NMC OSCE Safeguarding Adults & Children 2 — Questions and Answers
Question 1: In England, which organisation is responsible for conducting Section 42 safeguarding enquiries for adults?
- The NHS Trust
- The police
- The local authority (Correct answer)
- The Care Quality Commission
Correct answer: The local authority
Under the Care Act 2014, the local authority (usually via its adult social services) is responsible for conducting or ensuring Section 42 enquiries when there is a reasonable cause to suspect an adult with care and support needs is experiencing or at risk of abuse or neglect.
Question 2: A nurse is concerned that an elderly patient's pressure ulcer may have developed due to neglect in their care home. Which category of abuse does this represent?
- Physical abuse
- Neglect and acts of omission (Correct answer)
- Institutional abuse
- Discriminatory abuse
Correct answer: Neglect and acts of omission
Neglect and acts of omission include failing to provide adequate care, food, warmth, hygiene, or medical treatment. Preventable pressure ulcers developing due to failure of care homes to implement appropriate repositioning and skin care regimes constitute neglect.
Question 3: What is 'coercive control' in the context of domestic abuse?
- Physical violence that occurs repeatedly
- A pattern of behaviour that seeks to control, isolate, and intimidate a victim (Correct answer)
- Financial exploitation of a vulnerable person
- A one-off episode of threatening behaviour
Correct answer: A pattern of behaviour that seeks to control, isolate, and intimidate a victim
Coercive control involves a pattern of acts including isolation, degradation, monitoring, threats, and economic control that creates a climate of fear and dependence. It became a criminal offence in England and Wales under the Serious Crime Act 2015.
Question 4: A patient in A&E repeatedly presents with unexplained injuries. The patient denies abuse. What should the nurse do?
- Accept the patient's explanation and discharge them
- Document objectively and refer to the safeguarding team if there is reasonable cause for concern (Correct answer)
- Only act if the patient directly discloses abuse
- Ask the patient's partner, who is present, for their account
Correct answer: Document objectively and refer to the safeguarding team if there is reasonable cause for concern
Repeated unexplained injuries are a red flag for domestic abuse. The nurse should document objectively (using the patient's own words and factual descriptions), ensure the patient has a safe opportunity to speak privately, and refer to safeguarding if there is reasonable concern.
Question 5: Under the Mental Capacity Act 2005, when does an adult lack mental capacity?
- When they have a diagnosis of dementia
- When they are unable to make a specific decision at a specific time due to an impairment of the mind or brain (Correct answer)
- When they are under the influence of alcohol
- When they are below the age of 18
Correct answer: When they are unable to make a specific decision at a specific time due to an impairment of the mind or brain
Under the MCA 2005, lack of capacity is decision-specific and time-specific. An adult lacks capacity for a particular decision if, due to an impairment of the mind or brain, they cannot understand, retain, weigh, or communicate information relevant to that decision.
Question 6: A nurse identifies possible financial abuse of an elderly patient by a family member. What should they do?
- Confront the family member directly
- Report to the police immediately without following internal safeguarding procedures
- Raise a safeguarding concern with the local authority and document the concerns (Correct answer)
- Leave it as it is a private family matter
Correct answer: Raise a safeguarding concern with the local authority and document the concerns
Financial abuse, including misappropriation of money or property by family members, is a safeguarding concern requiring referral. Internal safeguarding processes (via the organisation's safeguarding lead) and local authority notification are the appropriate steps, with documentation.
NMC OSCE Safeguarding Adults & Children 2
In England, which organisation is responsible for conducting Section 42 safeguarding enquiries for adults?