MSRA Professional Dilemmas 2

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?

Accepted Answer

Politely decline and explain you must review the patient before prescribing

Answer

Prescribe it because a senior colleague requested it

Answer

Prescribe it but document that the consultant instructed you

Answer

Ask a nurse to prescribe it instead

Question 2

You notice a colleague has documented observations in the notes that you are certain were never taken. What should you do first?

Accepted Answer

Speak to the colleague directly to understand what happened

Answer

Report them immediately to the GMC

Answer

Ignore it as it is not your responsibility

Answer

Alter the notes yourself to correct them

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?

Accepted Answer

Stop the summary and attend to the acutely unwell patient

Answer

Finish the summary quickly then attend the patient

Answer

Ask the patient's relatives to find another doctor

Answer

Continue the summary as the discharge is also time-sensitive

Question 4

You are running an hour behind in clinic and patients are visibly frustrated. What is the most appropriate action?

Accepted Answer

Apologise to waiting patients and ask reception to keep them updated

Answer

Rush each consultation to catch up

Answer

Skip the histories to save time

Answer

Ask patients to rebook for another day

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?

Accepted Answer

Recheck the dose against guidelines and discuss it with the nurse

Answer

Tell her to administer it as written

Answer

Cross it out and let her decide the dose

Answer

Ignore her concern as prescribing is your role

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?

Accepted Answer

Explain the student must be supervised for a first attempt

Answer

Allow it since students must learn somehow

Answer

Refuse and tell the student to stop trying procedures

Answer

Let the student do it and watch the outcome

Question 7

You realise you gave a patient incorrect information about their diagnosis earlier today. What is the most appropriate action?

Accepted Answer

Contact the patient promptly to correct the information and apologise

Answer

Wait to see if it causes any problem

Answer

Ask a colleague to tell them instead

Answer

Document the correct information only in the notes