# The charge nurse audits care when death is imminent or has occurred. Which actions require follow-up? Highlight the actions that can delay or bypass the organ donation referral process.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=495939&lang=en  
> language: en  
> subject: Assignment/Delegation/Supervision  
> category: MOC

## Question

The charge nurse audits care when death is imminent or has occurred. Which actions require follow-up? Highlight the actions that can delay or bypass the organ donation referral process.

| Care point | Documented action |
| --- | --- |
| Imminent death | Notify the organ procurement organization under the hospital protocol |
| Suitability | Provide requested clinical information to the organ procurement organization |
| Referral timing | Wait until the family asks about donation before making a referral |
| Family communication | Use the organ procurement organization or designated requestor for the approach |
| Eligibility decision | Have the bedside nurse rule out donation from the diagnosis alone |
| Record handling | Document the referral time and the response from the organization |
| Ongoing care | Continue ordered physiologic support while suitability is being evaluated |
| Family choice | Respect a refusal after an informed donation discussion is completed |
| After death | Stop support before the organization determines whether donation is possible |

## Explanation

Waiting for the family to ask, letting the bedside nurse determine eligibility, and stopping support before the organ procurement organization evaluates suitability require follow-up. Refer promptly and preserve the designated roles.

## In-depth explanation

Quick answer
Highlight waiting for a family request, allowing the bedside nurse to rule out eligibility, and stopping support before the organ procurement organization completes its determination. Each action can close a donation pathway too early.

Why this is correct
Federal hospital conditions require timely notification to the organ procurement organization when death is imminent or has occurred. The organization, not the bedside nurse, determines medical suitability using the clinical information. Continuing ordered support during evaluation preserves options while the designated team communicates with the family and honors the final decision.[2]

Easy analogy or mental picture
Picture a relay race. The hospital identifies the possible donor and passes complete information; the organ procurement organization evaluates suitability and coordinates the donation discussion. Dropping the baton before the handoff prevents the next team from doing its job.

Memory hook
Refer early; let the designated team decide suitability.

NCLEX decision rule
When death is imminent or confirmed, think timely organ procurement organization notification; check the hospital trigger, maintain ordered support, and avoid personally ruling a client in or out.

Why the other choices are wrong
Providing records, documenting the response, using a designated requestor, continuing ordered care, and respecting an informed refusal all preserve the correct roles. These actions do not pressure the family or promise that donation will occur.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]eCFR: 42 CFR 482.45 Organ, Tissue, and Eye ProcurementU.S. Government Publishing Office

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