NMC OSCE Mental Capacity & Professional Communication

Question 1

The Mental Capacity Act 2005 is underpinned by five key principles. Which of the following correctly states the first principle?

Accepted Answer

A person must be assumed to have capacity unless it is established that they lack it

Answer

All adults are assumed to lack capacity until proven otherwise

Answer

Capacity must be formally assessed before any decision can be made

Answer

Only doctors can assess mental capacity

Question 2

A patient with advanced dementia needs a tooth extraction. They cannot consent to the procedure. Under the MCA 2005, how should clinicians proceed?

Accepted Answer

Make a best interests decision following MCA principles, consulting relevant people

Answer

Ask the patient's next of kin to consent on their behalf

Answer

Apply to the Court of Protection for a consent order

Answer

Refuse to proceed without valid consent from any source

Question 3

What is a Lasting Power of Attorney (LPA) for Health and Welfare?

Accepted Answer

A legal document allowing a nominated person to make health and welfare decisions on behalf of someone who loses capacity

Answer

A legal document allowing a person to manage someone else's bank account

Answer

A court order to impose treatment against a patient's wishes

Answer

A document signed by a doctor authorising emergency treatment

Question 4

Which of the following correctly describes the two-stage test for mental capacity assessment under the MCA 2005?

Accepted Answer

Does the person have an impairment of the mind or brain, AND does that impairment cause them to be unable to make the specific decision?

Answer

Is the person over 16, and have they been diagnosed with a mental disorder?

Answer

Is the person refusing treatment, and is the refusal harmful?

Answer

Has a psychiatrist assessed them, and do they have a psychiatric diagnosis?

Question 5

A patient with a learning disability is being consented for surgery. Which approach best supports their ability to make an informed decision?

Accepted Answer

Provide information in an accessible format (easy read, pictures) and allow extra time

Answer

Use standard consent forms without modification

Answer

Ask a family member to consent on their behalf without assessing the patient first

Answer

Assume they lack capacity and proceed to best interests decision-making

Question 6

A patient has an advance decision to refuse treatment (ADRT) that specifically refuses blood transfusion in all circumstances. The patient is now unconscious and requires a transfusion to survive. What should the clinical team do?

Accepted Answer

Follow the ADRT if it is valid, applicable, and made when the patient had capacity

Answer

Administer the transfusion as the patient cannot currently communicate their wishes

Answer

Ask the family if they agree with the patient's earlier decision

Answer

Seek a court order to override the ADRT