drtanvir
Forum Junior
Topics: 14
Posts: 41
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21.A 45 yr old man attempted suicide by driving his car into a pole with an intentional purpose of ending his life . he was found severly hemorrhaging & in the ER he refuses to give consent for surgery to stop the bleeding. He states to end his life. He was recently diagnosed with cancer & he refused surgery to remove it . he states that his life is complete & he wishes to end it .
What should u do about the surgery to stop the bleeding???
a.follow his stated wish & withhold surgery
b perform the surgery
c obtain a court order
d.ask family members for consent.
22.A 60 yr old male physician who is an internist has a female patient for the past 20 yrs. Both of them lost their spouses several years ago . they start spending time together outside the office. The female pt wants to begin a romantic relationship with the physician.
What should he tell her?
a.I can never do that with you ever.
b.We can be social but not sexual
c.We need the ethics board;s approval first
d.I cannot date u & be your doctor. May be in the future we can date, after u get another doctor.
e.Because this is your initiative ,we can begin dating.
23.A 38 yr old bus driver is seen in the clinic for fever , cough,with an apical infiltrate & sputum that is positive for acid fast bacilli. The pt is unwilling to take Anti TB medications & consistently the sputum is testing +. Directly observed therapy at home has failed. You continue to cajole , discuss, encourage, threaten, educate, advise him to take the medications, but he refuses,
What should u do.
a.nothing ,as he has a right to autonomy
b.arrest the patient & put him in prison
c.remove the pt from his job as bus driver & incarcerate him in the hospital to take medications.
d.Get a court order
24.You have a HIV+ pt in the office, U ask her if she has informed her partner of her + status. She has repeatedly resisted yout attempts to have her inform her partner. She is pregnant with his child. The partner is in the waiting room ,you have met him several times.
What should u do?
A inform the partner now
B respect her confidentiality
C refer the pt to another physician who is comfortable with her wishes
D tell the partner to practice safe sex from now on but don’t tell him of the HIV status.
25.A 34 yr old man is brought to the ER with fever, headache & a change in mental status leading to significant disorientation. His head CT is normal but he is in need for an urgent LP & IV antibiotics.
He is agitated & is waving at anyone who tries to get ner him . Co-workers accompany him . the resident informs u that the pt is pushing away the LP needle.
What should u do ?
A sedate the pt with lorazepan & perform LP
B wait for family to obtain consent
C use blood cultures as an alternative
D MRI of brain
E ask co-workers to sign consent.
26. A 70 yr old man is admitted to the hospital with endocarditis. At 7 days of therapy the antibiotic order expires & u forgot to re oder the medications for 2 days in the middle of the 4 week therapy. There is no clinical deterioration ans the antibiotics are restarted.
What should u do/
A.tell the pt it was a clerical error
B.because ti was nto clinicall ysignificant u do not have to say anything
C.Apologize & tell the pt that u forgot to reorder & that he will be alright
D.Inform the chief resident but not the pt
E.Ask the nurse to tell the pt about the error.
27.A physician in a busy inner city environment has developed his practice over the years to the point that he no longer needs to solicit new pts. He does not want to expand his hours of work, so he decides to limit his practice. He instructs his office staff to begin refusing to accept new pts.
Which of the foll most appropriately describes the action?
a.it is both legal & ethical
b.it is ethically acceptable but not illegal
c.he is within his legal rights to refuse pts but is ethically unacceptable
d.it is both illegal & unethical
e.it is ethical as long as he arranges transfer of care to another physician
28.U see a 14 yr old boy for an inguinal hernia. The pt requires elective surgery . U ask the parents for consent. The Father consents but the mother refuses . what should u do?
a.Do the surgery ,one parental consent is enough
b.Do not do the surgery since both parents need to sign consent
c.Get a court order
d.Do not perform surgery until the strangulation of bowel occurs.
29.An elderly pt with progressive Parkinson disease come s to see u because of fever, cough ,shortness of breath, sputum production with pneumonia. The pt’s Parkinson disease has been worsening & he has become quite depressed. He has insomnia ,early morning waking, & wt loss as well as anhedonia. He is refusing antibiotics & is asking for palliative care only to help him die.
What should u do?
a.psychiatric evaluation
b sedate the pt
c.comply with pt’s wishes
d seek opinion of family
e.ethics committee referral.
30.An 84 yr old woman with sever Alzheimer’s disease is admittied , she has lost the ability to communicate , is bed bound & is unable to eat. She did not appoint a proxy & there is no written will or clear verbal advance directive. Multiple family members routinely visit her & u are unable to achieve as clear consensus amongnst family members of what the pt ‘s wishes were.
What should u do in terms of her care?
a.follow the wishes of the eldest child
b.follow what u think is best
c.ask another attending of his opinion
d.ask the hospital administrator for consent
e.pursue an ethics committee evaluation.
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| sherry39
Forum Junior
Topics: 3
Posts: 105
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