NMC OSCE Communication and Consent 2

Question 1

A patient who has been assessed as lacking mental capacity requires a medical procedure. Under the Mental Capacity Act 2005, on what basis should the decision be made?

Accepted Answer

In the patient's best interests, considering their past and present wishes, beliefs, values, and consulting relevant people

Answer

Based solely on what the medical team considers clinically appropriate

Answer

The next of kin makes the decision

Answer

The procedure cannot be performed without capacity

Question 2

You need to break bad news to a patient about a cancer diagnosis. Which evidence-based communication framework is recommended?

Accepted Answer

The SPIKES protocol: Setting, Perception, Invitation, Knowledge, Emotions, Summary/Strategy

Answer

Simply tell the patient the diagnosis directly and quickly

Answer

Write the diagnosis in a letter and leave it by the bedside

Answer

Ask a family member to tell the patient

Question 3

A nurse discovers a colleague has been diverting controlled drugs for personal use. What action must the nurse take according to the NMC Code?

Accepted Answer

Report the concern immediately to the nurse in charge, follow the organisation's incident reporting policy, and if necessary escalate to the NMC as this represents a fitness to practise concern

Answer

Ignore it as it is not their responsibility

Answer

Confront the colleague privately and ask them to stop

Answer

Wait to see if it happens again before reporting

Question 4

When documenting in patient records, which of the following meets NMC standards for record-keeping?

Accepted Answer

Entries should be factual, consistent, accurate, made as soon as possible after the event, signed, dated, and timed, with no abbreviations that could be misinterpreted

Answer

Brief notes in pencil are acceptable if time is limited

Answer

Only significant events need to be documented

Answer

Records can be completed at the end of the week from memory

Question 5

A patient's family member asks to see the patient's medical records. The patient is conscious and has capacity. What is the correct response?

Accepted Answer

The patient's consent is required before sharing their records with family members, as the information is confidential to the patient

Answer

Family members have an automatic right to see records

Answer

Show the records to anyone who asks

Answer

Refuse under all circumstances as records are never shared

Question 6

During a clinical handover, a nurse uses the term 'the appendicitis in bed 4' to refer to a patient. Why is this unacceptable practice?

Accepted Answer

It depersonalises the patient, reducing them to a diagnosis rather than treating them as an individual, which contravenes NMC standards of person-centred care

Answer

It is too informal for a clinical setting

Answer

It reveals confidential diagnosis information

Answer

There is nothing wrong with this approach