Legal & Ethics · Exam Guide
DNR Orders: What Every HHA Must Know
A Do Not Resuscitate (DNR) order is one of the most important legal documents an HHA will encounter. Understanding what it means — and what your role is — is critical both for the job and for the certification exam.
Exam tip: DNR questions always test whether you understand the HHA must call 911 even with a DNR — and must NOT start CPR. These two facts appear on nearly every exam.
What Does a DNR Order Mean?
A DNR order is a legal medical document signed by a physician that instructs healthcare providers — including HHAs — not to attempt cardiopulmonary resuscitation (CPR) if the client's heart stops or they stop breathing.
A DNR is the client's legal right to decide how they want to be treated in an end-of-life situation. It reflects the client's values and wishes — not a judgment about the value of their life.
When a Client with a DNR Stops Breathing or Has No Pulse
✓ DO This
✓Call 911 immediately
✓Stay with the client and keep them comfortable
✓Notify the supervising nurse
✓Follow agency policy for end-of-life situations
✓Provide emotional support if family is present
✓Document the time and circumstances
✗ Do NOT Do This
✗Start CPR
✗Attempt rescue breathing
✗Use an AED if one is present
✗Ignore the DNR because you think CPR might help
✗Allow family pressure to override the DNR
✗Panic or leave the client alone
Types of Advance Directives HHAs Encounter
DNR (Do Not Resuscitate)Instructs providers not to perform CPR if the heart stops. Most relevant to HHAs.
HHA RoleDo not start CPR. Call 911. Notify supervisor.
Living WillA written document stating the client's wishes about end-of-life medical treatment (ventilators, feeding tubes, etc.).
HHA RoleKnow where it is kept. Do not make medical decisions based on it — that is the nurse's and physician's role.
POLST / MOLSTPhysician Orders for Life-Sustaining Treatment. A medical order (not just a directive) specifying which interventions to use or avoid. More detailed than a DNR.
HHA RoleFollow the order exactly. Know where it is posted (often on the refrigerator or near the bed). Call 911 and supervisor when needed.
Healthcare Power of Attorney / Healthcare ProxyA person designated to make medical decisions for the client if they cannot speak for themselves.
HHA RoleKnow who the proxy is and how to contact them. Follow the supervising nurse's guidance on their authority.
DNR Exam Practice Questions
Q1: A client has a DNR order and stops breathing. The HHA should:
A:Call 911 and notify the supervisor immediately. The HHA must NOT start CPR. Follow the DNR — this is the client's legally expressed wish.
Q2: A family member insists the HHA perform CPR on their parent who has a DNR. The HHA should:
A:Explain calmly that the client has a DNR order, call 911, and notify the supervisor. The HHA must respect the legal DNR — family pressure does not override a valid medical order.
Q3: The HHA arrives and is not sure if the client has a DNR. What should they do?
A:Contact the supervising nurse BEFORE an emergency occurs. Know where the DNR/POLST document is kept — it is usually posted on the refrigerator or in a binder per agency policy.
Q4: A DNR means the client does not want:
A:Cardiopulmonary resuscitation (CPR) if their heart stops or they stop breathing. A DNR does not mean the client refuses all medical care — they may still want pain management, oxygen, or IV fluids.
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