Advance care planning — ABIM Board MCQ

Correct answer: B — Document his daughter as health care proxy and discuss goals of care

The correct answer is B. Advance care planning should occur while the patient retains decision-making capacity. It includes eliciting and documenting his values and goals, discussing anticipated treatment decisions, and completing the appropriate state-specific document designating his daughter as health care proxy. Waiting until capacity is lost forfeits the opportunity to obtain his informed preferences. Clinicians should not make preference-sensitive decisions without patient or surrogate participation, and prognosis discussions should not be delayed. A do-not-resuscitate order addresses only cardiopulmonary resuscitation and should reflect an informed, patient-centered decision; advanced heart failure alone does not justify entering one without discussion and consent.

Reference: Centers for Medicare & Medicaid Services. Advance Care Planning — MLN Fact Sheet. March 2026. https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/advancecareplanning.pdf