Passmed

Question 1

If a patient refuses to be identified do you have to treat them still

Answer 1

Yes

Question 2

When escalating an issue what is an important consideration

Answer 2

always try to escalate within your team (reg, junior, consultant) before escalating outside

Question 3

When addressing a problem caused by someone in your team what is the best method of action

Answer 3

confront directly first before you speak to someone else about it

Question 4

If someone collapses in the street what do the GMC reccomend + how does it change if youve had a couple of drinks but dont feel drunk

Answer 4

whilst not legally required the GMC strongly recommend assisting however you can when in public - failing to help at all can cause your registration to be at risk

if you have had a drink but are not drunk this doesnt change, although mentioning it to bystanders can be of middle priority

Question 5

If a patient is insistent on taking a medication they do not ordinarily qualify for via an internet pharmacy what should you do

Answer 5

refuse to prescribe
agree to monitor them if it is required
discuss the reasons around why they insist on taking this medication

Question 6

If a patient comes in with signs of domestic violence but they do not say their life is at risk and they do not want the police invlolved what should you do

Answer 6

initially taking in all the details and referring to domestic violence groups/counselling is the top, with checking medical reasons for bruising as a middle priority. Police shouldnt be contacted due to confidentiality (only can if life is at risk), and contacting the partner directly is the least advisable

Question 7

as a junior if you initially suspect NAI when assessing a new admission in A+E, what should your next steps be

Answer 7

discuss with most senior nurse/doctor on ward, discuss with on call paeds and admit the child

Question 8

can nurses clerk patients in hospital

Answer 8

no

Question 9

what 2 things should you do before discussing any patient details with their family

Answer 9

obtain the patients consent + if you have it, ask the family what they know first

Question 10

how should you handle a formal complaint made against you

Answer 10

inform your consultant first, then contact your medical defence union. you then should write a statement to the GMC. you can get evidence from witnesses but this is lower tier. NEVER contact the patient directly.

Question 11

should blood be taken from a cannula

Answer 11

it should be avoided due to dilations - especially if there is treatment alongside

Question 12

how should you deal with a needlestick injury

Answer 12

top priority: encourage wound to bleed and inform occupational health

then someone senior on the ward should be notified then a clinical incidence form should be done

of lower priority is checking the medical history of the patient for communicable diseases

do no continue working as if it is normal

Question 13

When a mistake has to be reported to a family about a patient, after getting yourself or another doctor to talk to the family about it, what is the 3rd best option : not doing anything at that moment and ‘sneaking off’or telling them and pointing the finger/blaming the ward for being unsafe

Answer 13

not doing anything - doesnt actively cause harm although it is still not a reccomended option

Question 14

if an unknown patient in hospital collapses and CPR is required, but you are unsure of their DNCPR status what should you do

Answer 14

ask for help, start CPR, get someone to find out their resus status straight away

Question 15

if a patient declines a chaperone for an intimate exam what should you do

Answer 15

proceed without chaperone as long as it is documented in the notes

do not get one anyway if they have declined, not performing the exam (if there is an alternative investigation) is actually better than bringing a chaperone in after the patient has declined

Question 16

how should you deal with an inappropriate drug prescription acutely

Answer 16

cross out the prescription, inform and apologise to the patient and inform the senior doctor

Question 17

does the GMC prevent offlicense prescriptions as long as there is a coherent medical argument for using it

Answer 17

no

Question 18

how should you deal with disclosing information to the police involving a patient e.g. a patient that was attacked outside a bar

Answer 18

ask patient if theyre ok with me speaking to the police
contact a senior
say nothing if consent is not explicitly given

bring police to patient if none of these are an option

Question 19

how should you handle performing a procedure as an F1 you have not performed on a real patient before, especially if you are nervous about it

Answer 19

1. get supervised by a senior
2. get supervised by a FY1 who has more experience
3. get someone else to do it - esp if its a big part of their job too e.g. catheters for nurses
4. bleep on call doctor
5. do it anyway

Question 20

what member of staff should be informed first if someone is stealing drugs from the cabinet

Answer 20

Ward manager

Question 21

how do you deal with a doctor discussing their drug use with you when you are sure their work performance isnt compromised

Answer 21

discuss the negative consequences of the drug and leave it there, whilst it is illegal it is not your responsbility if patient safety isnt compromised

Question 22

how should you deal with an allegation made by a patient against another doctor, if that patient has a history of mental health problems

Answer 22

tell the patient you will investigate, tell the doctor an allegation has been made and inform the relevent members of staff that can provide evidence

Question 23

what should you do if you suspect a colleague is drunk on shift but no obvious mistakes have been made

Answer 23

1. ask if they have been drinking
2. inform your consulant about any concerns
3. check their prescriptions to identify any mistakes
4. do nothing but monitor the situation
5. do nothing

Question 24

what should you do if you overhear a group of professionals discussing patients loudly, even if theyre not sharing names

Answer 24

advise them theyre being loud, ask them to leave and complete an incidence form.

Question 25

how should you deal with an aggressive family member with no outright physical threat

Answer 25

ensure you have an escape route aknowledge his feelings listen and try to calm down

Question 26

how do you deal with a home patient that doesnt want to be admitted and you feel they have capacity

Answer 26

1. explore her fears 2. review them later in the day 3. get a specialist to obtain capacity 4. remind them you have a professional duty to call 999 5. phone 999 anonymously

Question 27

is it appropriate to refer someone for a serious condition (e.g. cancer) if they do not wish for it to be treated

Answer 27

no, but its better than actively doing harm e.g. sectioning them because you disagree or breaking confidentiality - the proper response to to ask to see them again in a week or so, or just to accept the decision

Question 28

how should you deal with a patient getting admitted too your ward from the ED without a drug card

Answer 28

1. phone the ED and see if they have it 2. complete it yourself 3. ask someone to go to ED to try and find it 4. leave it for someone else 5. refuse to attend to the patient

Question 29

how should you deal with a 15 year old who is pregnant with another 15 year olds child requesting an abortion, she does not want her parents to know

Answer 29

1. explore why she doesnt want them to know, discuss options, refer if she wishes 2. respect her decision and refer 3. offer counselling before the termination 4. refer but say you have to inform the parents 5. inform the parents immediately

Question 30

how should you deal with a patient who does not want to report domestic violence

Answer 30

1. document conversation and examination findings 2. give info on domestic abuse groups 3. do nothing 4. inform police 5. address the spouse directly

Question 31

what are the rules around accepting gifts

Answer 31

Every trust has a different policy on what these gifts can be. Usually you are unable to accept money or anything that is valued at more than £10.

Question 32

what are the top 3 things to do when an emergency lifesaving procedure Is required in an unconscious patient

Answer 32

1. act in best interests of patient 2. get urgent senior input 3. inform next of kin

Question 33

If unsure about antibiotic regimes what is the flowchart of people to ask

Answer 33

1. Senior within your team 2. On call microbiologist 3. BNF 4. Nurse with experience dealing with these patients 5. National guidelines

Question 34

after confronting the person who is the best person to the talk to concerning infection control

Answer 34

nurse in charge

Question 35

If someone that is due to be discharged develops symptoms what should you do

Answer 35

always delay and check with a senior as it is not the decision of the FY1 - inform the family too

Question 36

what tier of option is asking to move wards when you have a professional issue with another staff member

Answer 36

bottom tier

Question 37

what should be the flow of options for when you don't feel like the job has decent enough learning opportunities

Answer 37

1. ask consultant first (usually clinic) 2. offer to assist FY1s 3. Talk to programme director 4. take on extra work

Question 38

if a patient is concerned about something what is the number 1 thing you should always do

Answer 38

explore the concern

Question 39

what is the hierarchy of options for when you cant communicate with a patient

Answer 39

1. ask a Dr that can 2. phone translator 3. ask senior 4. family member 5. nothing

Question 40

what should you do if a patient needs senior review to discharge but your senior is unavailable

Answer 40

get another senior before phoning yours

Question 41

What are the top priorities if you feel that a patient is critically unwell

Answer 41

make every effort to involve lots of people and gather as much info as possible

Question 42

What should you do if someone calls in sick and you have evidence they're lying

Answer 42

``` Talk to them Talk to other FY1 take photos down talk to senior tell others to embarrass the person ```

Question 43

should you avoid shouty upset patients

Answer 43

no

Question 44

what should you do if you have a bad professional relationship with someone and you have already talked to them directly

Answer 44

1. inform consultant/senior 2. ask other jrs if theyve had an issue 3. inform their supervisor 4. go to them directly again 5. ignore

Question 45

should you give preferential treatment to aggressive patients + what should you do

Answer 45

no , check on other patients if you feel they are distressed

Question 46

what do you do for non-urgent incomplete tasks at the end of your shift

Answer 46

hand over to dr taking over seniors do not need to be informed

Question 47

if a prescribin error has been made what should you do

Answer 47

cross off escalate check on patient if facts arent known - establish them

Question 48

if a patient is obviously aggressive and borderline violent what should be done

Answer 48

try to talk before having to restrain

Question 49

what should you do if you feel you have too much work for one person

Answer 49

ask for help at your level (F1) ask for help above you if chronic - talk to consultant and try to resolve

Question 50

when do you not need to immediately inform patients of errors made

Answer 50

if theyre confused/disoriented

Question 51

what should you do if you ask someone to do a job and they refuse rudely

Answer 51

1. ensure the job is completed 2. check they actually have to do the job 3. speak to them privately about the manner of refusal

Question 52

what is a general principle to stick to when a colleague complains about work issues to you

Answer 52

if you have reccomended that they speak to a supervisor you generally don't also need to help them with the issues yourself

Question 53

what should you avoid doing when talking to a patient about a change of circumstances or if they're upset

Answer 53

explain why the change/thing that making them upset is better

Question 54

should a previous conversation about the topic change the importance of another conversation

Answer 54

no

Question 55

can nurses take bloods

Answer 55

yes unless indicated otherwise in the stem

Question 56

should you always take a learning opportunity if possible

Answer 56

yes

Question 57

what should you do if an clinical/educational supervisor isn't possible to contact over a longer period of time

Answer 57

report to foudation programme director

Question 58

is is appropriate to call a colleague back into the hospital after they've finished a shift

Answer 58

no

Question 59

if a patients family are upset and want to talk to you what should you avoid doing

Answer 59

explaining your way out of the situation - especially if it only absolves you

Question 60

what should you do if an FY1 colleague has been unprofessional and you want to report them

Answer 60

escalate to senior, rarely Fy1s report otehr Fy1s themselves

Question 61

what should you do if there is an emergency and you've finished your shift but no one is there to take over yet

Answer 61

stay late and cover

Question 62

what is the rule for contacting clinical supervisors over another drs ability

Answer 62

do not contact unless there is a pattern of behaviour

Question 63

what should you always consider when it says a colleague has decreased concentration and increased mistakes - even if they're minor

Answer 63

patient safety

Question 64

if the question stem says that you think that you know something, do you take that at face value?

Answer 64

no you should find more about before reaching a judgement

Question 65

what should you do it a patient records a consultation without your permission

Answer 65

1. ask why 2. ask a senior 3. say to the pt its their choice to keep/delete 4. say its inappropriate 5. ask to delete