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SJT > Passmed > Flashcards

Passmed Flashcards

1
Q

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

A

Yes

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2
Q

When escalating an issue what is an important consideration

A

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

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3
Q

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

A

confront directly first before you speak to someone else about it

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4
Q

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

A

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

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5
Q

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

A

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

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6
Q

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

A

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

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7
Q

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

A

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

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8
Q

can nurses clerk patients in hospital

A

no

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9
Q

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

A

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

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10
Q

how should you handle a formal complaint made against you

A

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.

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11
Q

should blood be taken from a cannula

A

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

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12
Q

how should you deal with a needlestick injury

A

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

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13
Q

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

A

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

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14
Q

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

A

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

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15
Q

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

A

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

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16
Q

how should you deal with an inappropriate drug prescription acutely

A

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

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17
Q

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

A

no

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18
Q

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

A

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

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19
Q

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

A
  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
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20
Q

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

A

Ward manager

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21
Q

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

A

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

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22
Q

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

A

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

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23
Q

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

A
  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
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24
Q

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

A

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

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25
Q

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

A

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

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26
Q

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

A
  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
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27
Q

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

A

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

28
Q

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

A
  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
29
Q

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

A
  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
30
Q

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

A
  1. document conversation and examination findings
  2. give info on domestic abuse groups
  3. do nothing
  4. inform police
  5. address the spouse directly
31
Q

what are the rules around accepting gifts

A

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.

32
Q

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

A
  1. act in best interests of patient
  2. get urgent senior input
  3. inform next of kin
33
Q

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

A
  1. Senior within your team
  2. On call microbiologist
  3. BNF
  4. Nurse with experience dealing with these patients
  5. National guidelines
34
Q

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

A

nurse in charge

35
Q

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

A

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

36
Q

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

A

bottom tier

37
Q

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

A
  1. ask consultant first (usually clinic)
  2. offer to assist FY1s
  3. Talk to programme director
  4. take on extra work
38
Q

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

A

explore the concern

39
Q

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

A
  1. ask a Dr that can
  2. phone translator
  3. ask senior
  4. family member
  5. nothing
40
Q

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

A

get another senior before phoning yours

41
Q

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

A

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

42
Q

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

A 
Talk to them 
Talk to other FY1
take photos down
talk to senior
tell others to embarrass the person
43
Q

should you avoid shouty upset patients

A

no

44
Q

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

A
  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
45
Q

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

A

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

46
Q

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

A

hand over to dr taking over

seniors do not need to be informed

47
Q

if a prescribin error has been made what should you do

A

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

48
Q

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

A

try to talk before having to restrain

49
Q

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

A

ask for help at your level (F1)

ask for help above you

if chronic - talk to consultant and try to resolve

50
Q

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

A

if theyre confused/disoriented

51
Q

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

A
  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
52
Q

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

A

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

53
Q

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

A

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

54
Q

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

A

no

55
Q

can nurses take bloods

A

yes unless indicated otherwise in the stem

56
Q

should you always take a learning opportunity if possible

A

yes

57
Q

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

A

report to foudation programme director

58
Q

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

A

no

59
Q

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

A

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

60
Q

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

A

escalate to senior, rarely Fy1s report otehr Fy1s themselves

61
Q

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

A

stay late and cover

62
Q

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

A

do not contact unless there is a pattern of behaviour

63
Q

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

A

patient safety

64
Q

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

A

no you should find more about before reaching a judgement

65
Q

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

A
  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

SJT (2 decks)

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