>KR vs US</span><br>NCLEX often tests legal documents, advocacy, and respectful family communication together.

Clinical scenario

<span class='merci-scenario-label'>Clinical Practice Guide</span><br>Advance directives support self-determination and should be communicated to the care team so treatment aligns with documented wishes.<br><br><span class='merci-scenario-label'>Caution</span><br>Escalate uncertainty through provider, ethics, or policy channels rather than improvising.

Key concepts

• Advance Directive — A legal document that states client wishes for future health care decisions if the client cannot communicate.
• DNR — A do-not-resuscitate order or status indicating CPR should not be initiated under specified conditions.
• Patient Advocacy — Nursing action to protect client rights, preferences, safety, and informed decisions.