A nurse is caring for a client who has a do-not-resuscitate (DNR) order in place. The client's spouse asks the nurse to perform cardiopulmonary resuscitation (CPR) if the client stops breathing. Which action should the nurse take?

Rationale: The nurse should respect the client's autonomy and right to self-determination, and ask the client to confirm their wishes regarding the DNR order. The client has the right to change or revoke their DNR order at any time, as long as they are competent and able to communicate.

Incorrect options:

A) Inform the spouse that the nurse is legally obligated to follow the DNR order. - This is an incorrect action, as it does not address the client's wishes or involve them in the decision-making process. The nurse should not assume that the spouse has the authority to make decisions for the client, unless there is evidence of a durable power of attorney for health care.

C) Notify the health care provider of the spouse's request. - This is an incorrect action, as it does not respect the client's autonomy or involve them in the decision-making process. The health care provider cannot change or revoke the DNR order without the client's consent, unless there is evidence of a court order or an advance directive that states otherwise.

D) Suggest the spouse to contact a lawyer to revoke the DNR order. - This is an incorrect action, as it does not respect the client's autonomy or involve them in the decision-making process. The spouse does not need a lawyer to revoke the DNR order, as long as the client is competent and able to communicate.

Rationale: The nurse's priority action in this situation is to review the client's advance directives and code status with the family, as these documents indicate the client's preferences and wishes regarding end-of-life care and resuscitation measures. The nurse should ensure that the family understands and respects the client's choices and that they have a copy of these documents available at home.

Incorrect options:

B) Assess the client's pain level and administer analgesics as prescribed. - This is an important action, but not the priority in this situation. The nurse should assess and manage the client's pain and other symptoms as part of palliative care, but this should be done after reviewing the advance directives and code status with the family.

C) Provide emotional support and counseling to the client and the family. - This is an important action, but not the priority in this situation. The nurse should provide emotional support and counseling to the client and the family as part of holistic care, but this should be done after reviewing the advance directives and code status with the family.

D) Educate the client and the family about the signs and symptoms of impending death. - This is an important action, but not the priority in this situation. The nurse should educate the client and the family about what to expect as death approaches, such as changes in breathing, circulation, consciousness, and skin color, but this should be done after reviewing the advance directives and code status with the family.