ENADE Nutrição Practice Questions - ENADE Nutrição - Exame Nacional De Desempenho Dos Estudantes Exam

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An 82-year-old patient with advanced end-stage vascular dementia and persistent dysphagia is hospitalized. The patient's advance healthcare directive (diretiva antecipada de vontade), drafted while fully competent, explicitly refuses invasive artificial enteral tube feeding in terminal stages. The interdisciplinary palliative team meets with the family. Grounded in clinical bioethics and human dignity, what is the most appropriate nutritional and ethical course of action?

Place an involuntary percutaneous endoscopic gastrostomy (PEG) tube immediately, arguing that paternalistic beneficence overrides patient autonomy. Honor the patient's valid autonomous refusal of invasive enteral feeding, providing comfort feeding by mouth (conforto oral) as tolerated and rigorous mouth hygiene. Discharge the patient immediately without any palliative care, symptom control, or nutritional consultation. Administer total parenteral nutrition (TPN) via central line against the directive, claiming that intravenous feeding does not constitute enteral tube feeding.

Correct Answer:

Honor the patient's valid autonomous refusal of invasive enteral feeding, providing comfort feeding by mouth (conforto oral) as tolerated and rigorous mouth hygiene.

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