FUNDAMENTALS CASE STUDIES
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
You are a new graduate nurse on the medical surgical unit. Your preceptor tells you to go discontinue the
central line of your patient. You're not sure how to do this.
Question: Where would you find out how to do this?
You've looked up your hospital's policy for central line discontinuation and curious how they came up
with this policy in the first place.
Question: What should influence the creation of this institutional policy?
The patient you've discontinued the central line on has discussed with you that he does not want to have
a surgery that's scheduled for tomorrow. He has cancer, and this is his 3rd surgery to debulk a brain
tumor that keeps coming back. The MD has told him that he will need surgery again in the future, and
whole-brain radiation. He has said he think he'd like to just go home and not do this anymore. He said
he's got advanced directives created and he wants to talk to his health - ANSWER Question: Where
would you find out how to do this?
Answer: You would look up your institution's policy and procedure for central line discontinuation and
follow that
, Question: What should influence the creation of this institutional policy?
Answer: Evidence-based practice, state practice acts, laws, standards of care, and patient rights
Question: What are advanced directives?
Answer: His advanced directives are his living will (what he does or does not want done, should he be
unable to make medical decisions for himself) and his health care power of attorney (a person who will
make decisions for him, if he become incapacitated).
Question: What is a DNR?
Answer: A do not resuscitate order, which means if his heart stops or he stops breathing... we let him
pass naturally.
Question: What should you do now?
Answer: Ensure that the patient and his chart is labeled appropriately per your hospital's policy (typically
a wristband is required). If not already done, it'd be a great idea to get palliative care involved at this
time.
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
You are a new graduate nurse on the medical surgical unit. Your preceptor tells you to go discontinue the
central line of your patient. You're not sure how to do this.
Question: Where would you find out how to do this?
You've looked up your hospital's policy for central line discontinuation and curious how they came up
with this policy in the first place.
Question: What should influence the creation of this institutional policy?
The patient you've discontinued the central line on has discussed with you that he does not want to have
a surgery that's scheduled for tomorrow. He has cancer, and this is his 3rd surgery to debulk a brain
tumor that keeps coming back. The MD has told him that he will need surgery again in the future, and
whole-brain radiation. He has said he think he'd like to just go home and not do this anymore. He said
he's got advanced directives created and he wants to talk to his health - ANSWER Question: Where
would you find out how to do this?
Answer: You would look up your institution's policy and procedure for central line discontinuation and
follow that
, Question: What should influence the creation of this institutional policy?
Answer: Evidence-based practice, state practice acts, laws, standards of care, and patient rights
Question: What are advanced directives?
Answer: His advanced directives are his living will (what he does or does not want done, should he be
unable to make medical decisions for himself) and his health care power of attorney (a person who will
make decisions for him, if he become incapacitated).
Question: What is a DNR?
Answer: A do not resuscitate order, which means if his heart stops or he stops breathing... we let him
pass naturally.
Question: What should you do now?
Answer: Ensure that the patient and his chart is labeled appropriately per your hospital's policy (typically
a wristband is required). If not already done, it'd be a great idea to get palliative care involved at this
time.
