Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

For a living will to go into effect, which of the following must NOT happen?

1. The patient is declared terminally ill.

2. The patient has become incompetent.

3. The patient has a DNR order.

4. No further interventions will alter the patient's course to a reasonable degree of medical certainty.

The correct answer is: The patient has a DNR order.

A living will is a legal document that outlines a person's preferences for medical treatment in scenarios where they may not be able to communicate their wishes due to illness or incapacitation. For a living will to be effective, certain conditions usually must be met. The correct answer indicates that having a Do Not Resuscitate (DNR) order is not a prerequisite for a living will to take effect. A living will focuses on broader directives regarding life-sustaining treatments and the continuation of care in terminal situations, while a DNR specifically pertains to the decision to forego resuscitative measures in the event of cardiac or respiratory arrest. Therefore, a patient can have a living will that expresses their wishes regarding comfort care and life-sustaining treatment independently of a DNR order. In contrast, the other conditions—declaring the patient terminally ill, the patient being declared incompetent, and no further medical interventions changing the patient's course—are integral to the situational context in which a living will becomes applicable. For instance, declaring the patient terminally ill and incompetent directly relates to the intent and scope of what the living will addresses, facilitating decisions aligned with the patient's desires in critical situations. Additionally, the statement that no further interventions will alter the patient's course reinforces