A 64-year-old woman with MS is hospitalized. The team feels she may need to be placed on a feeding tube soon to assure adequate nourishment. They ask the patient about this in the morning and she agrees. However, in the evening (before the tube has been placed), the patient becomes disoriented and seems confused about her decision to have the feeding tube placed. She tells the team she doesn't want it in. They revisit the question in the morning, when the patient is again lucid. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure. Which of the following is a true statement regarding the facts you have from this case?

Select one:

a. The patient has an impaired decision-making capacity.

b. The team is legally required to proceed with the feeding tube.

c. The patient was never competent.

d. The patient should be given a reasonable accommodation.

Clear my choice

Question 2

Amy Anderson has been certified in writing by one physician to be incompetent and to have a terminal condition. Amy has a directive to physicians and a durable power of attorney for health care that names her husband as her agent. Her husband has directed that all life-sustaining procedures be stopped. The physician is obligated to comply with the husband’s request.

Select one:

True

False

Question 3

Edith Edwards has contracted a highly contagious viral infection. Her physician, an infectious-disease specialist, instructs Edith to refrain as much as possible from contact with her family for the next 72 hours. As long as the physician has no physician-patient relationship with any other family members, he does not have a duty to warn them of Edith’s contagious condition.

Select one:

True

False

Question 4

A 55-year-old man has a 3-month history of chest pain and fainting spells. You feel his symptoms merit cardiac catheterization. You explain the risks and potential benefits to him, and include your assessment of his likely prognosis without the intervention. He is able to demonstrate that he understands all of this, but refuses the intervention. Which of the following is a true statement regarding the facts you have from this case?

Select one:

a. The patient has an impaired decision-making capacity.

b. The physician is legally required to proceed with the cardiac catheterization.

c. The physician has a duty to respect the patient's choice.

d. The patient should be given a reasonable accommodation.

Question 5

A newspaper reporter seeks information from a receptionist about a prominent personality who has been hospitalized. What information can be given to the reporter?

Select one:

a. None

b. The basic fact that the person is a patient.

c. The name and phone number of the attending physician.

d. There are no restrictions.

Question 6

Injection of seminal fluid into a woman to induce pregnancy is

Select one:

a. artificial insemination.

b. in vitro fertilization.

c. pre-implantation genetic diagnosis.

d. zygote intrafallopian transfer.

Question 7

The medical record is legally owned by the

Select one:

a. patient.

b. physician.

c. state.

d. lawyer.

e. no one.

Question 8

The doctrine of informed consent

Select one:

a. can be delegated by the physician to a trusted assistant.

b. may have to be waived in the event of an emergency situation.

c. does not have to be signed by every patient.

d. could result in a lawsuit for assault and battery if not performed.

e. b and d only.

Question 9

Mr. Cure presented with signs and symptoms suggestive of bacterial meningitis. When he was told his diagnosis and told he would be admitted to the hospital for treatment with antibiotics, he refused further care without giving a reason. The physician explained the extreme dangers of going untreated and the minimal risk of treatment. The young man persisted in his refusal. He exhibited no evidence of mental derangement or altered mental status that would suggest decisional incapacity. This patient's refusal of treatment is based on

Select one:

a. competent refusal.

b. refusal on the grounds of unusual belief.

c. enigmatic refusal.

d. an act of omission.

Question 10

A patient is given an inert substance with no pharmacological effect for her back pain. This treatment significantly decreases her level of pain. This is referred to as a

Select one:

a. act of omission.

b. placebo effect.

c. right "Not to Know."

d. disclosure.

Question 11

Confidentiality is an absolute obligation for a health care professional.

Select one:

a. True

b. False

Question 12

When the family does not know the wishes of the patient, end of life decisions may be very difficult.

Select one:

a. True

b. False

Question 13

A patient tests positive for tuberculosis. You are required to break patient confidentiality to protect the public welfare.

Select one:

a. True

b. False

Question 14

Frank Churchill has been admitted to the hospital after suffering extensive injuries in a motor vehicle accident. He is unconscious when he is brought into the Emergency Room. The Emergency Room surgeons have determined that Churchill needs immediate surgery to repair extensive external and internal traumatic injuries to the head and abdomen, any of which would be life-threatening if untreated, and all of which are potentially correctable with surgery. His immediate needs, in addition to surgery, include mechanical ventilation and a blood transfusion. The exact extent of his brain injuries, as well as the duration of any impairment that might result, are unknown at this early time. All physicians involved in Frank's care agree that the standard of care, in the absence of a competent refusal to consent, is immediate intubation, transfusion, and surgery. Jane Fairfax, Frank’s girlfriend, was brought into the hospital at the same time. She is conscious, alert, and competent. Jane insists (a) that Frank not be intubated or transfused and that (b) major surgery not be performed on the grounds that both types of intervention would oppose his "living will." If the physicians proceed with the surgery on Frank, they would be adhering to which of the following?

Select one:

a. Frank's advance directive

b. Frank's living will

c. Implied consent

d. Express consent

Question 15

Becky and Charlie are married. Becky does not produce viable eggs. Becky consents to an in vitro fertilization process in which a donor egg is combined with sperm from Charlie, and the resulting embryo is implanted in Becky’s uterus. On these facts, the Becky is NOT the

Select one:

a. Intentional mother.

b. Genetic mother.

c. Gestational mother.

d. Nurturing mother.

Question 16

The hospital committee concerned with the review, revision, and implementation of research protocols which address implications for human research and ethical issues of research in general is the

Select one:

a. Institutional Research Council.

b. Institutional Ethics Board.

c. Hospital Board of Trustees.

d. Institutional Review Board.

Question 17

When a husband and wife decide to have a child or children through a surrogate, we do know that the wife is not the

Select one:

a. intentional mother.

b. genetic mother.

c. gestational mother.

d. nurturing mother.

Question 18

It is believed that human embryonic stem cells offer great promise of a cure for which of the following conditions?

Select one:

a. Alzheimer's disease

b. Chronic obstructive pulmonary disease

c. Lung cancer

d. Cardiovascular disease

Question 19

Exceptions to informed consent include

Select one:

a. telling the patient about the risk involved in not having the procedure.

b. the discussion of sensitive sexual matters.

c. not having to explain risks that are commonly known.

d. all of the above.

e. none of the above.

Question 20

A 40-year-old gay man with AIDS presents to the emergency room with his third bout of pneumocystis pneumonia. He is intubated as his condition is worsening steadily and he has not responded to appropriate antibiotic therapy. The patient's longtime partner, Richard, has a signed durable power of attorney (DPOA) and states that if the patient's condition becomes futile the patient would not want ongoing ventilation. The attending physician decides that ongoing intubation is futile. Richard is consulted and the decision is made to remove the patient from the ventilator to allow him to die in the morning. The patient's Roman Catholic parents arrive from Kansas and threaten a lawsuit if the ventilator is withdrawn. Who is the legal decision maker here?

Select one:

a. The patient

b. Richard

c. The parents

d. The attending physician