A 32-year-old man visits his primary care physician for a routine health maintenance examination. During the examination, he expresses concerns about not wanting to become a father. He has been sexually active and monogamous with his wife for the past 5 years, and they inconsistently use condoms for contraception. He tells the physician that he would like to undergo vasectomy. His wife is also a patient under the care of the physician and during her last appointment, she expressed concerns over being prescribed any drugs that could affect her fertility because she would like to conceive soon. Which of the following is the most appropriate action by the physician regarding this patient's wish to undergo vasectomy?
AExplain the procedure's benefits, alternatives, and potential complications
BRefer the patient to a psychotherapist to discuss his reluctance to have children
CDiscourage the patient from undergoing the procedure because his wife wants children
DInsist that the patient returns with his wife to discuss the risks and benefits of the procedure together
ECall the patient's wife to obtain her consent for the procedure
A 79-year-old man with a history of prostate cancer is brought to the emergency department because of lower abdominal pain for 1 hour. He has not urinated for 24 hours. Abdominal examination shows a palpable bladder that is tender to palpation. A pelvic ultrasound performed by the emergency department resident confirms the diagnosis of acute urinary retention. An attempt to perform transurethral catheterization is unsuccessful. A urology consultation is ordered and the urologist plans to attempt suprapubic catheterization. As the urologist is called to see a different emergency patient, she asks the emergency department resident to obtain informed consent for the procedure. The resident recalls a lecture about the different modes of catheterization, but he has never seen or performed a suprapubic catheterization himself. Which of the following statements by the emergency department resident is the most appropriate?
A“I would prefer that you obtain informed consent when you become available again.”
B“Suprapubic catheterization is not the treatment of choice for this patient.”
C“I would be happy to obtain informed consent on your behalf, but I'm not legally allowed to do so during my residency.”
D“I will make sure the patient reads and signs the informed consent form.”
E“I will ask the patient to waive informed consent because this is an urgent procedure.”
You are a resident on a pediatric service entering orders late at night. Upon arrival the next morning, you note that you had mistakenly ordered that low molecular weight heparin be administered to a 17-year-old patient who does not need anti-coagulation. When you talk to her, she complains about the "shot" she had to get this morning but is otherwise well. How should you handle the situation?
ASince there was no lasting harm to the patient, it is not necessary to disclose the error
BTell the patient and her parents about the error
CYou cannot disclose the error as a resident due to hospital policy
DTell the patient, but ask her not to tell her parents
ESpeak to risk management before deciding whether or not to disclose the error
+ 7 more in the PDF
Browse all chapters