An older adult woman with end stage heart disease is alert and oriented and states that she does not want any heroic measures taken in the event she stops breathing. The client's children tell the nurse that they accept their mother's wishes and do not want to watch her suffer. Which action should the nurse take first?

Choice A reason: A business executive admitted with Guillain-Barre syndrome who has residual bilateral numbness in the lower extremities is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a complex and chronic condition, but it is not an acute or urgent situation that requires immediate collaboration and coordination of care.

Choice B reason: A woman who is pregnant with twins and whose due date is one week away is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a high-risk pregnancy, but it is not a complicated or emergent case that requires intensive and comprehensive care.

Choice C reason: An elderly client admitted through the emergency department with a broken hip whose blood glucose is 400 mg/dL (22 mmol/L) is the most important client to schedule a multi-disciplinary team meeting for. This client has a serious and potentially life-threatening condition that requires prompt and effective management of pain, infection, surgery, mobility, nutrition, and diabetes. A multi-disciplinary team meeting can facilitate the communication and collaboration among the healthcare professionals involved in the client's care and ensure the best possible outcomes.

Choice D reason: A 2-year-old who contracted Hepatitis A while at a local daycare center is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a contagious and unpleasant infection, but it is not a severe or critical condition that requires extensive and holistic care.

Choice A reason: This is the best intervention to ensure the safety of the clients and staff. According to the [hospital fire drill requirements](^3^), the first step in a fire evacuation is to rescue persons from the room or area and move them away from where fire, smoke, or the strong smell of smoke exists. Ambulatory clients can be assisted to the nearest fire exits by the nursing staff, following the [fire safety standard operating procedure](^2^).

Choice B reason: This is not a good intervention, as it may delay the evacuation and endanger the clients and staff. Wheelchairs are not designed to be used in fire situations, and they may not fit through the fire exits or the stairwells. Non-ambulatory clients should be transferred using evacuation devices such as evacuation chairs, stretchers, or mattresses, as recommended by the [hospital evacuation checklist](^5^).

Choice C reason: This is a dangerous intervention, as it may expose the visitors to the fire and smoke. Service elevators should not be used in a fire situation, as they may malfunction or stop at the fire floor. Visitors should be instructed to use the fire exits and the stairwells to evacuate the building, following the [fire safety standard operating procedure](^2^).

Choice D reason: This is a passive intervention, as it does not ensure the safety of the clients and staff. Shutting the doors to the client rooms may help to contain the fire and smoke, but it does not guarantee that they will not spread to other areas. The charge nurse should initiate the evacuation procedures as soon as possible, following the [hospital evacuation checklist](^5^).