NZREX Communication and Professionalism

Question 1

In the NZREX examination, what communication framework is recommended for breaking bad news?

Accepted Answer

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

Answer

Simply state the diagnosis directly without any preamble

Answer

Write the diagnosis on paper and hand it to the patient

Answer

Ask the nurse to deliver the bad news instead

Question 2

In NZ medical practice, what is the correct approach when a patient requests a treatment you believe is not in their best interest?

Accepted Answer

Explain your clinical reasoning, discuss the evidence, explore the patient's perspective, but ultimately respect their autonomy while documenting the discussion

Answer

Refuse the request without explanation

Answer

Agree to the request to avoid conflict

Answer

Report the patient to the Medical Council

Question 3

In the NZREX, how should a candidate handle a situation where they do not know the answer to a clinical question?

Accepted Answer

Honestly acknowledge the limits of their knowledge, state what they do know, and explain how they would seek the information (guidelines, senior colleague, specialist referral)

Answer

Guess an answer to appear confident

Answer

Change the subject to something they know more about

Answer

Remain silent until the examiner moves on

Question 4

In NZ, what is the appropriate response when a patient's family requests that you do not tell the patient their diagnosis?

Accepted Answer

Explore the family's concerns, but explain that the patient has the right to be informed under the Code of Rights, and work to find a culturally appropriate way to share the information

Answer

Agree to the family's request and withhold the diagnosis from the patient

Answer

Tell the patient immediately without speaking to the family

Answer

Ask the hospital administrator to decide

Question 5

What is the ISBAR communication tool used in NZ healthcare, and when is it used?

Accepted Answer

Introduction, Situation, Background, Assessment, Recommendation — used for clinical handover, escalation, and referral between healthcare professionals

Answer

A medication dosage calculator

Answer

A patient satisfaction survey tool

Answer

A hospital billing system

Question 6

In NZ, what is open disclosure and when should it be used?

Accepted Answer

An honest, transparent discussion with patients and whānau when an adverse event or error has occurred during their care

Answer

A method for disclosing financial information about the hospital

Answer

Publishing all patient records online for transparency

Answer

A technique for opening difficult conversations about billing