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NBME 23 Answers

nbme23/Block 2/Question#38 (33.8 difficulty score)
A 78-year-old man is found unresponsive in ...
"Thank you for telling me this. Your friend's previous statements to you can be helpful in making decisions for him."πŸ”

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submitted by stinkysulfaeggs(92),
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yeK dws:or at" siht "mtie nda "acn eb lf"pulhe

ehT ansrwe ot htis neuoisqt nts'i: gaert - own 'ewre gigon to keta him ffo hte tnev ebcesua yuo dlot su thsat' awth he endaw.t

nbmehelp  ^^^ exactly +  

submitted by bmilt34(2),

Some things ive noticed for these types of questions? 1) dont be a dick (b, d, e) 2) dont differ to some other person (a)

submitted by nlkrueger(43),
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.... uldwo we arelyl take hte dwro fo a fndrei hwo eeityinldf nt'ca be ?nmofidrce I feel klie htsi si imsnedilga

lispectedwumbologist  All the other answer choices make you come across as an asshole. Easy way to ace ethics questions is to just not be an asshole +9  
seagull  I would be a bigger asshole when the family came I'n after I pulled the plug...opps...but the friend said +28  
dr.xx  The patient has no wife, children, or close relatives... +3  
nwinkelmann  @lispectedwumbologist this is going to be my technique, because I've gotten a couple of these wrong, but I completely agree with everyone else's sentiments of suspicion of going off what a friend said without any confirmation about state of advance directives, etc. It's really dumb. +3  
paulkarr  With these questions; you have to take what NBME says at face value. If it says no family, he really does have no family. This friend is also claiming that the 78 y/o said this about himself, so we know it's the patients wishes rather than someone else's wishes for him. (A son saying he can't let go of his father yet despite the patient's DNR type of situation). +1  
suckitnbme  I think the point here isn't that we would take the patient off the ventilator because the friend said so. The answer is saying "Thank you for your input, we will take that into consideration." It's completely non-committal. +7  
vivijujubebe  they say no close relatives, which means he could have remote relatives, relatives must be asked before listening to a stranger/friend's words..... +  

submitted by syoung07(21),

YUUUUUUUGE key here- patient wife has been dead for 5 years and he has no children or close relatives. This "friend" has been taking care of our guy here like a relative would. So based on NBME that close enough.

submitted by rockodude(16),

not sure if this is right but the way I thought about it was that after family a surrogate decision maker can be a close friend and the neighbor has cooking for him and running errands for the last 5 years since his wife died so I believe that the close friend surrogate designation may apply

submitted by tinydoc(223),
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'Iev ahd a luwodr q rewhe hte trercoc npesesro aws to evorme eth ilef pspuotr fi hte ptntaie is mtriededen not ot be an ngroa eovon.enrd if het fliyam is vtciayle ngstiaa hist osi.dicne In my rnexieepce hte wrsane ahtt is smto thseno (nda llkyei kesma you snouds eikl a talecsst )oeslahs is suualyl het rcetcor one no MEs.BN I icdekp E dna I d'otn see woh htis isdnefr pnionoi on shi cdvanead reca idsveeictr era ta lal nterlave if hte iapentt yb all acnstou lmcelaiyd adn llyagle si eidoscernd ded.a

submitted by usmleuser007(377),
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So sa a hpcisainy pre isth itounqes uoy liwl go of msoe ho'snrebig wsrod nad tno frimcno if hte ipttane sha an davneadc msees liek het ocd adn hte ogibhren rae ni oems kidn of a ldea eher ....