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Advance directive — USMLE Step 2 CK MCQ

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HardEthics, patient safety, quality improvementAdvance directiveUSMLE Step 2 CK

A 50-year-old African American woman comes to the emergency department because of a care-planning concern. History and focused examination are notable for incapacitated patient with written directive refusing intubation. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. The clinical team is stable enough to pause, clarify roles, and choose an ethically and procedurally appropriate response. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Follow the valid advance directive

The vignette describes Advance directive, supported by incapacitated patient with written directive refusing intubation. Follow the valid advance directive is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: AMA Code of Medical Ethics