👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Management of Care🔖 Free to read, print, and share
Also known as: advanced directive · end of life wishes · healthcare directive · advance care plan
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Use this quick-reference guide to spot, treat, and prevent Advance Directives on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Def
Legal doc for incapacity wishes
Living will + healthcare proxy
PSDA: ask on admission
✅ Do
Offer to all clients at admit
Place copy in chart
Client may revoke anytime
📌 Avoid
Not required to have one
Don't influence client's choice
🚩 Report
Verbal change → notify team/MD
Conflict family vs doc → ethics committee
📚 Advance Directives — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Advance directives are legal documents that state a person's healthcare wishes and name a decision-maker in case they become unable to speak for themselves. The two main types are the living will (treatment preferences) and the durable power of attorney for healthcare (proxy). The Patient Self-Determination Act requires facilities to ask about and document advance directives on admission.
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Key points
Understand these first
An advance directive only takes effect when the patient loses decision-making capacity.
The two components are a living will (specifies wanted/unwanted treatments) and a durable power of attorney for healthcare (names a proxy).
A competent patient's current expressed wishes always override a previously written advance directive.
Advance directives can be changed or revoked by the patient at any time while competent.
The Patient Self-Determination Act requires hospitals to inform patients of their right to make advance directives at admission.
Having an advance directive is voluntary and cannot be a condition of receiving care.
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Nursing priorities
What to do, in order
Ask every patient on admission whether they have an advance directive and place a copy in the chart.
Offer information and resources to patients who wish to create an advance directive.
Communicate the patient's documented wishes to the healthcare team and ensure the plan of care reflects them.
Notify the provider and update orders if the patient verbally changes their wishes.
Support the patient's right to make decisions without imposing personal or family values.
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Red flags — report now
Escalate immediately
Report immediately if care being delivered conflicts with the documented advance directive.
Never pressure a patient to complete or not complete an advance directive.
Do not let family members override a competent patient's stated wishes.
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Patient teaching
What patients must know
An advance directive lets your wishes be followed if you cannot speak for yourself.
You can update or cancel your advance directive at any time.
Give copies to your proxy, your provider, and the hospital so everyone has the same instructions.
❓ Advance Directives: NCLEX FAQs
What are the priority nursing interventions for Advance Directives?
Ask every patient on admission whether they have an advance directive and place a copy in the chart. Offer information and resources to patients who wish to create an advance directive. Communicate the patient's documented wishes to the healthcare team and ensure the plan of care reflects them. Notify the provider and update orders if the patient verbally changes their wishes.
What are the warning signs of Advance Directives a nurse must report?
Report immediately if care being delivered conflicts with the documented advance directive. Never pressure a patient to complete or not complete an advance directive. Do not let family members override a competent patient's stated wishes.
What do I need to know about Advance Directives for the NCLEX?
An advance directive only takes effect when the patient loses decision-making capacity. The two components are a living will (specifies wanted/unwanted treatments) and a durable power of attorney for healthcare (names a proxy). A competent patient's current expressed wishes always override a previously written advance directive. Advance directives can be changed or revoked by the patient at any time while competent.
What patient teaching is important for Advance Directives?
An advance directive lets your wishes be followed if you cannot speak for yourself. You can update or cancel your advance directive at any time. Give copies to your proxy, your provider, and the hospital so everyone has the same instructions.
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Quick Tip
An advance directive only takes effect when the patient loses decision-making capacity.