A nurse is preparing to transfer a client to surgery when the client states, "I have changed my mind and don't want to go through with this surgery." Which of the following actions should the nurse take?

Informed consent is an ongoing process, and clients retain the right to withdraw consent and refuse treatment at any time, even immediately before surgery. Nurses play a key role in advocating for client autonomy while ensuring that decisions are properly communicated and documented. When a client expresses refusal, the nurse must not coerce or pressure the client but instead ensure accurate documentation and notify the appropriate healthcare team members. Ethical and legal principles of autonomy guide the nurse’s response. Rationale: A. Asking the family to speak to the client about their decision is inappropriate because it may create undue pressure or coercion. The client has the legal right to make independent decisions regarding their care. Family involvement should support the client, not influence or override their autonomy. B. Reinforcing the importance of the surgical procedure after the client has refused may be perceived as coercion. Although education is important during the consent process, once refusal is expressed, the nurse must respect the decision rather than attempt persuasion. This protects the client’s right to informed refusal. C. Notifying the facility’s risk management department is not the immediate priority action in this situation. Risk management may become involved later for documentation or legal review, but the nurse’s primary responsibility is to respect and document the client’s decision and inform the surgical team. D. Documenting the client’s decision to refuse treatment in the medical record is the correct nursing action. Accurate documentation ensures legal protection, continuity of care, and communication to the healthcare team. It also reflects respect for the client’s autonomy and ensures that the refusal is clearly recorded prior to surgery.