# A client has a signed do-not-resuscitate order in the chart. A family member tells the nurse, "Do everything if the heart stops." What is the nurse's best response?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=396575&lang=en  
> language: en  
> subject: Advance Directives  
> category: MOC

## Question

A client has a signed do-not-resuscitate order in the chart. A family member tells the nurse, "Do everything if the heart stops." What is the nurse's best response?

## Option

1. Contact the healthcare provider to request that the DNR order be reconsidered based on the family's input.
2. Review the documented order and notify the provider of the family concern. **✔ Correct answer**
3. Explain to the family that the DNR order is final and cannot be changed, so no further action is needed.
4. Ask the family to leave the room to avoid upsetting the client with their disagreement.

**Correct answer: 2**

## Explanation

The nurse must first review the existing DNR order to confirm it is valid, then communicate the family's concerns to the provider and care team. This ensures the client's wishes are honored while addressing the family's distress. Option 1 is incorrect because the nurse should not immediately request reconsideration without first reviewing the order and discussing concerns; the provider should be notified, not directed to change the order. Option 3 is incorrect because it is dismissive and does not involve the family in the care process; a DNR can be reassessed, and the nurse should advocate for communication. Option 4 is incorrect because asking the family to leave is not a therapeutic response and may escalate conflict; the nurse should facilitate communication.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Advance directive conflict.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Advance directive conflict, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Advance Directive** — A document describing a person's preferences for health care if they cannot decide later.
- **Do-Not-Resuscitate Order** — A medical order indicating that CPR should not be initiated if cardiac or respiratory arrest occurs.
- **Client Advocacy** — Nursing action that protects the client's rights, preferences, and safety.

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