A nurse is assessing a client who has refused a surgical procedure. The client states, “I just don’t want to do this,” while appearing anxious and avoiding eye contact when speaking. What is the nurse’s priority action?

Choice A reason: The priority action is to assess the client’s understanding of the procedure, including risks, benefits, and alternatives. This ensures informed decision-making and respects client autonomy. Anxiety and avoidance of eye contact suggest that the client may have underlying fears or misunderstandings that need clarification before any documentation or provider notification. This assessment is essential to provide accurate education, support informed consent, and prevent ethical or legal complications. Choice B reason: Documenting the refusal and notifying the healthcare provider is important, but it is secondary to ensuring the client fully understands the procedure. Immediate documentation without assessment may neglect the client’s need for education and support, potentially leading to uninformed decisions. Choice C reason: Asking a UAP to stay with the client provides emotional support but does not address the client’s knowledge deficit or anxiety related to the procedure. Emotional support is useful after assessing understanding but is not the first priority. Choice D reason: Reassuring the client that the procedure is safe ignores the client’s expressed autonomy and may be perceived as coercive. Providing reassurance without assessment may fail to address the client’s underlying concerns and could be ethically inappropriate.