D. ADVANCE CARE PLANNING

60. Which of the following statements best describes advance care planning?

1. Advance care planning is the process of discussion of end-of-life care at any time and revised periodically, clarification of related values and goals, and preferences through written documents and medical orders.
2. Advance care planning is the process of discussion of end-of-life care and life-sustaining treatments when the patient is terminally ill and preferences through oral and written documents.
3. Advance care planning involves conversations with a person’s healthcare agent and primary clinician regarding end-of-life care.
4. Advance care planning involves conversations with a person’s healthcare agent regarding end-of-life care and flexible decisions as health status changes.

61. Which of the following statements concerning advance directives (ADs) is correct?

1. An AD is a legally binding contract.
2. An AD is a statement that provides very specific instructions regarding the preferences for life-sustaining treatments an individual would want to receive if unable to express their wishes at a future date.
3. ADs are required to include a living will.
4. An AD designates a proxy to make decisions for a terminally ill patient.

62. Which is preferable—the durable power of attorney or the living will?

1. The living will is preferable because it states what kind of care an individual wants under specific conditions.
2. The durable power of attorney is preferable because it identifies the healthcare agent who will make medical decisions in case of patient incapacity.
3. The durable power of attorney is preferable because it covers not only decisions in a terminal situation but also any treatment decisions.
4. The durable power of attorney and the living will are both preferable. They are patient-initiated documents (advance directive).

63. A patient makes some comments about a living will that leads you to conclude the patient needs more information. You know he understands what a living will is when he says it:

1. Specifies disbursement of assets
2. Addresses all possible medical situations
3. May not always be honored and implemented
4. Describes the specific types of care to be used

64. Advance Care Planning (ACP) was a primary focus of the Institute of Medicine (IOM) report on “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” Of the following recommendations, which is being followed infrequently?

1. Individuals participate actively in decisions regarding their health care.
2. Individuals receive medical services that are consistent with their known values.
3. Clinicians initiate conversations about ACP.
4. ACP is revisited according to patients’ wishes and when status changes.