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Advance Care Planning — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGeriatric MedicineAdvance Care PlanningRACP Adult Medicine

A 75-year-old man with dementia, residing in aged care, presents with a temperature of 38.5°C, cough, and SpO₂ 91% on room air. CXR shows right lower lobe consolidation. He has a documented advance care directive (ACD) specifying no ICU admission and no intubation. He does not have a documented directive against IV antibiotics. What is the most appropriate approach?

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Correct answer: E — Commence IV antibiotics and supportive care as per ACD

The ACD specifies limitations on ICU and intubation but does not refuse treatment. IV antibiotics and ward-level supportive care (including supplemental oxygen) should be provided. ACDs should be interpreted literally for what they specify, not extrapolated beyond their scope. Ward-level care with ceiling-of-treatment decisions is appropriate. The clinical team should discuss goals of care with the patient (if capacity exists) and/or substitute decision-maker.

Reference: eTG – 2025 – Palliative Care; Australian Health Ministers Advisory Council – 2011 – National Framework for ACP