Patient RightsQuestion 7 of 200

A resident has a signed POLST indicating Do Not Resuscitate (DNR) and 'comfort measures only.' The resident becomes unresponsive with no pulse. The CNA should:

a.Call for the nurse immediately and not start CPR, consistent with the POLST
b.Begin CPR because every patient must be resuscitated regardless of paperwork
c.Wait until the family arrives to decide what to do
d.Move the resident to a chair to make breathing easier

Explanation

Under the Patient Self-Determination Act and 42 CFR §483.10(c)(6), residents may direct refusal of life-sustaining treatment through advance directives and California POLST. A valid POLST is a portable physician order that staff must honor; CPR is not initiated when DNR is specified. The CNA notifies the nurse so death can be pronounced and the family/physician notified. Starting CPR (b) violates the directive; delay (c) and repositioning a pulseless person (d) are inappropriate.

Law Reference: 42 CFR §483.10(c)(6); Patient Self-Determination Act 42 USC §1395cc(f)

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