NZREX Patient Communication & Informed Consent

Question 1

Which of the following best describes 'informed consent' under the NZ Code of Health and Disability Services Consumers' Rights?

Accepted Answer

Voluntary agreement given after receiving adequate information, understanding it, and having capacity to decide

Answer

Under Right 7 of the Code, informed consent requires: the patient has capacity, information has been provided and understood, consent is freely given without coercion, and the patient has the right to withdraw. A signature confirms but does not replace genuine informed consent.

Question 2

A 16-year-old presents alone requesting contraception. She appears to understand the information provided. What is the legal position regarding consent in New Zealand?

Accepted Answer

A 16-year-old can consent to medical treatment independently under the Care of Children Act 2004

Answer

Under the Care of Children Act 2004, a person aged 16 or over can consent to medical, surgical, or dental procedures as if they were an adult. Under 16, the Gillick/Fraser competence principles apply — the child may consent if they understand the information.

Question 3

When explaining a diagnosis of cancer to a patient, which communication approach is recommended?

Accepted Answer

Use clear language, pause frequently, check understanding, allow silence, and invite questions

Answer

Breaking serious news (SPIKES protocol) involves a structured approach: check what the patient knows, ask how much they want to know, give information in clear chunks, explore emotions, summarise, and plan. Patient-centred communication improves coping and trust.

Question 4

A patient has capacity but refuses a blood transfusion that the doctor believes is life-saving. What is the correct action?

Accepted Answer

Respect the refusal, document it thoroughly, and explore the patient's reasons and wishes

Answer

A competent adult has an absolute right to refuse medical treatment, even if the refusal is unwise or life-threatening. The doctor must respect this, document carefully, ensure the patient understands consequences, and continue to provide care within the patient's wishes.

Question 5

Which of the following is NOT a valid reason to override a patient's right to confidentiality?

Accepted Answer

The patient's partner requests information about their diagnosis

Answer

Confidentiality cannot be overridden simply because a partner or family member requests information. Valid exceptions include disclosure to prevent serious harm to others, statutory obligations, and sharing within the treating team on a need-to-know basis.

NZREX Practice Test

NZREX Practice Test

NZREX Patient Communication & Informed Consent