A client with a catastrophic brain injury is expected to die soon. The family asks whether the client's age and medical history rule out organ donation. Which action is appropriate for the nurse?
1Decide whether the client is eligible by reviewing the medical history
2Notify the organ procurement organization under hospital protocol✓ Correct answer
3Ask the family to authorize donation before making a referral
4Wait until cardiac death occurs before contacting the donation service
Explanation
Hospitals must notify the designated organ procurement organization in a timely manner when death is imminent or has occurred. The organ procurement organization determines medical suitability, and a trained representative or designated requestor manages the donation approach with the family.
Quick answer Follow the hospital protocol and notify the designated organ procurement organization. The bedside nurse should not independently rule the client in or out as a donor.
Why this is correct Timely referral preserves the opportunity for an expert suitability review. Age, diagnoses, and current physiology may affect donation, but the designated organization evaluates those factors and coordinates a sensitive family discussion through trained personnel.
Easy analogy or mental picture The referral is like sending a complex specimen to the qualified laboratory instead of interpreting it at the bedside. The comparison explains role boundaries, but donation decisions also require consent, ethics, and respectful family communication that a laboratory analogy cannot capture.
Memory hook Imminent death leads to timely OPO notification; the OPO determines suitability and trained staff approach the family.
NCLEX decision rule When an NCLEX item asks who decides donor suitability, choose timely referral to the designated organ procurement organization. Do not let the bedside nurse screen out the client, delay referral until death, or make an uncoordinated donation request.
Why the other choices are wrong The nurse does not make the final medical-suitability determination. Seeking authorization before referral reverses the proper sequence, and waiting for cardiac death can make the referral untimely.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
eCFR: 42 CFR 482.45 Organ, Tissue, and Eye ProcurementElectronic Code of Federal Regulations