Patient Care & Ethical Standards in Neurology Flashcards

A patient with early Alzheimer's disease wants to refuse a recommended medication. What should the clinician assess first?

Answer: Decision-making capacity for this specific decision

Capacity is decision-specific, and a dementia diagnosis alone does not remove a patient's right to decide.

Which four elements are used to assess decision-making capacity?

Answer: Understanding, appreciation, reasoning, and expressing a choice

The Appelbaum criteria are understanding, appreciation, reasoning, and communicating a consistent choice.

A patient with Broca's aphasia is having trouble giving consent. What is the most appropriate approach?

Answer: Use yes/no questions, pictures, and written cues to support communication

Aphasia hurts expression but not necessarily comprehension or capacity, so supported communication should come first.

Under HIPAA, which disclosure of a neurology patient's information is allowed without authorization?

Answer: Sharing records with another provider for treatment

HIPAA allows disclosures for treatment, payment, and operations without separate authorization.

A clinician puts long-term ALS ventilation within reach of all eligible patients regardless of insurance. Which ethical principle does this show?

Answer: Justice

Justice concerns fair and equitable distribution of care and resources.

What is the main purpose of a POLST form for a patient with advanced neurodegenerative disease?

Answer: To turn the patient's treatment wishes into actionable medical orders

A POLST is a set of portable medical orders that reflect current treatment preferences of seriously ill patients.

Which action best prevents falls in a hospitalized patient with Parkinson's disease?

Answer: Give dopaminergic medications on time and help with mobility

Late levodopa doses worsen rigidity and freezing, which raises fall risk, so on-time dosing and assisted mobility are key.