NZREX Patient Communication & Informed Consent 2

Question 1

A patient with schizophrenia refuses antipsychotic medication during a voluntary admission. What is the most appropriate initial response?

Accepted Answer

Explore the reasons for refusal, address concerns, and attempt to negotiate — do not impose medication without legal authority

Answer

A voluntary patient retains the right to refuse treatment. The clinician should explore reasons for refusal (e.g., side effects, insight, fears), attempt therapeutic negotiation, and only consider the Mental Health Act if the patient meets criteria for compulsory assessment.

Question 2

When using an interpreter for a patient who does not speak English, which approach is most appropriate?

Accepted Answer

Use a trained professional interpreter, ideally not a family member

Answer

Professional interpreters ensure accuracy, confidentiality, and neutrality. Family members (especially children) should not interpret as they may filter information, lack medical vocabulary, and compromise confidentiality or create conflict of interest.

Question 3

A patient asks for a copy of their medical records. Under the Privacy Act 2020, what is the general obligation of the health provider?

Accepted Answer

Provide access to records within a reasonable time, subject to limited exceptions

Answer

Under the Privacy Act 2020 (Information Privacy Principle 6), individuals have a right to access information about themselves. Health providers must respond within 20 working days and provide access subject only to limited grounds for refusal.

Question 4

Which of the following best describes 'therapeutic privilege' and its standing in NZ?

Accepted Answer

Withholding information believed harmful to the patient — this is not accepted under the NZ Code, which requires full disclosure

Answer

Therapeutic privilege (withholding information to prevent distress) is not accepted under the NZ Code of Rights. Right 5 guarantees patients the information they need to make decisions. Information should be delivered sensitively, not withheld paternalistically.

Question 5

A doctor is about to perform a lumbar puncture. Which elements must be covered in obtaining informed consent for this procedure?

Accepted Answer

Purpose, process, risks, benefits, alternatives, and the right to withdraw consent

Answer

Informed consent requires explaining: why the procedure is needed, how it is performed, risks (including uncommon but serious risks), benefits, alternatives (including doing nothing), and confirmation the patient can change their mind.

NZREX Practice Test

NZREX Practice Test

NZREX Patient Communication & Informed Consent 2