MSRA Practice and Application 5

Question 1

A 22-year-old student presents after a paracetamol overdose taken 4 hours ago. She is asymptomatic. What is the most important initial step?

Accepted Answer

Measure serum paracetamol level and plot on the treatment nomogram

Answer

The paracetamol level at 4 hours post-ingestion, plotted on the treatment nomogram, determines whether N-acetylcysteine is needed.

Question 2

You are writing a discharge letter and realize you are unsure about a clinical detail. The patient has already left the ward. What is the most appropriate action?

Accepted Answer

Review the patient's notes, contact the ward team if needed, and complete an accurate letter before sending

Answer

Accurate and complete discharge documentation is essential for safe continuity of care; any uncertainty should be resolved through the medical record or team before sending.

Question 3

A 58-year-old woman presents with sudden painless visual loss in the right eye described as a 'curtain coming down.' What is the most likely diagnosis?

Accepted Answer

Retinal detachment

Answer

A 'curtain descending' over vision is the classic description of retinal detachment, a time-critical emergency requiring urgent ophthalmology review.

Question 4

A patient with schizophrenia refuses antipsychotic medication. He has capacity and is not currently posing a risk to himself or others. What is the most appropriate response?

Accepted Answer

Respect his decision, document it, and arrange close follow-up

Answer

A capacitous adult has the right to refuse any treatment; this decision must be respected, documented, and followed up appropriately.

Question 5

You are performing a venepuncture and accidentally sustain a needlestick injury from a patient with known HIV on antiretroviral therapy with an undetectable viral load. What is the most appropriate immediate action?

Accepted Answer

Wash the wound, report immediately, and seek urgent occupational health assessment for post-exposure prophylaxis

Answer

All needlestick injuries require immediate wound care, incident reporting, and formal occupational health assessment for PEP eligibility within 1–2 hours.

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

MSRA Practice and Application 5