MSRA Professional Dilemmas 2 — Questions and Answers
Question 1: A consultant asks you to prescribe a medication for a patient you have not assessed and whose notes you cannot access. What is the most appropriate first action?
- Politely decline and explain you must review the patient before prescribing (Correct answer)
- Prescribe it because a senior colleague requested it
- Prescribe it but document that the consultant instructed you
- Ask a nurse to prescribe it instead
Correct answer: Politely decline and explain you must review the patient before prescribing
You remain personally accountable for any prescription, so you must assess the patient and review information before signing.
Question 2: You notice a colleague has documented observations in the notes that you are certain were never taken. What should you do first?
- Speak to the colleague directly to understand what happened (Correct answer)
- Report them immediately to the GMC
- Ignore it as it is not your responsibility
- Alter the notes yourself to correct them
Correct answer: Speak to the colleague directly to understand what happened
Raising the concern directly first allows clarification and gives the colleague a chance to explain or correct it.
Question 3: A patient becomes acutely unwell on the ward while you are mid-way through a non-urgent discharge summary. What is the most appropriate response?
- Stop the summary and attend to the acutely unwell patient (Correct answer)
- Finish the summary quickly then attend the patient
- Ask the patient's relatives to find another doctor
- Continue the summary as the discharge is also time-sensitive
Correct answer: Stop the summary and attend to the acutely unwell patient
Clinical urgency takes priority, so an acutely unwell patient must be attended before non-urgent paperwork.
Question 4: You are running an hour behind in clinic and patients are visibly frustrated. What is the most appropriate action?
- Apologise to waiting patients and ask reception to keep them updated (Correct answer)
- Rush each consultation to catch up
- Skip the histories to save time
- Ask patients to rebook for another day
Correct answer: Apologise to waiting patients and ask reception to keep them updated
Honest communication and updates maintain trust without compromising the quality of each consultation.
Question 5: A nurse tells you a drug chart you wrote contains a dose she believes is too high. You think it is correct. What should you do?
- Recheck the dose against guidelines and discuss it with the nurse (Correct answer)
- Tell her to administer it as written
- Cross it out and let her decide the dose
- Ignore her concern as prescribing is your role
Correct answer: Recheck the dose against guidelines and discuss it with the nurse
A raised safety concern warrants rechecking the evidence and open discussion before the drug is given.
Question 6: A medical student asks to perform a procedure on a patient that the student has never done before, without supervision. What is the best response?
- Explain the student must be supervised for a first attempt (Correct answer)
- Allow it since students must learn somehow
- Refuse and tell the student to stop trying procedures
- Let the student do it and watch the outcome
Correct answer: Explain the student must be supervised for a first attempt
First attempts at a procedure require supervision to protect both patient safety and the student's learning.
Question 7: You realise you gave a patient incorrect information about their diagnosis earlier today. What is the most appropriate action?
- Contact the patient promptly to correct the information and apologise (Correct answer)
- Wait to see if it causes any problem
- Ask a colleague to tell them instead
- Document the correct information only in the notes
Correct answer: Contact the patient promptly to correct the information and apologise
Duty of candour requires promptly correcting the error directly with the patient and apologising.
MSRA Professional Dilemmas 2
A consultant asks you to prescribe a medication for a patient you have not assessed and whose notes you cannot access.
What is the most appropriate first action?