Mr. Taylor's lung cancer has recently metastasized to his bones, ...

[bclement10]

Mr. Taylor's lung cancer has recently metastasized to his bones, resulting in a sudden worsening of his prognosis and a sharp increase in his pain.
 
  Despite his earlier declarations to fight this thing to the bitter end and the absence of a living will, he has now informed the nurse that the only medication he now wants is for pain control. How should the care team respond to Mr. Taylor's statement?
 
  A) Maintain aggressive medical treatment until Mr. Taylor produces a written statement.
  B) Discontinue medical treatment if Mr. Taylor's family members unanimously agree.
  C) Document and honor Mr. Taylor's wishes.
  D) Refer the matter to the hospital's ethics committee.

Question 2

An 81-year-old woman has been experiencing episodes of increasing forgetfulness in recent months, a problem that prompted her to seek care from her primary care physician.
 
  After tests and referrals, she has just received a diagnosis of early-stage Alzheimer's disease. What type of loss is this woman most likely to experience?
 
  A) Sudden and perceived
  B) Gradual and observable
  C) Temporary and unexpected
  D) Anticipatory and perceived

[meganlapinski]

Answer to Question 1

Ans: C
The dying declaration exception to hearsay allows statements referred to as death bed declarations to be honored by the medical and nursing staff. For example, a client, who is aware that death is imminent and has not completed a living will, may inform the nursing staff that he wants all medication, including intravenous (IV) therapy, to be discontinued. Such a request can be honored if documented.

Answer to Question 2

Ans: B
Cognitive declines are typically gradual in progression and the effects are readily observable to others. Such a loss would likely be unexpected and anticipatory, but it would not be perceived (ie, invisible to others) or temporary.