A patient with end-stage disease requests no resuscitation. The nurse should:

• A. Honor patient autonomy; discuss advance directives and DNR; document accordingly
• B. Initiate resuscitation to be safe
• C. Seek family consent before honoring patient
• D. Delay decision until physician consult

Answer: (A)

The main idea here is respecting the patient’s right to self-determination and ensuring that their wishes about resuscitation are clearly understood, documented, and acted upon. When a patient with end-stage disease asks for no resuscitation and is capable of making decisions, their choice should be honored. The nurse supports this by helping the patient articulate goals of care, discussing what a code status means, and guiding the patient to establish an advance directive or a DNR order. Once the patient expresses a clear, voluntary decision, it must be documented in the medical record and communicated to the entire care team so every provider respects the code status.

If the patient lacks capacity, the nurse should involve a legally authorized surrogate and aim to follow the patient’s known wishes or best interests, but never override them with a default to intervene.

Delaying or overriding the patient’s wishes would undermine autonomy. Initiating resuscitation without consent contradicts the patient’s expressed preferences. Seeking family consent before honoring the patient’s request can misalign care when the patient is competent, since the patient’s own wishes take precedence. Waiting for a physician consultation before acting can unnecessarily postpone honoring a clearly stated preference.