ABPS Patient Care & Treatment Decision Making 2

Question 1

A 68-year-old patient with stage IV COPD refuses intubation during an acute exacerbation. What is the most appropriate next step?

Accepted Answer

Respect the patient's refusal and pursue non-invasive ventilation and comfort measures

Answer

A competent adult's refusal of treatment must be respected; non-invasive ventilation and comfort-focused care align with the patient's wishes.

Question 2

Which principle of bioethics is best exemplified when a physician discloses all risks of a surgical procedure before obtaining the patient's signature?

Accepted Answer

Autonomy

Answer

Informed consent respects autonomy by ensuring the patient can make a voluntary, informed decision about their own care.

Question 3

A 45-year-old diabetic patient presents with a new HbA1c of 9.8%. Current regimen is metformin 1000 mg BID. What is the most guideline-concordant next step?

Accepted Answer

Add a second oral agent or GLP-1 agonist per ADA guidelines

Answer

ADA guidelines recommend combination therapy when HbA1c remains above goal on metformin monotherapy.

Question 4

During a care conference, the team disagrees on whether to pursue aggressive treatment for a terminally ill patient. What resource is most appropriate to resolve this conflict?

Accepted Answer

Hospital ethics committee

Answer

Ethics committees are specifically designed to mediate complex clinical-ethical disputes among patients, families, and care teams.

Question 5

A patient's surrogate decision-maker demands aggressive life-sustaining treatment the care team believes is medically futile. What is the best approach?

Accepted Answer

Explain the concept of medical futility and facilitate an ethics consultation

Answer

Open communication about futility combined with ethics consultation helps align surrogate expectations with medical reality.

(ABPS) American Board of Physician Specialties Certification Practice Test

(ABPS) American Board of Physician Specialties Certification Practice Test

ABPS Patient Care & Treatment Decision Making 2