NCLEX · Advance Directives and Legal Rights

A client with a terminal illness has signed a 'Do Not Resuscitate' (DNR) order. What does this order mean?

Correct answer

The client refuses cardiopulmonary resuscitation (CPR) and related interventions in the event of cardiac or respiratory arrest — other treatments continue as ordered

  1. A The client refuses all medical treatment
  2. B The client refuses cardiopulmonary resuscitation (CPR) and related interventions in the event of cardiac or respiratory arrest — other treatments continue as ordered
  3. C The client's care will be withdrawn entirely
  4. D The order only applies after the client's death

Why this is the answer

A DNR order specifically directs that CPR (chest compressions, defibrillation, intubation, advanced cardiac medications) will not be performed if the client experiences cardiac or respiratory arrest. The order does NOT mean: no treatment at all (the client continues to receive all other ordered treatments — antibiotics, IV fluids, pain management, comfort care); no nursing care; no medical attention. DNR is specific to resuscitation. Other related orders include: DNI (Do Not Intubate); AND (Allow Natural Death); POLST/MOLST (Physician/Medical Orders for Life-Sustaining Treatment, a more comprehensive form); 'comfort measures only' or 'comfort care' orders. The nurse must understand the specific scope of the order and continue to provide all care within those limits. Discussion of advance directives is required upon hospital admission under the Patient Self-Determination Act.
Source: NCLEX-RN Test Plan, Advance Directives — DNR

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