Final Flashcards

1
Q

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

A

Nurse > Reg > Monitor > Tell infection control

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2
Q

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

A

Telephone next of kin to ask about symptoms

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

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3
Q

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

A

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)

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4
Q

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

A

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).

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5
Q

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

A

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.

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6
Q

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

A

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.

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7
Q

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

A

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.

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8
Q

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?

A

If you are in the process of completing a critical action

E.g. Completing a drug chart

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9
Q

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

A

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

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10
Q

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

A

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

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11
Q

Rate the appropriateness of:
“I’m here to help you, please don’t speak to me that way”

A

3 - Somewhat inappropriate

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12
Q

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

A

3 - Of minor importance

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13
Q

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?

A

2 - Somewhat appropriate

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

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14
Q

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

A

4 - Inappropriate

It is out of your scope of practice

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15
Q

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

A

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

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16
Q

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

A

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

17
Q

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

A

2 - Important

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

18
Q

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

A

3 - Of Minor importance

Patient care and safety comes first

19
Q

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

A

Send a text

20
Q

Your colleague calls in sick. They have posted pictures of a night out last night:
A. Make other colleagues on the rota aware of the photos from the party
B. Suggest to your FY1 colleague that she remove the photos from the social networking site
C. Seek advice from another FY1 colleague
D. Ask your colleague for an explanation of why she called in sick the day after a party
E. Alert a senior colleague to the photos on the social networking site

A

DCBEA

Informing a senior colleague would only be the correct action if there was no adequate explanation forthcoming, the doctor did not show genuine remorse and learning or there were on-going concerns regarding patient safety (E)

21
Q

Nurse consistently rude to you and undermines you in front of patients and staff
Inform consultant
Inform Nurse in charge

A

Consultant

Informing the nurse in charge (B) is best left to your consultant.

22
Q

Colleague has social media post about a patient which can be identified.
C. When you next see Neal, suggest that he removes the social media post
D. Inform your on-call consultant of Neal’s social media post
E. Advise Neal to change his social media settings to ‘private’ so that only his contacts are able to read his posts

A

CDE

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.

23
Q

You see a handover list at your colleagues house:

A. Inform Susanna that this is a breach of patient confidentiality
B. Advise Susanna to destroy the handover list
D. Destroy the handover list
E. Advise Susanna to discuss the breach of patient confidentiality with her educational supervisor*

A

ABED

Discussion and reflection with her supervisor (C) are important but represent an action that will become more appropriate later once the immediate issue with the handover sheet has been dealt with. Destroying the list (D) may mean that Suzanna is unaware of what has happened to the document which may cause problems when reporting the breach of confidentiality at work.

24
Q

You are in the Acute Admissions Unit* (AAU) and are writing up a patient’s drug chart. The nurse tells you that one of the patients has been waiting 10 minutes for a cannula to be inserted. You know that the patient was seen by your FY1 colleague, Alex, five minutes ago. Alex has now left the AAU but you do not know the reason why. The nurse informs you that Alex did not insert the cannula when he was with the patient. There is no clinical urgency to insert the cannula.

A. Ask the staff if they know why Alex has left the ward
B. Contact Alex and ask him to return to the ward and insert the cannula
C. Ask the nurse to contact Alex to request that he returns to AAU to insert the cannula
D. Tell the nurse you will insert the cannula as soon as you have finished writing up the patient’s drug chart

A

ADCB

The most appropriate response is to establish why Alex left the ward (A) as this may have been to attend an emergency or obtain equipment for the procedure. Doing the cannula when you are able can ensure the ongoing care of the patient (D), but it does not address why a member of the team (Alex) has left. Contacting Alex is reasonable but it is more important to establish why he left the ward first from the staff as he may be busy with an important task. As you are in the process of dealing with a patient critical action i.e. completing a drug chart, this should take priority so asking the nurse to find where Alex is would be more appropriate (C) than leaving the task to contact him on your own (B).

25
Q

You are working on your first rotation in surgery. Whilst assessing a 65 year old female patient with jaundice, the consultant surgeon asks you to refer the patient to the Gastroenterology department regarding further treatment. You are unsure why this referral is required.

A. Ask a more experienced colleague to make the referral
B. Conduct research on the Internet into why the referral could be required
C. Contact the gastroenterology consultant to explain that you need to make the referral, and ask what information they need to proceed
D. Ask a more experienced colleague what information the Gastroenterology department will require to make the referral
E. Speak to the consultant surgeon again to gain more information before making the referral

A

EDBCA

If you are unsure about why a referral has been requested, check with the person requesting it (E). They may have forgotten to explain the details to you, and it furthers your learning and understanding. Failing this, speaking to another senior member of the team for generic information about this type of referral will be helpful (D), however they may also be unsure of the consultant’s reason for requesting this referral. Taking a proactive approach and researching your questions will be appreciated by the team you are referring to (B) and will also further your knowledge. Contacting the gastroenterology consultant without understanding why you are calling is likely to be unproductive and frustrating for yourself and the team you are referring to (C). Asking a colleague to make the referral for you is inappropriate as you are passing work to a colleague and failing to address your own learning needs (A)

26
Q

Rate the importance of:
The impact on the rest of the ward staff if you leave your shift early

A

1 - Very important

27
Q

Nurses are criticising your colleague. Rate the appropriateness of:
Find your F2 colleague and tell her what you heard the nurses saying

A

4 - Inappropriate

28
Q

Family is complaining as there relative’s surgery has been cancelled due to an emergency procedure. Pick 3
Option A: “I’m sorry but there is an emergency case that takes priority.”
Option B: “I can see you are upset. I know this must be disappointing.”
Option C: “I agree, this is not the best outcome.”
Option D: “Is there anything else I can do to help?”
Option E: “The registrar/specialty trainee has made the decision; I can not do anything about it I’m afraid.”
Option F: “You can wait to discuss this further with the registrar/specialty trainee if you would prefer?”
Option G: “I understand your frustration but getting angry will not help.”
Option H: “There is no need to shout at me, I can not change anything.”

A

BDF

29
Q

Lara is going for a meal with one of her patients.
* Option A: Ask to speak to Lara in private to reiterate that her behaviour is unprofessional
* Option B: Advise Lara to tell the patient that she cannot go out for dinner with him
* Option C: Suggest to Lara that she speaks to her other colleagues to see what they think
* Option D: Discuss the situation directly with Lara’s clinical supervisor*
* Option E: Ask Lara if she has previously arranged to meet up with patients outside of work

A

ABDCE

Ask Lara if she has previously arranged to meet up with patients outside of work as this is outside the scope of your interest as a current colleague and therefore not your responsibility to explore further

30
Q

Samira is ill but wants to come in to attend teaching sessions. Which is more important:

The ability of Samira to meet her educational needs
Whether there are enough staff to see the patients should Samira be off sick

A

Samiras educational needs

Options D is not an important consideration in determining if Samira can go off sick, as she is putting others at risk by attending the hospital when she is unwell.

31
Q

PM

Child says they’ve been sexually assaulted:
Refer the child to the duty social worker
Ask safeguarding lead to see child
Refer the child to the local centre which deals with cases of sexual assault/abuse

A

Safeguarding lead
Duty social worker
Local Centr