AMA Code of Medical Ethics Physician-Patient Relationships, Informed Consent,

Competency and Capacity, Surrogate Decision Making Standards, Duty to Warn, Minor's
Healthcare Decision Making, Confidentiality in Healthcare, EMTALA

1. Correct Answer: B) The patient's ability to understand and appreciate the consequences
of his health decisions
o Explanation: Evaluating a patient’s competency involves assessing their ability
to comprehend the implications of their health decisions, which is critical in acute
psychiatric settings. This is foundational to ethical and informed consent.
o Why others are wrong:
 A) Age is not a direct indicator of competency.
 C) Socioeconomic status does not affect competency evaluation.
 D) The urgency of treatment does not negate the need for competency
assessment.
 E) Previous medical history can provide context but does not solely
determine competency.
2. Correct Answer: B) Maintain confidentiality according to the patient's rights
o Explanation: Maintaining confidentiality is essential in healthcare, particularly
with minors seeking sensitive services like birth control, where legal provisions
allow.
o Why others are wrong:
 A) Parental financial responsibility does not override confidentiality
rights.
 C) Providing treatment conditional on parental notification contravenes
confidentiality protections.
 D) Referring to another state is unnecessary and impractical.
 E) Court intervention is not required where minors can legally consent.
3. Correct Answer: D) A patient threatens direct violence against a specific person
o Explanation: The duty to warn arises when a patient poses a credible threat to a
specific individual, requiring the physician to take steps to prevent harm.
o Why others are wrong:
 A) Cheating does not pose a direct threat to others.
 B) While important, STI disclosure does not fall under the duty to warn.
 C) Vague intentions are not sufficient to necessitate a breach of
confidentiality.
 E) Child neglect should be reported, but it is a different legal and ethical
issue from the duty to warn.
4. Correct Answer: C) Provide the necessary treatment to stabilize the patient
o Explanation: EMTALA requires emergency departments to provide stabilizing
treatment for patients in emergent conditions regardless of their ability to consent
or pay.
o Why others are wrong:
 A) Delaying treatment could jeopardize the patient’s health.
 B) Transfer is not appropriate without stabilization.
 D) Waiting for a guardian can delay necessary immediate care.
  E) Discharging an unstable patient is unethical and illegal under
EMTALA.
5. Correct Answer: A) His closest adult relative
o Explanation: In surrogate decision-making, the closest adult relative usually has
the legal standing and personal insight to make health decisions for an
incapacitated adult.
o Why others are wrong:
 B) Healthcare providers can assist but typically do not make decisions
unless designated.
 C) A state-appointed guardian is usually a last resort.
 D) Willing adults in the facility are not automatically qualified.
 E) Roommates unless legally designated, generally do not have decision-
making authority.
6. Correct Answer: B) The minor’s right to confidential care
o Explanation: In jurisdictions where minors can consent to healthcare services
such as STD testing, the physician should respect the patient's right to
confidentiality.
o Why others are wrong:
 A) Parental rights do not override specific legal protections for minor’s
health confidentiality.
 C) The law supporting minor’s consent is already being followed.
 D) Public health implications do not override individual rights to
confidentiality.
 E) Facility policies must align with legal standards, not contravene them.
7. Correct Answer: A) Witnessed documentation of the patient’s consent
o Explanation: Documenting a DNR order with clear, witnessed consent ensures
that the patient’s wishes are respected and legally recognized.
o Why others are wrong:
 B) Family agreement is supportive but not legally necessary.
 C) Ethics committee approval is not required for DNR orders.
 D) Understanding the decision is important but must be documented.
 E) Physician's assessment is part of the care process but secondary to
documented consent.
8. Correct Answer: C) Before performing any non-emergency diagnostic or therapeutic
procedure
o Explanation: Informed consent is necessary before any significant medical
procedure that carries risk, ensuring that the patient is aware and agrees to the
intervention.
o Why others are wrong:
 A) Discussing the condition with professionals is part of treatment and
does not always require consent.
 B) Entering a relationship requires general consent but not specific
informed consent for procedures.
 D) Invasive surgery is included but not the only scenario requiring
informed consent.
  E) Every hospital visit doesn't necessitate new informed consent unless
new procedures are planned.
9. Correct Answer: C) Regardless of the patient's ability to pay or insurance status
o Explanation: EMTALA mandates that emergency departments provide necessary
stabilizing treatment to all patients regardless of their financial status or insurance.
o Why others are wrong:
 A) Ability to pay is irrelevant under EMTALA.
 B) Payment agreement beforehand is not a requirement for emergency
care.
 D) Legal status or violations do not affect the provision of emergency
care.
 E) Citizenship or residency status does not influence emergency medical
treatment under EMTALA.

Grief Cycle, Effective Communication Delivering News

10. Correct Answer: C) Bargaining

 Explanation: In the grief cycle, bargaining often involves the person seeking ways to
delay or mitigate the impact of the diagnosis, such as seeking multiple opinions or
alternative treatments.
 Why others are wrong:
o A) Denial typically involves outright refusal to accept the diagnosis.
o B) Anger might be directed towards the medical staff or situation but doesn't
involve seeking alternatives.
o D) Depression involves feelings of hopelessness, not active seeking of
alternatives.
o E) Acceptance indicates a recognition and acceptance of the diagnosis, not
seeking to change it.

11. Correct Answer: C) Ensuring privacy, using clear language, and allowing time for
questions

 Explanation: Effective communication, especially when delivering bad news, requires a

private setting, clear and understandable language, and ample time for the patient to
process information and ask questions.
 Why others are wrong:
o A) Using medical jargon can confuse and alienate patients.
o B) Providing detailed statistics can overwhelm and distress the patient further.
o D) Rushing the discussion can prevent adequate understanding and adjustment.
o E) Ignoring potential challenges can leave the patient unprepared for future
realities.

12. Correct Answer: B) Discuss detailed plans for end-of-life care

  Explanation: When a patient is in the acceptance stage of grief regarding a terminal
illness, it is appropriate to discuss end-of-life care plans to ensure their wishes are
understood and respected.
 Why others are wrong:
o A) Reconsidering treatment options may not be relevant if the patient has
accepted their prognosis.
o C) Immediate family counseling might not be necessary if the patient is already at
acceptance.
o D) Focusing on immediate medical interventions might ignore the patient’s
current acceptance of their condition.
o E) Challenging their acceptance can be seen as dismissive of their understanding
of their situation.

Due to the character limit, I will continue with explanations for the remaining questions in a
follow-up message.

Continue
ChatGPT

Continuing with the detailed explanations and reasons why other choices are incorrect for the
questions provided:

Benefits of Hospice, Admission Criteria, Payment, Eligibility, Interprofessional Team, Non-

Disease-Specific Evidence of Rapid Decline

13. Correct Answer: C) It offers comprehensive symptom management and support

 Explanation: Hospice care focuses on the comprehensive management of symptoms and

provides support for patients and their families, emphasizing comfort and quality of life
at the end of life.
 Why others are wrong:
o A) Hospice does not provide cures for underlying diseases.
o B) The focus is not on prolonging life at all costs but on comfort.
o D) Hospice care does not require hospitalization; it is often provided at home.
o E) Hospice care is not about conducting research but providing palliative care.

14. Correct Answer: B) Patient must have a life expectancy of 6 months or less

 Explanation: One of the primary criteria for hospice eligibility is that the patient must
have a prognosis of six months or less if the disease follows its expected course.
 Why others are wrong:
o A) Having a caregiver at home may be helpful but is not a criterion for eligibility.
o C) Being fully ambulatory is not required for hospice care.
 o D) Patients do not need to discontinue all other medical treatments to qualify.
o E) The number of hospitalizations does not directly determine hospice eligibility.

15. Correct Answer: B) Through Medicare Part A with no cost to the patient for hospice
services

 Explanation: Hospice care is typically covered under Medicare Part A, which covers all
necessary hospice services without cost to the patient.
 Why others are wrong:
o A) It is not typically funded out-of-pocket.
o C) While private insurance can cover hospice, Medicare is primary for many.
o D) State programs may assist, but Medicare is a federal program.
o E) Hospice care is funded through insurance and Medicare, not donations or
charity care.

16. Correct Answer: B) To coordinate care focused on the patient’s quality of life

 Explanation: The interprofessional hospice team coordinates care plans focused on the
patient’s symptoms and quality of life, ensuring comprehensive management.
 Why others are wrong:
o A) The focus is not on intensive curative treatments.
o C) Family training for complex medical procedures is not a primary role.
o D) Experimental treatments are generally not part of hospice care.
o E) Spiritual counseling is included, but the focus is broader than just this aspect.

17. Correct Answer: C) Eligibility for hospice care based on rapid decline criteria

 Explanation: Non-disease-specific evidence of rapid decline, such as increased

confusion and inability to perform daily activities, can qualify a patient for hospice under
rapid decline criteria.
 Why others are wrong:
o A) Surgical interventions are not appropriate for hospice care eligibility
considerations.
o B) Such evidence does not disqualify a patient from hospice.
o D) Re-evaluation in six months is not relevant if current symptoms indicate rapid
decline.
o E) Aggressive rehabilitation is contrary to the goals of hospice care.

18. Correct Answer: C) A patient experiencing progressive weight loss and frequent
hospital visits

 Explanation: Progressive weight loss and frequent hospitalizations are indicative of a

significant decline in health, which can be criteria for hospice care eligibility under non-
disease-specific triggers.
 Why others are wrong:
o A) Intermittent headaches and mild anxiety do not typically qualify for hospice.
 o B) Stability in chronic illness does not meet the criteria for rapid decline.
o D) Desire for aggressive therapy is incompatible with hospice eligibility.
o E) Minor age-related memory loss alone does not qualify for hospice without
other declining health factors.

19. Correct Answer: C) Documented rapid decline in physical and mental status

 Explanation: Documentation of rapid decline in both physical and mental capacities is

critical in determining eligibility for hospice care, as it reflects a significant progression
towards end-of-life.
 Why others are wrong:
o A) Educational background is irrelevant to hospice eligibility.
o B) Supportive family environments are helpful but not a criterion for eligibility.
o D) Financial resources do not determine medical eligibility for hospice.
o E) Availability of facilities is a logistical issue but does not impact the medical
criteria for eligibility.

This completes the explanations for the specified questions. Each explanation is designed to
clarify the correct answer and provide insight into why alternative options do not correctly
address the question, ensuring a comprehensive understanding of each topic.

Continue
ChatGPT

Let's continue with detailed explanations for the remaining questions in the specified categories:

Palliative Care vs Hospice Care, Palliative Care Effects on Length of Survival, Importance
of Advance Care Planning and Living Will, Role of a Surrogate and Physician in ACP,
Challenges of ACP, MOST and POLST Forms

20. Correct Answer: B) Hospice care requires a prognosis of 6 months or less to live

 Explanation: Hospice care is specifically designed for patients who have a prognosis of
6 months or less, emphasizing comfort and quality of life rather than curative treatment.
 Why others are wrong:
o A) Palliative care is not limited to end-of-life scenarios but is appropriate for any
stage of a serious illness where symptom management is needed.
o C) Palliative care can indeed be provided alongside curative treatments.
o D) Hospice care does not focus on curing the illness; it focuses on comfort.
o E) Palliative care is available to patients with a variety of illnesses, not just
cancer.

21. Correct Answer: B) Longer length of survival compared to those receiving standard care
 Explanation: Studies have shown that patients with serious illnesses like advanced lung
cancer can experience a longer length of survival when palliative care is integrated early,
likely due to better overall management of symptoms and reduced treatment-related
complications.
 Why others are wrong:
o A) Early palliative care does not typically shorten survival; it tends to enhance
quality of life and can extend it.
o C) The focus of palliative care is not on curing the underlying disease.
o D) Palliative care generally improves quality of life, rather than decreasing it.
o E) Palliative care aims to reduce the use of invasive procedures by focusing on
symptom management.

22. Correct Answer: B) To provide patients with control over the medical care they receive
towards the end of life

 Explanation: Advance care planning is crucial for ensuring that patients' preferences for
end-of-life care are understood, respected, and followed, giving them control over how
they receive care as their condition progresses.
 Why others are wrong:
o A) The main purpose is not merely to follow healthcare provider's expertise but to
align care with the patient's wishes.
o C) Discussing potential medical complications is a part of advance care planning,
not something to avoid.
o D) ACP ensures personalized care that respects individual preferences, not
uniformity.
o E) The priority in ACP is the patient's wishes, not the family's unless designated
by the patient.

23. Correct Answer: B) To interpret and implement the patient’s preferences for end-of-life
care if the patient is unable to do so

 Explanation: The surrogate’s role in ACP is to ensure that the patient’s advance
directives and end-of-life care preferences are implemented, particularly when the patient
can no longer communicate their wishes.
 Why others are wrong:
o A) The surrogate must base decisions on the patient's previously expressed
wishes, not independent decision-making.
o C) Providing information about treatment options is typically the role of the
healthcare provider.
o D) Financial management is not typically within the surrogate's role unless
specifically designated.
o E) Deciding to withdraw all medical treatment without following the patient’s
directives would be inappropriate.

24. Correct Answer: C) It can be difficult for patients to predict their future healthcare
preferences
 Explanation: One of the significant challenges in advance care planning is that patients
may find it hard to foresee their preferences for future healthcare situations, which can
change as their medical condition evolves or new treatments become available.
 Why others are wrong:
o A) Having too much medical knowledge is not a typical challenge faced in ACP.
o B) It is generally assumed that healthcare providers will follow legally valid
advance directives.
o D) Legal restrictions typically support, rather than hinder, the creation of advance
directives.
o E) Studies have shown that advance care planning improves outcomes by
ensuring care aligns with patient wishes, making it an essential part of patient-
centered care.

25. Correct Answer: B) Specific medical orders that relate to the current standard of care for
their condition

 Explanation: POLST forms provide specific medical orders that are intended to be
followed by healthcare professionals, especially in emergency situations, to ensure that
the care provided aligns with the patient's wishes as they relate to their current health
status.
 Why others are wrong:
o A) POLST forms are not concerned with financial or inheritance issues.
o C) They are not about lifestyle changes but specific medical interventions.
o D) They do not deal with insurance coverage specifics.
o E) They do not provide legal advice.

26. Correct Answer: B) It provides specific medical orders for emergency medical services

 Explanation: Unlike a traditional living will, which may express broader wishes about
end-of-life care, a MOST form (Medical Orders for Scope of Treatment) provides
explicit and actionable medical orders to healthcare providers, particularly useful in
emergency situations.
 Why others are wrong:
o A) MOST forms are legally binding and used to guide immediate medical care.
o C) They are applicable to patients with serious health conditions, not just those
without serious illnesses.
o D) They are not focused on financial planning.
o E) MOST forms are recognized in many states, making them widely applicable.

27. Correct Answer: B) To facilitate understanding of the patient's values and treatment
preferences

 Explanation: The physician's primary role in advance care planning is to help the patient
articulate and document their values and preferences regarding future medical care,
ensuring these are understood and can be respected.
 Why others are wrong:
 o A) The physician should not impose standard medical advice over personalized
patient preferences.
o C) The physician should not make unilateral decisions about patient care.
o D) Delegating decision-making to nursing staff is inappropriate in the context of
ACP.
o E) While documenting medical history is important, the focus in ACP is on
discussing and documenting future care preferences.

28. Correct Answer: C) Patients may change their mind about their preferences as their
condition evolves

 Explanation: One of the primary challenges in advance care planning is that a patient's
preferences may change, particularly as their medical condition changes or as they have
different experiences with their illness and treatment.
 Why others are wrong:
o A) Clarity and consistency in medical preferences are often not observed due to
changes in the patient's condition or new medical information.
o B) Physicians often face time constraints, making detailed discussions about end-
of-life options challenging.
o D) There is no universal protocol for ACP, which can complicate the planning
process.
o E) Medical technology enhances treatment options but does not eliminate the
need for personalized advance care planning.

29. Correct Answer: B) It ensures that the patient’s healthcare preferences are followed if
they become unable to communicate

 Explanation: A living will is crucial because it documents a patient's healthcare

preferences in detail, which is especially important if the patient later becomes unable to
communicate their wishes due to illness or incapacity.
 Why others are wrong:
o A) A living will does not absolve the healthcare team of legal responsibilities; it
guides them in following the patient's wishes.
o C) It does not guarantee that medical errors will not occur but helps prevent errors
in the type of care administered against the patient's wishes.
o D) It is not intended to serve as a financial plan for the patient’s family.
o E) It does not prevent emergency care unless specified in the document.

30. Correct Answer: A) To detail the patient’s wishes for specific interventions like
intubation or resuscitation

 Explanation: POLST forms are designed to specify a patient's preferences for critical
interventions such as intubation or resuscitation, ensuring that these preferences are clear
and can be immediately acted upon in emergency situations.
 Why others are wrong:
o B) POLST forms are not mere suggestions; they are specific directives.
 o C) They do not deal with property or legal issues.
o D) While educational about medical conditions, this is not the primary purpose of
POLST forms.
o E) They focus on current medical decisions, not historical health records.

These detailed explanations ensure a thorough understanding of why each answer choice is
correct or incorrect, providing clarity on the application of medical ethics, advanced directives,
and care planning in clinical practice.

Continue
ChatGPT

Continuing with the answers and explanations for the final set of questions:

HDI, EPI, Relation Between Health and Education, Risk Factors for DALYs in Low-
Income Countries

31. Correct Answer: B) It includes health as a key component along with education and
income

 Explanation: The Human Development Index (HDI) is a composite statistic of life

expectancy (health), education, and income per capita indicators, which are used to rank
countries into tiers of human development.
 Why others are wrong:
o A) HDI measures broader impacts rather than direct medical treatment effects.
o C) It is not solely focused on economic wealth but includes health and education
as critical components.
o D) HDI is not used for individual treatment plans but for assessing the general
development level of populations.
o E) It does not predict technological advancements but measures current states of
development.

32. Correct Answer: C) Increasing the rate of immunizations against vaccine-preventable

diseases in children

 Explanation: The Expanded Program on Immunizations (EPI) aims to ensure that all
children, particularly those in countries with high disease burden, receive vaccines
against major preventable diseases like measles, polio, and tuberculosis.
 Why others are wrong:
o A) EPI is focused on communicable, not non-communicable diseases.
o B) It does not provide health insurance but directly facilitates vaccinations.
o D) Its primary goal isn’t to promote private healthcare facilities.
o E) While beneficial to public health, EPI's main focus is on immunization, not
funding medical research.
 33. Correct Answer: C) Higher education levels are correlated with lower mortality rates

 Explanation: Studies consistently show that higher education levels correlate with lower
mortality rates. Education contributes to better health behaviors and access to healthcare,
improving overall health outcomes.
 Why others are wrong:
o A) Higher education typically leads to better, not worse, health outcomes.
o B) Education significantly impacts health through various social and economic
mechanisms.
o D) Impact is not limited to primary education; all levels of education contribute to
health.
o E) Education generally decreases the prevalence of chronic diseases by promoting
healthier lifestyles and access to healthcare.

34. Correct Answer: C) Unsafe water and poor sanitation

 Explanation: In low-income countries, unsafe water and poor sanitation are critical risk
factors contributing to a high disease burden, particularly for conditions that lead to
significant DALYs like diarrheal diseases.
 Why others are wrong:
o A) Overutilization of healthcare is typically not a problem in low-income
countries; underutilization due to lack of access is more common.
o B) Imported goods do not directly affect DALYs related to health conditions.
o D) Technology use is generally low in low-income countries and does not directly
relate to health risks.
o E) High rates of employment do not necessarily correlate with health risks;
unemployment and poor working conditions are more relevant factors.

Role of Different Healthcare Providers, SBAR, Institute of Medicine's Core Competencies,

Best Communication Practices

35. Correct Answer: A) By providing a brief and structured communication outline about
patient status

 Explanation: SBAR (Situation, Background, Assessment, Recommendation) provides a

clear, structured method for communication that enhances the accuracy and efficiency of
information transfer during shift changes or other handoffs.
 Why others are wrong:
o B) SBAR focuses on objective, relevant clinical information, not personal
opinions.
o C) Omitting details can lead to incomplete care or misunderstandings.
o D) SBAR should include both resolved and unresolved issues to provide
comprehensive care.
o E) It’s important to report all relevant patient information, not just new
admissions.
36. Correct Answer: B) They emphasize an interdisciplinary approach to patient care

 Explanation: The Institute of Medicine’s core competencies are designed to foster an

interdisciplinary approach to healthcare, which improves patient outcomes by integrating
diverse expertise and perspectives in patient care planning.
 Why others are wrong:
o A) The competencies encourage integration across specialties, not isolation.
o C) They promote, rather than restrict, the use of appropriate technology in care.
o D) They support roles for various health professionals, not just physicians.
o E) The format of medical education is outside the scope of these core
competencies.

37. Correct Answer: C) Tailoring the discussion to the patient’s level of understanding

 Explanation: Effective communication in healthcare involves adjusting the complexity

of information to match the patient's understanding, ensuring they can make informed
decisions about their care.
 Why others are wrong:
o A) Using complex medical terminology can confuse patients rather than help
them understand their condition.
o B) Providing information too quickly can overwhelm patients and impede
understanding.
o D) Avoiding negative information can prevent patients from fully understanding
their condition and the possible outcomes.
o E) It’s the provider's responsibility to ensure the patient understands their health
status; delegating this to nursing staff may lead to inconsistency in
communication.

38. Correct Answer: D) To optimize medication management and educate patients on drug
interactions

 Explanation: Pharmacists play a crucial role in managing medication therapies,

including adjusting dosages, ensuring medications are safe and effective, and educating
patients about potential drug interactions and side effects.
 Why others are wrong:
o A) Diagnosing conditions is generally outside the pharmacist's scope of practice.
o B) Primary care services are typically provided by physicians or nurse
practitioners.
o C) Managing the entire healthcare team is generally the role of administrative or
clinical leaders, not pharmacists.
o E) Pharmacists do not perform surgical procedures; their expertise is in
pharmacology.