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Do-not-resuscitate order — USMLE Step 2 CK MCQ

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EasyEthics, patient safety, quality improvementDo-not-resuscitate orderUSMLE Step 2 CK

A 43-year-old Hispanic man comes to the urgent care clinic because of a care-planning concern. History and focused examination are notable for patient with DNR order needing urgent surgery for bowel obstruction. 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: D — Discuss perioperative resuscitation preferences before surgery

The vignette describes Do-not-resuscitate order, supported by patient with DNR order needing urgent surgery for bowel obstruction. Discuss perioperative resuscitation preferences before surgery 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: American Society of Anesthesiologists Ethical Guidelines