SJT Mock 1

Question 1

Pharmacist says the drug your consultant asks for is contraindicated. Is it better to ask your reg to review the situation or say that the consultant requested the antibiotic and it would be best to speak to him

Answer 1

say that the consultant requested the antibiotic and it would be best to speak to him

Question 2

Patient is scared of upcoming discharge, who do you send to speak to them?

Answer 2

Occupational Therapist > Reg

Question 3

What matters more: patient safety, your own health?

Answer 3

As a doctor, the care of the patient is your main concern

Question 4

Most important consideration: right to finish on time at the end of shift, disappointing friends by being late, poor consultant reference

Answer 4

right to finish on time at the end of shift > poor consultant reference> disappointing friends by being late

Question 5

You are on the way to theatre. A nurse asks you to review a patients medication which was done erroneously. A lonely patient beckons you to come talk to him.

A.Review the patient’s dose, as requested by the nurse
B.Respond to the patient’s immediate question or query
C.Attend the theatre to observe the procedure
D.Take steps to investigate the nurse’s allegations about prescription errors further
E.Spend more time with the patient if he wants someone to talk to

Answer 5

Answer: ABCDE
Rationale: Preventing a potential medication error and ensuing patient harm should be the absolute first priority (A). The patient beckoning you may have a very valid and important question and therefore this should be acknowledged as a priority (B). Attending theatre is a good learning opportunity which will help you deliver better patient care (C). Ensuring that the nurse’s concerns about errors are addressed is very important, but not immediate (D). Spending time with a patient is desirable but can be done by others if necessary –you will need to draw it tothe attention ofanother member of staff(E).

Question 6

Who to contact if you cannot find the folder containing the pre-operative protocols? (3)

Answer 6

1) Reg
2) On-call microbiologist
3) BNF

Question 7

The worst place to get information on pre-operative protocols?

Answer 7

National Guidelines

National guidelines would be the last place to get information in this situation (C). Local guidelines are based on the national ones but they will include information specific to local circumstances.

Question 8

What is worse for finding out pre-operative protocols: asking a nurse or using national guidelines

Answer 8

using national guidelines

Question 9

What to do about someone who always has sleeves down?
Monitor situation
Tell Infection control
Tell nurse in charge of ward
Tell Reg

Answer 9

Nurse > Reg > Monitor > Tell infection control

Question 10

Key thing to do if a patient who is meant to be discharged raises concerns over leaving (or their family does)?

Answer 10

Seek the opinion of a senior colleague informing the patient there will be a delay as the team decides what to do

Question 11

Allie, tells you that her mother has been complaining about her chest and is struggling with a cough. You review the observation chart and listen to Joan’s chest, which doesnot indicate a problem. Allie insists that her mother has a chest infection and should not be discharged.

A.Ask the ward nurse to inform the rehabilitation hospital that Joan’s condition needs assessing on arrival
B.Inform Allie that she should insist on a further review of Joan’s condition when she arrives at the rehabilitation hospital
C.Advise Allie that you will delay the transfer in order to consult with a senior member of your team
D.Advise Allie of the urgent need to discharge her mother to create space on the ward
E.Contact the rehabilitation hospital and write detailed notes outlining Joan’s symptoms and possible investigations to send with her

Answer 11

C.Advise Allie that you will delay the transfer in order to consult with a senior member of your team
E.Contact the rehabilitation hospital and write detailed notes outlining Joan’s symptoms and possible investigations to send with her
A.Ask the ward nurse to inform the rehabilitation hospital that Joan’s condition needs assessing on arrival
B.Inform Allie that she should insist on a further review of Joan’s condition when she arrives at the rehabilitation hospital
D.Advise Allie of the urgent need to discharge her mother to create space on the ward

Question 12

First step if you feel that your contributions, decisions and confidence are being undermined by other team members? (3)

Answer 12

1) Discuss your concerns with all team members
2) Seek advice from senior colleague
3) Document what happens

Question 13

Why is documenting a less appropriate option in many scenarios?

Answer 13

Not proactive

Question 14

Not had many learning opportunities:

A.Take on a position of responsibility as part of the junior doctors’ committee
B.Ask the Foundation Programme Director if you can move to work at another unit
C.Ask your consultant if you can support outpatient clinics and theatre sessions
D.Offer to assist your FY1 colleagues on other busier wards
E.Inform the Foundation Programme Director that the job should be reviewed to include more learning elements

Answer 14

CDEBA

Taking on additional positions of responsibility, whilst admirable, is something that you should do because you want to, and can fit in around your professional life both in this, and other teams to which you will move (A)

Question 15

Patient arrives without correct paperwork at the end of your shift, do you:

Ask a Nurse to chase up paperwork
Handover
Inform Reg there is no paperwork
Ring where patient came from

Answer 15

Ring > Handover > Nurse > Reg

A more senior doctor will be in a position to ‘chase up’ the admitting unit to complete the relevant paperwork and drug chart, but they will also have to other duties that require attention from someone at their level (E).

Question 16

Lack of information handed over, what is not an early action to take?

Answer 16

Informing a senior, they are busy enough. Chase this up yourself

Question 17

Someone refuses a handover. Is it better to:
Tell them you will leave detailed notes in their folder so they can follow it up later
Ask a nurse to find another doctor who will accept the handover (taking blood)

Answer 17

Tell them you will leave detailed notes in their folder so they can follow it up later

–> informing a nurse is less reliable as you have not handed over the task to a specific doctor, and the nurse does not know which doctor to contact

Question 18

Patient doesn’t speak ANY english. Do you continue trying to communicate as best possible or telephone next of kin to ask about symptoms

Answer 18

Telephone next of kin to ask about symptoms

Simply continuing without taking any alternative action would not be good clinical care (B).

Question 19

Best thing to do if a patient only speaks a certain language?

Answer 19

Find a doctor who speaks the language > book a translator

Question 20

Better to offer patient a self discharge form or discharge them yourself as an F1

Answer 20

Self discharge

FY1 doctors should never discharge patients without close supervision so Option (A)is inappropriate.

Question 21

Keep patient in hospital or discharge them with verbal approval of a senior over the phone

Answer 21

Discharge them with verbal approval of a senior over the phone

Question 22

What do you tell the husband when he asks about his wife who just found out she is pregnant?

A.Tell Mr Mathews that he will need to speak to Mrs Mathews directly about her condition
B.Tell Mr Mathews that you would like to obtain Mrs Mathews’ permission to speak to him first
C.Tell Mr Mathews that you would like to discuss Mrs Mathews’ case with a senior colleague before speaking with him
D.Tell Mr Mathews that you are currently investigating Mrs Mathews’ abdominal pain

Answer 22

BDAC

Sharing only the information that the family member is aware of (abdominal pain) would buy you some time and you will not have divulged any confidential information with her husband hence (D)is the next option. The patient’s husband is likely to be under stress and asking him to speak directly to his wife to get information is likely to add further stress which makes option (A)less preferable. Similarly saying that you need to discuss the case with your senior (C)is evasive and doesn’t establish patient consent to discuss the results.

Question 23

You suspect a dose is doubled, do you change it or assume its right?

Answer 23

Change it

Could be dangerous to do nothing

Question 24

Should you explain the clinical need for other scans to be conducted before your patients scan

Answer 24

Yes, after apologising first

May help them to understand why there is a delay

Question 25

Your colleague leaves your ward for theatre and directs her bleeps to you. Is it better to: Write a list of the jobs that have arisen in their absence so that they can complete them when they return to the ward Report them to their line manager

Answer 25

Write a list of the jobs that have arisen in their absence so that they can complete them when they return to the ward --> Jobs will be ordered on clinical need and completed as such

Question 26

Your colleague sees someone with epilepsy driving, what do you do? A.Advise your FY1 colleague to speak to Haman about what she observed B.Advise your FY1 colleague to seek advice from a senior colleague C.Ask Haman if he has been driving after he has had a seizure

Answer 26

A B C As your colleague saw Haman driving it is the colleague’s duty to act. They have directly witnessed the driving and therefore are in a better position to describe what they saw

Question 27

Consultant requests scan that reg says is not needed, is it better to Request Scan Discuss with consultant radiologist

Answer 27

Request Scan The consultant retains overall responsibility for the patient and so if it is not possible to discuss the reasons for different viewpoints, it is appropriate to follow the consultant’s advice (A). Discussing the case with the radiologist is likely to be beneficial for patient management and your learning but it would be better to understand the reasons for the difference in opinion by discussing with your own team rather than involving another consultant (B)

Question 28

Should you advise the patient to withdraw his consent until he has further details of the operation if he is unsure of the procedure?

Answer 28

Nah It would be inappropriate for you to give this advice to the patient (B)without making an attempt to resolve the issues.

Question 29

Rank these options if you are concerned a patient may be allergic to what has been prescribed? A.Speak with the on-call pharmacist about whether you should prescribe the drug B.Explain to the locum doctor that you are concerned about prescribing the drug C.Ask another senior doctor whether it is appropriate to prescribe the drug to D.Prescribe the drug as requested by the locum doctor E.Speak about your concerns with the nurse who would administer the drug

Answer 29

BAECD The nurse also has a responsibility, as they will be giving the drug to Mr Singh and needs to know about your concerns(E).You may find that experienced nurses will bring concerns regarding prescribing to your attention. Talking to another senior doctor about this would also be a reasonable course of action but not as good as speaking to the doctor concerned and introduces another opinion (C).

Question 30

Who to contact if you think a patient will have an allergic reaction to a drug prescribed as he is allergic to a similar drug

Answer 30

The doctor who prescribed it 1st Then the on-call pharmacist

Question 31

You see photos of a colleague at a party on social media what is a better thing to do: Ask your F1 colleague for advice Suggest they delete the photos

Answer 31

Ask your F1 colleague for advice

Question 32

Mrs Singh is dying and her family have requested a single room to provide her with some privacy. A nurse has advised Mr Green that he is to be moved out of the single room but he has refused as he says he feels uncomfortable being in award with other patients. A.Mrs Singh and her family have a right to privacy B.That another single room is unlikely to become available in the near future C.That Mr Green’s daughter is a medico-legal solicitor D.That Mr Green had the room first E.Mr Green’s reasons for wanting to stay in the single room

Answer 32

ABEDC Mrs Singh has a greater medical and social need and recognising her right to privacy is the most important consideration(A). If resources permit then avoiding conflict and minimising movement of patients takes precedence, but there is no time to wait for this possibility (B).

Question 33

Cannot contact F1 taking over shift and you've forgotten to do a proper handover: Contact an FY1 colleague working on another ward to ask her to look up the investigation results for you Telephone the ward nursing staff and ask them to get the FY1 taking over your shift to look up the investigation results Contact the on-call specialty trainee* and explain the situation

Answer 33

Contact the on-call specialty trainee* and explain the situation Nurse > different FY1 Contacting the ward nursing staff to pass on the message to the FY1 achieves the same result but is less reliable, since you have not handed the task over to a specific doctor for a medical task, and you will have less certainty that it will be acted upon (A). Option A is however preferable to Option D, because you are passing the problem on to a colleague who has no on-going responsibility for this patient (D).

Question 34

Can a post mortem be described as standard practice?

Answer 34

No, very inappropriate

Question 35

Should you tell someone to calm down before you can speak to them?

Answer 35

No May inflame the situation further (inappropriate)

Question 36

Nurse's relative is in your care and asks about her. What is the best course of action? Explore her anxieties Remind her about patient confidentiality

Answer 36

Remind her it is confidential

Question 37

Pharmacist has noticed there is double dose: Change dose to half Explain to pharmacist you want to keep it the same as the consultant requested Ask the patient if he knows why he is on a higher dose of the drug than normal

Answer 37

Ask the patient if he knows why he is on a higher dose of the drug than normal Change dose to half Explain to pharmacist you want to keep it the same as the consultant requested

Question 38

Which is better: A.Make a list of the patients under your care on the AAU, detailing their outstanding issues, leaving this in the doctors’ office when your shift ends and then leave at the end of your shift B.Quickly go around each of the patients on the AAU, leaving an entry in the notes highlighting the major outstanding issues relating to each patient at the end of their bed and then leave at the end of your shift

Answer 38

End of the bed Leaving a list in the general doctors’ office is least effective as your colleague is unlikely to know it is there

Question 39

Tried to speak to a nurse who undermines you without success in the past and she continues her behaviour what do you do: Speak to her in private Inform your consultant Inform the nurse in charge Ask other F1s for similar experiences Continue ignoring her

Answer 39

Jill is behaving unprofessionally here, and could potentially become subject to disciplinary measures via her professional body, the Nursing and Midwifery Council. You should inform your consultant (D), or Foundation Programme Director, who would then make enquiries, leading to action if deemed appropriate. It is worthwhile to ask other FY1s if they have had similar problems (E), as it would remind them that they, too, should not be expected to suffer such behaviour. You should advise them to discuss it with their consultant, or with the Foundation Programme Director. Informing the nurse in charge (B) is best left to your consultant. Option (C)carries a significant risk that Jill may become antagonistic and verbally hostile; she may potentially make unfounded allegations against you, particularly if you were speaking to her with no witness present. You have already tried unsuccessfully to have an informal conversation. Continuing to ignore Jill’s comments (A)is inappropriate

Question 40

When may you not have to tell a patient there has been an error as a priority?

Answer 40

They are confused Option(B) is not immediately necessary and the patient would probably not be able to retain or understand the information as they are confused.

Question 41

Can you reassure a patient that their pain is definitely not a symptom of cardiac disease

Answer 41

Yes If a cardiologist has documented that all investigations have been normal and that her pain is not cardiac in origin.

Question 42

Colleague smells of alcohol, pick 3: A.Ask them if they have been drinking alcohol B.Tell them that they should go home immediately if they are unfit to work C.Inform the consultant in charge of the ward that they smell of alcohol and is unsteady when walking D.Seek advice from a senior colleague about how to manage the situation E.Explore with them if there are any reasons behind their behaviour F. Tell them that if this happens again, you will have to tell the consultant

Answer 42

ABD Your first concern should be for the patients under his care, so it is essential that he does not remain at work if his judgement and ability are impaired (B). Exploring the underlying issues at the time (E) will be fruitless, and is best done in a more appropriate environment by a trained counsellor.

Question 43

Not been sleeping due to stress and worried about upcoming on-call weekend shift. Do you: See GP Seek time off work from consultant

Answer 43

Time off s clearly appropriate in that the situation will impact directly on consultant’s firm and the safety of the patients, and the consultant is most likely to be able to organise cover for the doctor. GP not inappropriate but does not address the issue of the imminent weekend on-call.

Question 44

Misread that urine culture is sensitive to amoxicillin. Gave amoxicillin but it is actually resistant to it, and only sensitive to cipro. Pick 3 A.Inform your consultant of the correct result B.Record the incident as a learning point in your learning portfolio* C.Contact microbiology for advice D.Tell Mrs Taylor that you have prescribed the incorrect antibiotic E.Reassess Mrs Taylor's vital signs F.Change the antibiotic to ciprofloxacin G.Repeat the urine specimen culture H.Ask your specialty trainee* for advice

Answer 44

ADF This question asks you to make decisions that demonstrate your professionalism. Your consultant might want to know that a change to the management is required, and the patient needs to know that an error (albeit minor) has occurred (A, D). Changing the antibiotic is required to treat the patient (F). Repeating the urine (G)and contacting microbiology (C)will add nothing and,in the absence of an adverse reaction reassessing the patient’s vital signs is unlikely to be of benefit (E).

Question 45

Patient says they can show you evidence that using double the recommended dose of their current medication will be better? Is it appropriate to ask her to show you the evidence.

Answer 45

No It may provide interesting information and demonstrates you are responding to Mrs Jenson's query but won't change your response You must inform them that you cannot prescribe more than the recommended dose without senior consultation

Question 46

F1 Colleague faints: A.Discuss whether she will be able to undertake her remaining tasks for the day B.Ask a nurse to help you transfer her onto an available bed C.Alert your specialty trainee* of the incident D.Speak to the patients on the ward and reassure them that they will be seen to soon E.Give her a blanket and a cup of water

Answer 46

BECDA Approach her just as you would an unwell patient Eventually, once your colleague has had chance to recover from her faint, it would be appropriate to ask how she is feeling and whether she feels able to continue with work

Question 47

What is the last thing you would do if your colleague fainted during work?

Answer 47

Ask them whether they can continue to work. Ensure they are okay and inform a senior member of the incident first.

Question 48

You need to do discharge letters, but there is a patient a nurse asks you to assess. There is a 4th year student who offers to assess the patient. What is important? A.The medical student's confidence to assess the patient independently B.The medical student's level of clinical competence to assess the patient effectively C.The discharge letters should have been completed a week ago D.The urgency for the patient to be assessed is not yet clear E.The possible time delay before the senior nurse is able to find another available colleague to assess the patient

Answer 48

BAECD Confidence is secondary to competence. The medical student's initial findings could help you to establish the urgency for a full assessment of the patient. The discharge letters do not constitute an urgent clinical priority (C).The urgency of the assessment required will only be determined by an initial assessment (D)which should happen with a minimum of delay.

Question 49

First and 2nd thing to establish when letting a medical student undertake important tasks.

Answer 49

1st - Clinical Competence 2nd - Confidence

Question 50

Offensive language from consultant during surgery. What is most important to consider: A. The disruption that your interjection may cause to the procedure B. All healthcare professionals are entitled to work in a respectful environment at all times C.The impact on other team members if the consultant continues to use similar language during the rest of the procedure

Answer 50

BCA The most important consideration in management of your response here is the right for colleagues to work in a respectful environment, thinking about the impact thatAlan’s outburst may have on this environment (B). This is followed by a consideration of how uncomfortable colleagues may become and the impact on their performance for the rest of the procedure (C). The impact of interjecting (A)should then be considered -whilst this behaviour clearly should be challenged, the priority is to complete the complex procedure. This may mean then considering when it is most appropriate to interject(for example during a break or after the procedure is complete) should be considered.

Question 51

When should you advise a colleague to put his social media settings onto private if he is posting about patients in a potentially identifiable way?

Answer 51

Last Although the advice to change media settings to private (E)is sensible that could be interpreted as condoning the original post which is inappropriate irrespective of settings

Question 52

Partner has fabricated data for an audit do you? Tell the supervisor the data is fabricated Tell the supervisor there was a mistake and you need to change the data Tell the supervisor you had no input so your partner should present it alone

Answer 52

Tell the supervisor the data is fabricated Last is saying you had no input, as fraudulent data may end up being presented.

Question 53

Consultant has done a long shift and seems unable to concentrate and is shaking before surgery. Do you: B.Raise your concerns in the surgical team’s pre-operative discussion C.Continue with the surgery and discuss the incident with your clinical supervisor* afterwards D.Bleep* the on-callconsultant, explaining the situation and asking for advice on what to do E.Suggest to the consultant that another doctor carries out the surgery

Answer 53

DEBC (D)is appropriate as this raises an appropriate concern and ensures senior, supportive input. It is also most likely to achieve the desired outcome with the least potential difficulty. (E)addresses patient safety but is less direct in that it doesn't explain to the consultant why you are concerned. (B)is an even more indirect route but ensures patient safety.

Question 54

A patient invites you to their birthday party. Is it better to: Say you cannot attend but buy a small gift Ask another doctor to manage her care

Answer 54

Ask another doctor to manage her care Explaining you are unable to attend without explanation and buying a gift (E)conveys a mixed message and would most likely be viewed as inappropriate.

Question 55

Registrar is upset and has disappeared from the ward. Consultant is attending an emergency. You need advice on a patient do you: Contact Reg Report Reg Contact consultant Leave ward to find reg Ask F1 Colleagues

Answer 55

Contact Reg > Consultant > Ask F1 > Leave ward > report In this circumstance, seeking another specialty trainee would be a reasonable initial response. If this was not possible to maintain safety, contacting the consultant would be the next step in escalation to maintain safety. Discussing with other FY1 doctors may be helpful but is ultimately not an acceptable substitute for a senior opinion for unwell patients. Reporting is inappropriate and doesn't help patients.

Question 56

Disruptive relatives when you are trying to take blood. Do you: Ask a nurse to take the blood sample whilst you talk to the relatives elsewhere Ask the relatives to be quiet whilst you take the blood sample

Answer 56

Ask the nurse (C)will also deliver patient care but involves other staff and may take more time. (A)delivers safe patient care but doesn't defuse a stressful situation. Further, it doesn't maintain patient privacy and puts added pressure on the procedure.

Question 57

You receive a friend request from a patient. Is it better to: Ignore the friend request Ask your educational supervisor for advice

Answer 57

Ignore the request It would also be appropriate to simply ignore the request(A), however this does not provide an explanation for the patient, and they may repeat the request at a later time. If unsure what to do, the next most appropriate choice would be to seek senior advice(D).

Question 58

You are taking urgent blood samples and a nurse asks you to examine a patient immediately. There is no need to urgently examine the patient but she is the relative of a surgical consultant in the hospital. A.Tell the nurse that, at the moment, you must prioritise taking the blood samples B.Ask a senior whether you should continue taking blood samples or examine the patient C.Tell the nurse that you will examine the patient once you have taken all the blood samples D.Ask your consultant to examine the patient next, explaining that she is a relative of the surgical consultant E.Examine the patient, as requested

Answer 58

CABDE It is clear that the blood samples have been identified as urgent, they would therefore take priority over the non-urgent task. (C)conveys this and reassures Reuben that it will be dealt with when you are available; it is therefore the most appropriate response. (A)conveys the urgency and need to take blood samples but is less appropriate as it does not address Reuben's query specifically. Seeking clarification from the FY2 (B)is reasonable if you are unsure what to do -however, in this case the prioritisation of the blood samples has already been made clear. Asking Dr Patrick to examine the patient (D)is less appropriate as it has been established that the ward is busy and that examining the patient is a non-urgent task. Finally, simply examining the patient (E)means that you have moved from completing a specific urgent task to a non-urgent task without informing your colleagues.

Question 59

Consultant asks you to do a procedure you have not done before? A. Ask for instructions on how to do it and some supervision B. Explain that you do not feel comfortable C. Ask whether he can suture and you can observe

Answer 59

BAC Explaining to your consultant that you have not performed this skill before and that you do not feel comfortable proceeding is the most appropriate option (B). It is always possible to learn but the consultant should be aware of your level of competency and you should never work above your level of capability. Asking for assistance is another sensible approach, it implies that you are uncertain though you could be clearer about the fact that you have not performed this procedure before (A). Asking for a demonstration is an appropriate approach, though you will not be able to practice the skill yourself (C).

Question 60

GP refers her own daughter to you to be seen urgently? A. Seek advice from on call consultant of whether to accept referral B. Re-emphasise this is inappropriate C. Suggest she go to the emergency department if needed D. Complete a critical incident form E. Accept the referral on this occasion only

Answer 60

BCAED (B)is the most appropriate course of action as per GMC Guidance. (C)advises of the correct referral route if the patient requires urgent assessment. (E)would be against GMC guidance and is therefore a less appropriate answer. It would result in the patient receiving urgent care but it would reinforce inappropriate behaviour. (D)is the least appropriate as this doesn't help the patient to receive appropriate emergency care and it does not resolve the situation.

Question 61

Can a patient film your conversation with them without your consent?

Answer 61

Yes It is their choice whether they keep the recording

Question 62

Family needs an urgent death certificate from colleague called Claire. Do you Telephone Claire to ask that she comes back to the hospital to sign the patient's death certificate Tell the relatives that Claire has left the hospital and will not be able to return to sign the death certificate until her next shift on Monday

Answer 62

Tell the relatives that Claire has left the hospital and will not be able to return to sign the death certificate until her next shift on Monday Calling is inappropriate in that Claire is not on duty at the hospital and may be on protected rest time

Question 63

When may it be more appropriate to ask a nurse to contact your F1 colleague who has disappeared from the ward instead of doing it yourself?

Answer 63

If you are in the process of completing a critical action E.g. Completing a drug chart

Question 64

Family has questions about a patient with a rare disease you do not understand what do you do? A. Contact a senior to talk to them ASAP B. Explain what you know C. Explain that as an F1 you are not expected to know rare diseases D. Apologise and excuse yourself E. Explain that they should wait to see a senior doctor

Answer 64

AEBCD (A) ensures that the relatives receive the correct information. (E)is a clear statement that very specialist knowledge is required for this rare condition. Whilst it is not unreasonable to act as per (B)to share the limited insight that you have, this may lead to further questions and you becoming drawn into areas you are unable to answer. (C)is helpful as it explains that you are not a senior expert, but it does not further assist the family, and could be misconstrued as being unhelpful.

Question 65

Is it better to explain to a patient what you know about a rare disease or say as an F1 you do not know about rare diseases?

Answer 65

Explain what you know

Question 66

You don't understand why you need to make a gastro referral. Do you: Contact the gastroenterology consultant to explain that you need to make the referral, and ask what information they need to proceed Ask a more experienced colleague what information the Gastroenterology department will require to make the referral

Answer 66

Ask a more experienced colleague what information the Gastroenterology department will require to make the referral

Question 67

You don't understand why you need to make a gastro referral. Do you: Contact the gastroenterology consultant to explain that you need to make the referral, and ask what information they need to proceed Conduct research on the Internet into why the referral could be required

Answer 67

Conduct research on the Internet into why the referral could be required

Question 68

Why might it be better to inform a senior about a colleague making rude remarks rather than apologising to the patient?

Answer 68

Whilst it is likely that an apology will need to be made this would likely be part of the action plan instigated by the senior doctor rather than something an FY1 would be expected to take responsibility for.

Question 69

What do you need for role play or a communication skills workshop

Answer 69

Direct supervision from a trained facilitator

Question 70

Should I arrange cover for my F1 colleague

Answer 70

If cover needs to be arranged for Lucie that should be carried out by the seniors on that shift in liaison with hospital management (H).

Question 71

Rate the appropriateness of: "I'm here to help you, please don't speak to me that way"

Answer 71

3 - Somewhat inappropriate

Question 72

Rate the appropriateness of: "Let me see if a senior doctor is available to assess you"

Answer 72

2- Somewhat appropriate You haven’t reassured the patient that she will be assessed by another doctor as requested

Question 73

Rate the appropriateness of: "I can see if a senior doctor is available, however, you might end up having to wait a while to be seen"

Answer 73

2 - Somewhat appropriate

Question 74

Rate the appropriateness of: "It is up to you whether or not you go home"

Answer 74

4 - Very inappropriate

Question 75

Rate the appropriateness of saying this to a nurse who anxiously asks about their nephew who is your patient: "You know that this is confidential information that I cannot discuss with you"

Answer 75

2 - Somewhat appropriate The nurse is clearly anxious and may interpret your response as being unsympathetic

Question 76

Rate the appropriateness of: "Try not to worry, I'm sure everything is going to be fine"

Answer 76

4 - Inappropriate

Question 77

You are stressed and ask to leave your shift early. How important is the amount of time you have left on your shift?

Answer 77

3 - Of minor importance

Question 78

Nurses are saying your colleague is rude in the staff room. Rate the appropriateness of: Ignore the nurses, and leave the staff room

Answer 78

3 - Somewhat inappropriate

Question 79

Rate the appropriateness of: Advise your F2 colleague that you have observed a change in behaviour that is having a negative impact on their work?

Answer 79

2 - Somewhat appropriate It is the F2s responsibility to be aware of their behaviour, but you should raise concerns

Question 80

Rate the appropriateness of: Suggest taking on some of your F2 colleague's workload to allow her more time to study

Answer 80

4 - Inappropriate It is out of your scope of practice

Question 81

Rate the appropriateness of: Inform your colleague that some of the nurses have noticed a change in her behaviour

Answer 81

2 - Somewhat appropriate It is your responsibility to raise concern about your colleague's behaviour and be honest about its impact on the rest of the team

Question 82

Rate the importance of: The ward nurse in charge must have a reason for wanting you to stay

Answer 82

2 - Important They may have a different but equally relevant perspective about clinical priorities which needs to be considered.

Question 83

Rate the importance of: Your relationship with the ward nurse might be negatively affected if you leave the ward

Answer 83

3 - Of Minor importance Patient care and safety comes first

Question 84

Your colleague is asleep and the ward is busy. Rate the appropriateness of: Decide to work late and finish the tasks

Answer 84

4 - Inappropriate

Question 85

Can you advise a stressed colleague to take a 10 minute break and then seeing if they can continue their shift if they are saying they are going to leave hospital now

Answer 85

Yes And you could offer to swap some jobs with you

Question 86

Cardio registrar refuses to come assess a deteriorating patient, is it more important to: Continue management on your own Document their refusal

Answer 86

Continue management on your own (GET HELP!) You can wait to document the refusal

Question 87

A 20 y/o patients mother keeps answering questions on their behalf. Do you: Ask the mother to leave the cubicle for a moment while you ask the patient a few questions Inform the mother that she can stay in the cubicle but will need to remain quiet

Answer 87

Ask the mother to leave the cubicle for a moment while you ask the patient a few questions

Question 88

Your colleague has arranged to meet with a patient socially. Is it better to: Ask her whether she has done this before Ask her to see what her other colleagues think about doing this

Answer 88

Ask her to see what her other colleagues think about doing this Asking about doing this previously is outside the scope of your interest as a current colleague and therefore not your responsibility to explore further (ranked last)

Question 89

A patient invites you to their birthday party. Can you decline the invite but buy them a small gift

Answer 89

No - Inappropriate

Question 90

What is more important when raising a concern? You were not directly involved in the incident Your colleague is more senior than you

Answer 90

More senior Not being directly involved does not absolve your duty of care to patients

Question 91

A nurse keeps repeatedly bleeping you about non-urgent matters. A. Please don't bleep me again about non-urgent matters B. If I don't answer a bleep, please assume that i am with a sick patient and leave some time before trying again C. By constantly bleeping me, you are delaying me from helping you

Answer 91

BCA A - not good for working relationships

Question 92

You forgot to take blood: Send a text to your colleague to do it Return to the ward

Answer 92

Send a text

Question 93

You are asked to stay beyond your shift. What is more important: The length of the shift you have just worked Whether there are doctors who could stay for a couple hours instead

Answer 93

The length of the shift you have just worked --> you do not want to breach working time directives which are in place for patient safety.

Question 94

Nurse asks you to speak to a patient who has asked for an update on their progress but you have mandatory teaching for your final sign off A. Ask the patient if you can discuss this after the teaching session B. Ask a colleague to speak to the patient C. Miss the teaching D. Speak to the patient and attend teaching late E. Inform the nurse you are too busy with mandatory teaching

Answer 94

ABDCE A takes responsibility E does not take into account patient care whatsoever and is rude.

Question 95

Patient wants an abortion, and your colleague wants to persuade them not to due to his beliefs. Which 2 are more appropriate to say: "You should respect the patient's decision regardless of your beliefs" "You shouldn't let your feelings be known to the patient" "It is unprofessional to be judgemental towards others who have different beliefs to you"

Answer 95

"You should respect the patient's decision regardless of your beliefs" then... "It is unprofessional to be judgemental towards others who have different beliefs to you"

Question 96

You are asked to review one of your colleagues patients who you don't know as they are late: Explain they are not your patient so you do not feel comfortable completing a review Explain that you will complete a very basic review as you don't know the patient

Answer 96

Explain they are not your patient so you do not feel comfortable completing a review --> better than completing an inadequate review

Question 97

Is considering whether there are enough staff on the wards should you stay of sick an important consideration

Answer 97

Not important (minor) as you put patients at risk on the ward (Ranked 4th)

Question 98

SHO was treating a patient earlier today who died. The family want a quick burial and need the death certificate signed: A. Telephone SHO to come back to hospital B. Escalate to on-call consultant C. Tell the relatives the SHO will be back in 2 days to sign it D. Sign it yourself E. Contact the ward manager to see if any doctors are available who could sign it

Answer 98

EBCAD SHO may be on protected rest time

Question 99

Partner fabricated audit data: Tell supervisor there was a mistake and you need to collect more data Tell supervisor you had no input

Answer 99

Tell supervisor there was a mistake and you need to collect more data