PAR Advance Directives and Patient Consent 2 — Questions and Answers
Question 1: What is informed consent?
- A patient's agreement to pay their medical bill before receiving treatment
- A process in which a patient voluntarily agrees to a proposed treatment after receiving adequate information about it (Correct answer)
- A physician's approval required before any nursing intervention
- A hospital policy requiring patients to sign all admission forms before registration is complete
Correct answer: A process in which a patient voluntarily agrees to a proposed treatment after receiving adequate information about it
Informed consent is the process by which a patient voluntarily agrees to a proposed medical intervention after being fully informed of its nature, risks, benefits, and alternatives.
Question 2: Which of the following is considered a key element of valid informed consent?
- The patient must sign the consent form in the presence of a notary
- The patient must be told which insurance will cover the procedure
- The patient must receive information about the risks, benefits, and alternatives to the proposed treatment (Correct answer)
- The patient must agree to the treatment within 24 hours of the discussion
Correct answer: The patient must receive information about the risks, benefits, and alternatives to the proposed treatment
Valid informed consent requires disclosure of risks, benefits, and alternatives so the patient can make a knowledgeable, voluntary decision.
Question 3: Under what circumstance may a minor consent to their own medical treatment without parental involvement?
- When the minor is at least 14 years old and accompanied by a school counselor
- When the minor is an emancipated minor or the treatment involves certain legally specified services such as STI treatment (Correct answer)
- When the minor presents a valid student ID and a signed note from a teacher
- Minors may never consent to their own treatment under any circumstances
Correct answer: When the minor is an emancipated minor or the treatment involves certain legally specified services such as STI treatment
Emancipated minors and, in many states, minors seeking treatment for specific sensitive services (e.g., STIs, substance abuse, reproductive health) may provide their own consent.
Question 4: What is a POLST (Physician Orders for Life-Sustaining Treatment) form?
- A financial assistance application for patients who cannot afford life-sustaining treatment
- A set of medical orders reflecting a patient's wishes about specific life-sustaining treatments, signed by a physician (Correct answer)
- An insurance preauthorization form for ICU-level care
- A legal document that appoints a healthcare proxy
Correct answer: A set of medical orders reflecting a patient's wishes about specific life-sustaining treatments, signed by a physician
A POLST is a portable, actionable medical order signed by both the patient (or surrogate) and a physician that specifies the patient's preferences for resuscitation, hospitalization, and other life-sustaining interventions.
Question 5: If a patient who previously signed a DNR order verbally states they have changed their mind and now want resuscitation, what should the PAR do?
- Ignore the verbal statement because the signed DNR takes legal precedence
- Immediately inform the nursing staff and document the patient's expressed wish to revoke the DNR (Correct answer)
- Contact the patient's healthcare proxy to confirm whether the change is valid
- File a new advance directive on the patient's behalf
Correct answer: Immediately inform the nursing staff and document the patient's expressed wish to revoke the DNR
A competent patient can revoke an advance directive or DNR at any time verbally or in writing; the care team must be notified immediately and the change documented.
Question 6: Who has the legal authority to revoke a patient's advance directive?
- Any immediate family member of the patient
- Only the patient's attending physician
- The patient themselves, at any time while competent (Correct answer)
- The hospital's ethics committee after formal review
Correct answer: The patient themselves, at any time while competent
Only the patient who created the advance directive can revoke it, which they may do at any time as long as they retain decision-making capacity.
Question 7: What is implied consent?
- Consent given by a patient's insurance company on behalf of the patient
- Consent assumed in emergency situations when a patient is unconscious and cannot provide consent (Correct answer)
- A standing agreement between a hospital and a physician for routine procedures
- Consent provided by a patient's employer for occupational health treatments
Correct answer: Consent assumed in emergency situations when a patient is unconscious and cannot provide consent
Implied consent applies in emergency situations where a patient is unable to give consent and delay of treatment would result in death or serious harm — the law assumes the patient would consent if able.
