NCLEX · General

A client refuses a procedure that their physician believes is necessary. The nurse's role is to:

Correct answer

Document the refusal, ensure the client understands the risks of refusal (informed refusal), notify the RN and physician, and respect the client's decision — competent adults have the absolute right to refuse any medical treatment

  1. A Convince the client to comply
  2. B Document the refusal, ensure the client understands the risks of refusal (informed refusal), notify the RN and physician, and respect the client's decision — competent adults have the absolute right to refuse any medical treatment
  3. C Proceed with the procedure anyway
  4. D Call the client's family to override the refusal

Why this is the answer

RIGHT TO REFUSE TREATMENT: LEGAL AND ETHICAL FOUNDATION: Competent adults have an absolute legal and ethical right to refuse any medical treatment or procedure, including life-saving treatments; EXCEPTIONS: Emergency situations where the patient is unconscious or incapacitated and no advance directive exists; court orders for involuntary treatment (specific narrow circumstances); NURSE'S ROLE: Ensure the client understands the consequences of refusal (informed refusal documentation); assess whether the client is competent to make decisions; notify the RN and physician; document thoroughly (client's statement, understanding of risks, notifications made); NEVER: Proceed without consent; coerce; manipulate; INFORMED REFUSAL: Must document that: the client was informed of the risks; alternative options were presented; the client's decision was voluntary and free of coercion; a family override is NOT valid — family cannot override a competent adult's decisions; ADVANCE DIRECTIVES: A living will or healthcare proxy comes into play when the patient is no longer competent — not while the patient can make their own decisions.
Source: NCLEX-PN Safe Care — Management of Care, Right to Refuse Treatment