MSRA Situational Judgement Flashcards

You are about to discharge a patient when the pharmacist calls to say there is a potentially dangerous interaction between two medications just prescribed. What should you do?

Answer: Hold the discharge, review the interaction, and modify the prescriptions before the patient leaves

A pharmacist warning about a dangerous drug interaction requires immediate clinical review and prescription modification before discharge to prevent patient harm.

A senior colleague uses a term you consider to be racially offensive toward a patient during a ward round. What is the most appropriate immediate response?

Answer: Address it calmly at the time or immediately after, apologise to the patient, and report through the appropriate channel

Discriminatory language toward patients is unprofessional and potentially harmful; addressing it respectfully and promptly, with a formal report if necessary, upholds patient dignity and professional standards.

You have been working for 14 consecutive hours due to short-staffing and feel your concentration is significantly impaired. What is the most appropriate action?

Answer: Inform the registrar or on-call consultant that you are no longer safe to work, document this, and hand over outstanding tasks

A doctor who is too fatigued to function safely must escalate this to a senior and formally hand over care — continuing to work unsafely puts patients at risk and is a professional duty breach.

A patient discloses that they have been physically abused by a family member. They are an adult with capacity and ask you to keep this confidential. What should you do?

Answer: Provide support, safety information, and specialist referral; override confidentiality only if there is serious ongoing risk to the patient or others

Adults with capacity can choose not to report abuse; the clinician should offer support and resources, but confidentiality may be breached only when there is a serious and ongoing safety risk that cannot otherwise be managed.

You realise mid-procedure that you have consented the patient for the wrong side. The patient is under anaesthetic. What should you do?

Answer: Stop the procedure, inform the anaesthetist and consultant, wake the patient if safe, and re-consent properly

A wrong-site or wrong-consent discovery requires immediate cessation of the procedure, transparent escalation, and re-consent before proceeding — the Never Events framework mandates this.

A colleague asks you to see their private patients during NHS working hours for a small financial arrangement. What should you do?

Answer: Decline, as seeing private patients during NHS time is a conflict of interest and breach of employment contract

Using NHS time to provide private clinical care constitutes a breach of employment contract, a conflict of interest, and a failure of professional duties to NHS patients.