CPR should be initiated when a living will is unavailable. Which option best reflects this guidance?

• A. rigor mortis is obvious
• B. a valid living will is unavailable
• C. signs of putrefaction are present
• D. the carotid pulse is very weak

Answer: (B)

The main idea is that CPR decisions hinge on whether there is a documented wish about life support. If there is no living will or advance directive to guide resuscitation, the default is to initiate CPR to attempt to preserve life, unless there are clear, unmistakable signs that death has already occurred or explicit directives to withhold resuscitation.

In this scenario, the best choice is the one that states a valid living will is unavailable, because it describes the situation where resuscitation should be started. If a living will exists and directs against CPR, you would not perform it.

Rigor mortis and putrefaction are definite signs of death, so CPR would not be attempted there. A carotid pulse that is very weak suggests some circulating flow is still present, so CPR is not indicated solely on a weak pulse; assessment and continued monitoring would guide further action.