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CPTC Review > Declaration of Death and Authorization > Flashcards

Declaration of Death and Authorization Flashcards

1
Q

In a patient that is brain dead, which of the following would not be noted when looking for a doll’s eye reflex?

  • -No corneal reflex to touch
  • -No jaw reflex
  • -Cold calorics
A

Cold Calorics

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2
Q

A skier suffers a closed head injury and also a C4 fracture. In the ER he is intubated and remains unresponsive to all stimuli. A cerebral angiogram can be used to evaluate which of the following?

  • -Brain tissue
  • -Size of the cranium
  • -Four cranial arteries
A

Four Cranial Arteries

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3
Q

When performing an apnea test, which of the following is a correct procedure?

  • -As the physician to order a paralytic to minimize pain the patient may feel during the test
  • -Starting PCO2 of less than 20 mmHg
  • -Temporary disconnection of ventilator support
A

Temporary disconnection of ventilator support

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4
Q

During an ice water coloric test, the physician injects an infusion of ice water into the patient’s ear to test which of the following?

  • -Only the cerebral hemisphere
  • -The cerebral hemisphere and brain stem
  • -Only the brain stem
A

The cerebral hemisphere and brain stem

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5
Q

Can brain death declaration be done when the patient has a “therapeutic” or higher level of pentobarbital on board?

  • -Yes, the amount of pentobarbital does not matter when declaring brain death
  • -No, you must wait until all of the pentobarbital has worn off
  • -Yes, provided that a cerebral blood flow study is used as a confirmatory test
A

Yes, provided that a cerebral blood flow study is used as a confirmatory test

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6
Q

When completing the authorization form, the designated requestor must do which of the following?

  • -Read aloud, word for word, the text contained in the form
  • -Leave the form with the NOK to complete anytime before the case ends
  • -Sign the form if the family is unable to
A

–Read aloud, word for word, the text contained in the form

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7
Q

The donor’s family consists of his wife, their 18 yr old daughter and his mother. Who is the legal next-of-kin?

A

Wife

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8
Q

A patient is being assessed for brain death and during a physical assessment, the patient’s leg flexes up at the ankle, as does the knee and hip. What is this reflex called and is the patient brain dead?

  • -No, the patient is not brain dead and the exam should stop
  • -Yes, this patient is brain dead; this is a Babinski reflex
  • -Yes, the patient is brain dead; this is a triple flexion reflex
A

Yes, the patient is brain dead; this is a triple flexion reflex

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9
Q

Which of the following is not a component in the critical pathway developed for management of the organ donor?

  • -Referral of potential donor
  • -Declaration of brain death
  • -Acquisition of consent from the eldest next-of-kin for donation
A

Acquisition of consent from the eldest next-of-kin for donation

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10
Q

A patient arrives on the ICU and is experiencing a sudden fall in blood pressure, arrhythmia, and a decrease in ICP. Which of the following conditions is this indicative of?

  • -Brain herniation
  • -Diabetic ketoacidosis
  • -Hypovolemia
A

Brain herniation

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11
Q

A condition know as Cushing’s reflex is often seen prior to brain stem herniation. What signs would you see?

  • -Increased Temp, decrease in SBP, and decreased ICP
  • -Increase in SBP, bradycardia, and increased ICP
  • -Increase in SBP, tachycardia, and increased ICP
A

Increase in SBP, bradycardia, and increased ICP

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12
Q

A 15 yr old assault victim presents to the ER with a blunt injury to the head. The patient’s blood pressure is stable, but he is unresponsive. His spontaneous respiration has irreversibly ceased due to brain damage. He is likely brain dead, but in order to evaluate him, he will need to be on which of the following?

  • -Blood transfusions
  • -Artificial life support (ventilator)
  • -Antibiotics
A

artificial life support (ventilator)

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13
Q

A confirmatory test is mandatory for patients when which of the following cannot be evaluated?

  • -brain stem function
  • -Blood pressure
  • -kidney function
A

brain stem function

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14
Q

Which of the following conditions would interfere with the diagnosis of brain death?

  • -Babinski reflex
  • -Spontaneous movement of limbs
  • -Preexisting pupillary abnormalities
A

spontaneous movement of limbs

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15
Q

All cranial nerve function is absent in the brain dead patient. This includes pharyngeal and tracheal reflexes seen by:

  • -Dolls eyes
  • -Spinal reflexes
  • -Gag & cough response to bronchial suctioning
A

Gag & cough response to bronchial suctioning

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16
Q

Brain death means a complete and irreversible loss of brain function resulting from an injury such as:

  • -broken patella
  • -stomach ulcer
  • -myocardial infarction (MI)
A

MI

17
Q

When authorizing donation, a family may choose to authorize which of the following?

  • -designate that the organ be sold anonymously if they cannot be used for transplant
  • -Donate all or part of the body
  • -Designate that organs are allocated to certain ethnic groups
A

donate all or part of the body

18
Q

An EEG is used during brain death testing to measure which of the following?

  • -The amount of cerebrospinal fluid (CSF) surrounding the brain
  • -Electrical activity within the brain
  • -The flow of blood to the brain
A

electrical activity within the brain

19
Q

Which of the following is a confirmatory test for the diagnosis of brain death?

  • -MRI
  • -Skull x-ray
  • -CBF
A

CBF

20
Q

A patient presents in the emergency room with a blood alcohol level of 350. She is unresponsive and there are no motor or visceral responses to any stimuli. A diagnosis of brain death should not even be considered until which of the following is excluded:

  • -Marijuana
  • -Intoxication (alcohol)
  • -Cocaine
A

Intoxication (alcohol)

21
Q

A 65 yr old patient is presenting in the emergency room with stroke like symptoms. The physician feels there has been some brain damage and orders a doppler ultrasound test. Which of the following is the ultrasound measuring?

  • -Blood gases
  • -Blood type
  • -Blood flow velocity
A

blood flow velocity

22
Q

A patient is resuscitated in the field by EMTs. He is unresponsive for about 20 minutes before a pulse is regained. During cardiac resuscitation, perfusion to the brain decreases sufficiently to induce which of the following?

  • -Migraine headache
  • -Sinus pain
  • -Hypoxia
A

Hypoxia

23
Q

Numerous conditions lead to impaired neurological function and potentially brain death. Which of the following is not a common cause of brain death?

  • -anoxia
  • -cerebral palsy
  • -GSW to head
A

cerebral palsy

24
Q

A 50 yr old gentleman has been complaining of a headache for two days. He has a history of high blood pressure which he has received medication for, but he has been non-compliant. Which of the following may result from his non-compliance?

  • -Hypoxic event
  • -Intracranial aneurysm
  • -Anoxic event
A

Intracranial aneurysm

25
Q

All designated requestors must receive authorization training from which of the following?

  • -Hospital chaplain
  • -Funeral director
  • -OPO
A

OPO

26
Q

Which of the following ocular conditions are present in brain death?

  • -Nystagmus
  • -Negative Dolls eyes
  • -Dilated, reactive pupils
A

Negative Dolls eyes

27
Q

The Uniform Determination of Death Act (UDDA) defines death as cessation of circulatory and respiratory function and which of the following?

  • -deep coma
  • -complete and irreversible cessation of all brain activity including the brain stem
  • -absence of brain stem activity with positive cerebral blood flow
A

complete and irreversible cessation of all brain activity including the brain stem

28
Q

While performing an apnea test on a patient, if no respiratory movements are noted, the final arterial blood gas should show:

  • -no change in PCO2
  • -a decrease in PCO2
  • -PCO2 increases from 40 to 60 mmHg or 20 mmHg increase from the pre-test baseline
A

PCO2 increases from 40 to 60 mmHg or 20 mmHg increase from the pre-test baseline

29
Q

Who has the authority to declare brain death?

A

Physician

30
Q

Patients are matched to organs based on which factor?

  • -age
  • -blood and tissue typing
  • -ethnic group
A

blood and tissue typing

31
Q

A written document of the donor’s wishes may include which of the following?

  • -Social Security card
  • -passport
  • -signed donor card
A

signed donor card

32
Q

Which law/act recognizes the rights of individuals to donate by means of an organ donor card and gives the immediate family of a deceased person the option to donate?

A

UAGA (Uniform Anatomical Gift Act)

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