NMC CBT - Nursing and Midwifery Council Computer-Based Test Safeguarding Vulnerable Adults and Children 1 — Questions and Answers
Question 1: Under Section 42 of the Care Act 2014, which statement best describes a local authority's adult safeguarding duty?
- To investigate all allegations of abuse independently, without involving other agencies
- To make enquiries, or cause enquiries to be made, when an adult with care and support needs may be at risk of abuse or neglect (Correct answer)
- To remove the adult from their home immediately whenever abuse is suspected
- To act only when the adult has been formally assessed as lacking mental capacity
Correct answer: To make enquiries, or cause enquiries to be made, when an adult with care and support needs may be at risk of abuse or neglect
Section 42 of the Care Act 2014 places a statutory duty on local authorities to make (or cause to be made) enquiries when an adult with care and support needs may be at risk of abuse or neglect and is unable to protect themselves, regardless of mental capacity or whether the adult consents to enquiry.
Question 2: A nurse at a GP practice confirms that a girl under 18 has undergone Female Genital Mutilation (FGM). Under the Serious Crime Act 2015, what action is legally required?
- Discuss the situation with the family to obtain their consent before reporting
- Report only to the local authority safeguarding team and document in the records
- Report to the police as soon as reasonably practicable (Correct answer)
- Monitor and review at the next scheduled appointment before escalating
Correct answer: Report to the police as soon as reasonably practicable
The Serious Crime Act 2015 introduced a mandatory reporting duty requiring regulated health and social care professionals to report directly to the police when they identify that FGM has been carried out on a girl under 18. This duty is absolute and cannot be deferred pending family discussion or parental consent.
Question 3: A patient discloses ongoing domestic abuse but explicitly requests that the nurse keep all information confidential. What is the most appropriate response?
- Honour the patient's request entirely and make no further disclosure
- Share the information immediately with all members of the multidisciplinary team without further discussion
- Explain the limits of confidentiality, then share information without consent only where there is serious risk of significant harm, following Caldicott Principles and the NMC Code (Correct answer)
- Take no action until the patient provides written consent to share information
Correct answer: Explain the limits of confidentiality, then share information without consent only where there is serious risk of significant harm, following Caldicott Principles and the NMC Code
Confidentiality is not absolute in safeguarding. The NMC Code and Caldicott Principles permit — and in some cases require — disclosure without consent when there is a serious risk of significant harm to the individual or others. The nurse must first explain these limits to the patient and act proportionately to the level of risk identified.
Question 4: A community nurse visiting an elderly man notices several potential indicators of financial abuse. Which of the following findings is most characteristic of this abuse type?
- Unexplained bruising on the upper arms and torso
- Sudden changes to a will or power of attorney, unpaid bills despite adequate income, and unexplained missing funds (Correct answer)
- Poor personal hygiene, pressure ulcers, and significant unintentional weight loss
- Social withdrawal, low mood, and expressions of fear around a particular carer
Correct answer: Sudden changes to a will or power of attorney, unpaid bills despite adequate income, and unexplained missing funds
Financial abuse involves the unauthorised or improper use of money, property, or assets. Classic indicators include abrupt alterations to legal documents such as wills or lasting powers of attorney, unexplained financial transactions, bills going unpaid despite sufficient funds, and disappearance of money or possessions — often perpetrated by someone in a position of trust.
Question 5: Which professional or agency holds lead statutory responsibility for conducting a Section 47 enquiry under the Children Act 1989?
- The Named Nurse for Safeguarding Children in the NHS trust
- The child's registered GP
- Children's Social Care within the local authority (Correct answer)
- The police officer assigned to the family's case
Correct answer: Children's Social Care within the local authority
Section 47 of the Children Act 1989 places the duty to enquire squarely on the local authority (Children's Social Care) when there is reasonable cause to suspect that a child is suffering, or likely to suffer, significant harm. Health professionals and police are required to cooperate and assist, but Children's Social Care leads and coordinates the enquiry.
Question 6: A nurse is caring for an adult with a severe learning disability who lacks capacity to consent to a proposed surgical procedure. Under the Mental Capacity Act 2005, which principle must guide the decision?
- The next of kin holds legal authority and their decision is final
- The least restrictive option that is in the person's best interests must be chosen, with input from those who know them well (Correct answer)
- Treatment should be withheld entirely until the patient regains capacity
- The responsible consultant has sole authority to decide without consulting family or carers
Correct answer: The least restrictive option that is in the person's best interests must be chosen, with input from those who know them well
The Mental Capacity Act 2005 requires that any decision made for a person who lacks capacity must be in their best interests and must represent the least restrictive option available. The decision-making process must involve people who know the person — such as family members, carers, or an Independent Mental Capacity Advocate — although next of kin do not hold automatic legal authority to consent on behalf of an adult.
NMC CBT - Nursing and Midwifery Council Computer-Based Test Safeguarding Vulnerable Adults and Children 1
Under Section 42 of the Care Act 2014, which statement best describes a local authority's adult safeguarding duty?