Supporting Organ and Tissue Donation in Clinical Settings: The Pennsylvania Requirement _ ____________
F inal E xam
SUPPORTING ORGAN AND TISSUE DONATION IN CLINICAL SETTINGS: THE PENNSYLVANIA REQUIREMENT Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 121 or complete your test online at BOOK.CME.EDU. A passing grade of at least 70% must be achieved in order to receive credit for this course.
31. What should you do when a patient with a history of treated metastatic cancer presents with a catastrophic brain injury and organ donation is being considered? A) Contact the transplant surgeon to review the patient’s medical history before calling the OPO. B) Defer the donation discussion until the family brings up the topic independently. C) Refer the patient to the OPO and allow the OPO medi- cal director to determine medical suitability. D) Rule the patient ineligible for donation based on the cancer history and document accordingly. 32. What is the defining feature of the donation after circulatory death (DCD) pathway? A) Cardiac death following withdrawal of life-sustaining treatment precedes organ procurement. B) Declaration of brain death by a physician independent of the transplant team precedes organ procurement. C) Organ procurement begins while the patient is main- tained on mechanical ventilatory support throughout. D) Simultaneous consent for donation and withdrawal of treatment must be obtained before any procurement. 33. Before beginning the clinical brain death examination, what prerequisite must be confirmed in an adult patient? A) A documented observation period of at least 48 hours following the neurological injury B) Confirmation of bilateral fixed and dilated pupils on bedside assessment C) Documentation of an isoelectric pattern on electroen- cephalography D) Exclusion of CNS-depressant drugs and absence of pharmacologic paralysis
34. In which situation is ancillary testing appropriate when evaluating a patient for brain death? A) A clinical team member prefers additional objective evidence to support the bedside examination B) Clinical examination or apnea testing cannot be com- pleted due to the patient’s medical condition C) Family members request independent confirmation before accepting the brain death diagnosis D) Institutional policy mandates two physician declara- tions for the brain death determination 35. What does the principle of decoupling describe in the context of organ donation family communication? A) Separating the notification of brain death from the subsequent conversation about donation B) Structuring communications so the OPO coordinator leads all family meetings independently C) Waiting until the family independently raises the topic of donation before any discussion D) Withholding clinical information until the family sup- port coordinator is fully briefed 36. What is a clinically important distinction between tissue donation and solid organ donation eligibility? A) Brain death declaration is required as a prerequisite before any tissue recovery can occur. B) Registration in the state donor registry is required before tissue donation authorization. C) Solid organ donors are the only patients from whom tissue donation can be pursued. D) Tissue donation can occur up to 12 to 24 hours after cardiac death, expanding the potential donor pool.
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MDPA2326
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