UMAT Section 2

Tertiary Prep Skills 2002-2004
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UMAT SUPERPREP COURSES
PRE-COURSE STUDY MATERIALS

PART 2
INTERPERSONAL COMMUNICATION

CONTENTS
GENERAL INTRODUCTION
SECTION 1: PERSONAL DEVELOPMENT
Empathy
Honesty
SECTION 2: COMMUNICATION SKILLS
Conflict Resolution
Appropriate Communication
SECTION 3: PROFESSIONAL DEVELOPMENT
Professional Conduct
Prioritising Skills
TIMED TRIAL TESTS...........

SECTION 1: PERSONAL DEVELOPMENT
Empathy
Answers
Honesty
Answers
SECTION 2: COMMUNICATION SKILLS

Conflict Resolution
Answers
Appropriate Communication
Answers
SECTION 3: PROFESSIONAL DEVELOPMENT
Professional Conduct
Answers
Prioritising Skills
Answers
General introduction:

The purpose of this book is to provide a structured preparation for all Health Professionals
wishing to review or learn initially, interpersonal skills essential to the practice of their
occupation.The topic of Interpersonal Skills has been divided into three main sections
dealing with the three important recurring aspects of interpersonal communication:
Personal development
Communication skills
Professional development
The first section deals with qualities. These are attitudes that people have towards other
people that are engendered from a young age. However, the principles surrounding many
personal qualities can be taught, and through the process of education and personal
development, certain qualities can be fostered.
The latter two sections are about skills. These are different in that they are less likely to be
innate and have to be taught. Most people will have some basic proficiency at
communication skills and professional conduct, as these are skills we use on a day to
day basis. In a profession such as medicine, it has been necessary to foster and teach these
in a specific context, as there are ethical and legal ramifications attached to our behaviour
when we interact with people in a professional context.
Each section has been divided into two categories as follows:
Section 1: Personal
development
Section2: Communication skills
Section3: Professional
development
Qualities:
Skills:
Skills:
1.1 Empathy
2.1 Conflict resolution
3.1 Professional conduct
1.2 Honesty
2.2 Appropriate communication
3.2 Prioritising skills
Section 1: PERSONAL DEVELOPMENT:

1.1 Empathy:
What is empathy?
Empathy may be defined as the ability to accurately perceive the feelings of another person
and to communicate this understanding to that person. Empathy is important in any
healthcare setting as it allows the healthcare professional to understand the patients needs
and also deepens the relationship between carer and patient. This ultimately results in better
treatment of the patient and better patient compliance with that treatment.
There are several general guidelines for developing empathic understanding. The most
important are:
Listening: Empathy can perhaps best be achieved through the process of carefully
listening and attending to the other person. The ear is often as important as the eye in
medical practice and other healthcare professions.
Relating: This means understanding the problem from the patients point of view. (Health
care workers often learn the value of empathy when they themselves fall sick and can
then relate to the feelings of other people who are ill.)

Reassuring: The ability to provide reassurance to another person is important. In a

medical setting, reassurance may often contain medical information, which should always
be explained in such a way that the patient can understand it easily.
The Health Professional should be aware that many questions in the Interaction Skills section
will examine basic attitudes toward patient empathy. The following examples all illustrate the
principles of listening to the patients concerns, relating to their problem and then offering
some form of reassurance or explanation.
Example:1
Category: Empathy
Scenario:
You are a nurse looking after a teenage boy who is awaiting a major operation to remove a
bone tumour near his knee. He is very anxious as he has never had an operation before and
is worried that he may not be able to walk normally again. As you are preparing him for his
operation, he starts crying. What do you do?
Choices:
a) You have other patients to prepare for their operations and hurriedly rush off and get on
with your duties.
b) You sit down with him for as long as you can, listen to his concerns, and try to reassure
him that he will most probably make a good recovery and will be able to walk again given
time.
c) You tell him not to be silly and that he is old enough to be brave and handle the situation.
d) You sternly tell him to pull himself together and that if he does not have the operation
the tumour might kill him.
e) You quietly leave his room so that neither of you will be embarrassed.
Answer:
The preferred answer is (b).
Discussion:
This question deals with compassion and understanding. As a professional dealing with the
care of patients, you are often required to help them with their emotional and psychological
concerns. Responses (a), (c) and (d) dismiss the patients need for reassurance and lack
empathy. Response (e) avoids dealing with the issue. Response (b) demonstrates caring
and concern the little extra time taken to reassure the patient can go a long way towards
allaying his fears.
Example: 2
Category: Empathy
Scenario:
You are a junior doctor who is rostered off for the afternoon. At 11.00 AM you visit an elderly
patient who has been under your care for a few weeks, and is having an operation that
afternoon. The old man asks you if you could please spend some time with him, as he is very
anxious about his operation, and would like to ask you a few questions. You spend a while
with the patient, and then decide to go home as you have an arranged commitment to
attend to. The old man desperately asks if you cant stay longer. What do you say to the
patient?
Choices:

a) You tell the patient that unfortunately you have a prior commitment and cannot be at the
hospital that afternoon.
b) You tell the old man that you have a previous commitment, which you will try to reschedule. If this is possible, you will spend more time with him.
c) You tell the old man that you have to go, however if he has any more questions you will
get another doctor to answer these for him.
d) You say nothing about a previous commitment, but simply agree to stay with the patient
as long as possible and answer any more questions he might have.
e) You say that you are feeling very ill and cannot stay long, as you have worked very long
hours.
Answer:
The preferred answer is (d).
Discussion:
This situation requires you to deal with a certain degree of empathy and act in a professional
manner towards one of your patients. It is obvious that this patient places a lot of trust in
you, and even spending a few minutes more before attending to your other commitment may
mean a lot to the patient. Thus the correct answer is (d).
Example: 3
Category: Empathy
Scenario:
You are a nurse on a ward round with a group of doctors and medical students. The
consultant doctor interrupts the ward round to go off and answer his pager. In the meantime
the medical students start chatting with the junior doctors and laugh among themselves quite
loudly. They are all standing near the bed of a patient who has been in severe pain all night
and has just managed to fall asleep. The patient wakes up and asks you what is going on
and that he cannot sleep with such a racket going on. What do you tell him?
Choices:
a) You tell the patient in a loud tone of voice, so that the doctors are sure to hear it, that you
are sorry the racket woke him up.
b) You tell the patient in a loud tone of voice that the doctors did not know that he was
sleeping and had been up all night.
c) You tell the patient to try to go back to sleep and tell the group to move away from the
patients bed.
d) You ask the group politely if they can move slightly away from this patients bed, as he
has been up all night with severe pain and then tell the patient to try and sleep again.
e) You tell the patient that you will complain to the consultant doctor.
Answer:
The preferred answer is (d)
Discussion:
This scenario deals with a conflict situation for you the nurse. Do you have enough empathy
for the patient to tell the doctors to keep down the volume of their conversation, or do you
give the patient some excuse, as reprimanding the junior doctors in front of the medical
students might embarrass them. Answer (d) is the appropriate choice, as it ensures peace
and quiet for the patient and avoids a direct confrontation with the doctors.
1.2 Honesty:

Honesty is an important issue in any professional healthcare setting, as honesty engenders

trust, and trust is one of the most important components in any health professional-patient
relationship.
For Health Professionals many questions in practice will deal with the issue of honesty, often
in the context of a scenario where a little white lie may not necessarily be cause any harm,
or may help the health professional out of a sticky situation. The aim of these questions is to
assess the candidates attitudes towards honesty and integrity in a professional setting.
Example: 1
Category: Honesty
Scenario:
You are a nurse on a surgical ward in a public hospital. One day you accidentally forget to
give a patient the anti-nausea drug that was written up with his pain relieving medication
(nausea is a very common side effect of some pain medications), as you are tired, having
just finished a very busy night shift. As a result of your oversight the patient becomes really
nauseous. None of the doctors or nursing staff knows about your oversight (as patients can
still experience nausea despite having had medication to prevent it). You decide not to fill out
an incident report and not to tell anyone about your oversight. However, a couple of days
later, the patient questions you about the episode of severe nausea. What do you tell him?
Choices:
a) You tell him that it is a common reaction to some pain relieving medications.
b) You tell him that you forgot to give him an anti-nausea drug and that these mistakes
sometimes happen, as the nursing staff have so many things to think of.
c) You tell him that you forgot to give him an anti-nausea drug. You apologise and say that
you were tired from working a night shift.
d) You tell him that another nurse forgot to give him an anti-nausea drug and you apologise
on the other nurses behalf.
e) You tell him that you did give him an anti-nausea drug and that it obviously didnt work.
Answer:
The preferred answer is (c).
Discussion:
This scenario deals with the nurse being faced with a potentially embarrassing situation,
(apart from the issue of medically negligent behaviour towards the patient). The temptation
is to cover up the initial mistake as in options (a), (d) and (e), but this is dishonest. In this
case an apology and honest explanation might win the patients understanding, as in answer
(b). Answer (c) is absolutely truthful.
Example: 2
Category: Honesty
Scenario:
You are a medical student who is trying to insert a drip into a patient. The patient keeps
referring to you as the young doctor and you are actually not sure whether the patient
knows that you are only a medical student with little experience. After two unsuccessful
attempts, you are hesitant to carry on, but the senior doctor has informed you that he wants
you to conduct the procedure. It is obvious that the patient is getting upset at being made to
suffer this discomfort. How should you proceed?

Choices:
a) You apologise to the patient and tell him not to worry, as you are very good at this.
b) You tell the patient that you have performed this procedure hundreds of times and are
just having a bad day.
c) You apologise to the patient, and tell the patient that you would rather get someone more
experienced to conduct the procedure.
d) You tell the patient that you are aware he is not comfortable with the situation, however it
has to be done.
e) You tell the patient that you are just learning and that if you fail again, the procedure will
not be performed at all.
Answer:
Discussion:
This situation requires you to communicate honestly with your patient. The patients wellbeing is still your prime objective, thus to get someone more experienced to conduct the
procedure as in (c) might be the most appropriate course of action after all. Answers (a) and
(b) show blatant dishonesty.
Example: 3
Category: Honesty
Scenario:
You are a GP in a busy practise. A 17-year-old girl comes to see you with her mother. As part
of your history taking and related to the complaint that brought the girl to you in the first
place, you have to ask some intimate questions. You are concerned that the girl will not
answer truthfully with her mother present. How do you handle this situation?
Choices:
a) You tell the mother that there is some paperwork to be filled out in the reception area and
it would save time if she left the room to complete that while you have a brief word with her
daughter.
b) You ask the mother if she would be kind enough to do you a favour. You send her on an
errand to the reception area so that you can speak to the daughter in private.
c) You ask the mother if she would please leave the room while you have a chat with the
daughter in private.
d) You tell the mother that the daughter asked you before if she could see you alone. You
hope that the daughter does not contradict your statement.
e) You tell both mother and daughter that it is important you take down an accurate history
and state that the girl may not feel comfortable answering all questions in front of her
mother.
Answer:
Discussion:
As a doctor your prime responsibility is directed towards your patient. Any interference in the
way of attaining information from the patient or considering the correct course of treatment
needs to be removed. Especially younger patients are often reluctant to reveal certain
information in front of family members. It is important to be honest and direct in your
request, which is why (c) is the preferred answer. Note that answer (e) is worded in such a
way that it might offend the mother as it implies that the daughter may not trust her mother.

Section 2: COMMUNICATION SKILLS:

2.1 Conflict Resolution:
Why is conflict resolution an important interaction skill?

In a setting where the health of a patient is reliant not only on good communication between
the patient and their health care professional, but also between health care professionals
amongst themselves, anything which interferes with the communication process is potentially
deleterious to the proper care of the patient.
The Health Professional may be presented with scenarios describing conflict between a
patient and a health professional, or conflict between patients, which needs to be mediated
by another healthcare professional. These scenarios will examine the Health Professionals
attitudes and skills with regard to mediation of disagreements and efficient conflict resolution.
How can conflict in a healthcare environment be resolved?

At a professional level the following general pointers should be taken into account:
Focus on the Problem: It is important to focus on the relevant issues surrounding a

problem in order to find a solution. Focussing on how the problem arose in the first place
and how it can be solved is more important than issues such as who is to blame.
The Team Approach: United we stand divided we fall - Usually, the first course of
action in a conflict situation is to attribute blame. This does not solve the problem. It
singles out one group or person, instead of uniting people as a team to solve the
problem.
Compromise: Often the parties involved in a conflict situation will have to reach a
compromise each party will have to yield some ground to reach a solution that is
acceptable to everyone.
The Win-Win Situation: For effective conflict resolution it is important that all parties
involved feel satisfied with the solution.
The following examples illustrate some of these issues. The preferred answers emphasise:
Explaining the situation (usually to a patient) so that any misunderstanding between

conflicting parties may be resolved.
Being impartial: Not taking sides is crucial in solving a conflict situation between two
parties.
Suggesting solutions, which are acceptable to both parties, but may involve some
compromise by each (as explained above).
Example: 1
Category: Conflict resolution
Scenario:
You are a nurse caring for two elderly male patients. One of the patients spends most of the
day reading books. The other patient has a small portable radio, which he listens to all day.
The patient reading the books is not happy about the constant noise, complaining that he
cannot concentrate. He has spoken to the man with the radio, who has paid no heed to his
requests for some peace and quiet. The man complains to you. What do you say?
Choices:
a) You ignore the situation and hope that they will resolve the problem.
b) You threaten to report the complaining man to the clinical nurse consultant.

c) You explain to both patients that they have to be considerate of each other, and ask the
man with the radio to turn down the volume.
d) You tell the man with the radio that you have to confiscate it, if he does not turn down
the volume.
e) You tell the man reading the books to read out loud.
Answer:
The preferred answer is (c)
Discussion:
This is a conflict situation between two patients. As a nurse you have the choice whether to
ignore the situation or to help resolve the conflict. By choosing to ignore the situation, both
patients wellbeing and comfort are being compromised. Answer (c) is the preferred answer.
It is far better to speak in a polite and friendly manner to both parties concerned and to
negotiate a compromise between the patients, which will ensure a comfortable hospital
environment, than to ignore the problem (a), or aggravate it (e). Threatening the man (b)
will not resolve the issue in the short term and choice (d) is not appropriate either as you
have no right to confiscate personal property.
Example: 2
Scenario:
You are a young nurse in the childrens ward at a public hospital. You are in charge of a ward
with six boys, between the ages of eight and thirteen years. One boys has had his tonsils
removed and is in some discomfort. His mother has informed you that her son is constantly
being teased and bullied by all the other boys. How best should you handle the situation?
Choices:
a) You ignore the mothers complaint, as the child might be over-reacting.
b) You tell the other boys to stop bullying the child, or you will make sure that they will not
get their meals that evening.
c) You tell the mother that bullying does not happen in hospitals and that her child might be
lying.
d) You tell the mother that this problem does not fall within your job description.
e) You explain to all the boys in the room that the boy being teased is not well, just like
them, and has a right to be left in peace in order to fully recover.
Answer:
The preferred answer is (e).
Discussion:
In this situation your diplomatic people-skills are required. The emotional wellbeing of one of
your patients is being seriously compromised. Answer (e) is the preferred answer, because
you are not just reprimanding the other boys, but hopefully enlisting their cooperation and
understanding. Answer (d) is incorrect because by taking no action the boys comfort and
recovery are compromised. Choice (a) and (c) indicate that you do not believe the child or its
mother. Without adequate grounds and investigation this is certainly inappropriate. Choice
(b) constitutes entirely inappropriate behaviour.
Example: 3
Category: Conflict Resolution
Scenario:

You are a nurse in a maternity ward. Under your care is a young woman who has given birth
to twins. Not only the adoring husband, but many relatives and friends are constantly
bringing her flowers. Sharing the room with the young woman are two other ladies. One of
them suffers from hayfever. As a result of the many flowers she is constantly showing signs
of hayfever. She is complaining about her reaction to the many flowers. How do you handle
the situation?
Choices:
a) You remove all the flowers from the room and inform the mother of the twins that she
may not receive any more flowers.
b) You tell the patient suffering from allergies, that there is actually nothing you can do, as
everyone is allowed to receive flowers in hospital.
c) You ignore the complaints of the patient with hayfever and hope the mother of the twins
will not receive any more floral gifts.
d) You offer the patient medication to alleviate the allergies.
e) You discuss the situation with the patient receiving the flowers and ask if the flowers can
be kept at home for her by her family.
Answer:
The preferred option is (e).
Discussion:
In this case, the wellbeing of all patients is your prime responsibility. Every patient in the
hospital environment has the right to feel comfortable. Although there is no rule about
receiving flowers in hospital, they are in this case however causing a great discomfort to one
of your patients. Option (a) is too drastic as there is no discussion with the patient
concerned. Choices (b) and (c) do nothing to help the patient with allergies, while choice (d)
is only a short term measure. Option (e) is the most fair and democratic approach as it
explains the situation to the mother of the twins and tries to find a solution that proves to be
most beneficial for all parties concerned.
2.2 Appropriate Communication:
Discussion:
What does the word communication mean to you? For the next few moments I would like
you to do some brainstorming by yourself. Think about:
A definition of communication
The purpose of communication
Appropriate and inappropriate communication in a professional environment
Appropriate communication in a challenging situation:

Health professionals may be faced with scenarios where awareness of appropriate
communication skills is examined in situations where the health professional is challenged
with a difficult situation or with a patient who is behaving inappropriately. The health
professional may even be insulted or taunted by a patient.
Responding appropriately in such a setting is extremely important. The health professional
should be aware of the following issues regarding appropriate communication skills.
Respect: The patient should always be addressed in a respectful manner, even if the
patient is being inappropriate.
Language: Patients are to be addressed by their title where appropriate and colloquial
language and a casual or careless attitude or demeanour is inappropriate when
communicating with patients.

Direct and Honest Approach: Issues or problems should be explained to patients in

clear terms and the patient should never be misled or lied to. Refer to the section on
Honesty.
Professional Barriers: Patients should never be discriminated against or made to feel
uncomfortable, even if they are behaving inappropriately or are clearly in the wrong.
Here are some examples:

Example: 1
Category: Appropriate Communication
Scenario:
You are a nurse working on a general ward. One of your patients, a middle-aged man in a
shared room, requires regular oral administration of medication, as instructed by his doctor.
You have privately been informed by one of the other patients, that as soon as you leave the
room the man spits out the pills you have given him. What should you tell him?
Choices:
a) You inform the patient that you will tell the doctor that he spits out the tablets he should
be taking.
b) You confront the patient with the information you have and explain carefully to him that it
is in his best interest to take the medication prescribed by his doctor.
c) The next time you have given the patient his medication you unobtrusively observe his
actions. If the allegations made are true you speak to him concerning the need to follow his
treatment plan carefully and that it is in his best interest to follow the doctors orders.
d) You tell the patient that you suspect that he is not taking his medication and that you
shall have to report him to the doctor, as this may have very serious repercussions for his
recovery.
e) You explain to the patient the importance of taking the prescribed medication and then
decide to stay with the patient until you have seen him swallow all the tablets prescribed and
give instructions to the other nursing staff to do the same.
Answer:
Discussion:
This scenario deals with appropriate communication and action in a difficult situation. As a
nurse it is your duty to ensure that all instructions by the doctor are meticulously and
conscientiously carried out. By implying to the patient, that you are aware of what is going
on regarding his intake of medication and then explaining the importance of accepting the
appropriate treatment protocol, as well as making sure that the doctors orders are properly
carried out, the situation may be resolved. Thus the most accurate answer is (e).
Example: 2
Category: Appropriate communication
Scenario:
You are a young nurse working for a pathology laboratory. It is your duty to draw blood on a
regular basis from patients who are unable to get to the appropriate medical centres. Most of
your patients are either bed-ridden or elderly people who have trouble getting around. Every
month you have to visit an old man, who is very querulous and difficult. Whenever you
attempt to get a blood sample from him, the old man jerks his arm away, inflicting injury
upon himself. He then blames you for being inefficient and incompetent. Every visit is an
ordeal for you. What should you do?

Choices:
a) You tell the old man to keep quiet and to keep still whilst you are trying to take blood.
b) You explain to the old man why you have to take blood from him, that you do not wish to
hurt him and that if he holds completely still it will make your job a lot easier.
c) You complain to your superior and refuse to see the old man again.
d) You explain to the old man, that you are an experienced nurse and that you will make this
procedure very painful if he does not keep still.
e) You apologise to the old man and tell him that you are trying to do your best.
Answer:
Discussion:
You may often have to deal with patients who are difficult and querulous, and who may be
quite demanding or even rude to you. It is important to always communicate appropriately
with these patients, explain why you are doing a procedure and how they can help you, as
this will make it easier for both the carer and the patient. Choice (a) is inappropriately and
rude, choice (d) is diabolical and certainly incorrect, while in choice (e) there is no further
information or explanation given to the patient.
Example: 3
Scenario:
You are a young doctor working on a surgical ward. Two of your patients have undergone
surgery. Both of these patients are still in recovery and need to stay there for some time. The
families of both patients are anxiously waiting to speak to you when you leave the operating
theatre. The first family rush towards you with questions about the well-being of their son,
taking up much time with questions. The other patients father and wife are nervously
standing by, obviously in a great hurry to speak to you, the father mumbling that he urgently
needs to get back to work. What do you do?
Choices:
a) You briefly explain the outcome of the operation to the first family, then excuse yourself
for a moment to speak to the father and wife of the other patient. You then return to the first
family and answer any questions.
b) You briefly explain the outcome of the operation to the first family, then excuse yourself
and speak to the father and wife of the other patient for a long time before leaving the ward.
c) You ask the relatives of the second patient to phone the surgeon for information later that
day.
d) You abruptly end your conversation with the first family and speak to the father and wife
who are waiting for you.
e) You call both families together and explain the results of both procedures to all of them.
Answer:
The preferred answer is (a).
Discussion:
As a health care practitioner you need to be able to communicate with patients families,
often under distressing circumstances. It is always important to be calm and reassuring.
Illness and suffering affect not only the patient, but also the families involved. The preferred
choice (a) gives you time to talk to both parties and allows the father to leave after hearing
the news in brief. Choices (b) and (d) imply that the needs of the second family are being put
above those of the first, which is not correct.

Answer (c) ignores the immediate needs of the second patients family, while answer (e)
violates the rights of each family to discuss this news with you in private.
Section 3: PROFESSIONAL DEVELOPMENT:
3.1 Professional Conduct:
What is Professional Conduct?

Professional conduct is behaviour in accordance with the highest standards of character and
practice, incorporating dignity, respect - for oneself, for others and for any task performed and appropriate behaviour in accordance with the legal and ethical principles prescribed by a
given profession. It is important for a health care professional to uphold these standards of
conduct when dealing with patients in any given situation.
Why is it important that we relate to clients or patients in a professional manner?

Professional conduct is universal across different professions and essentially provides a
prescribed code of interaction between the professional and the client, which allows for a
very defined and (on the part of the professional) structured interpersonal communication to
ensue. This allows a comfortable environment for a client to discuss or divulge information,
which may be of a personal nature or which may be embarrassing or even incriminating.
Professional conduct thus helps foster trust between client and professional and aids the
professional in helping or serving the client effectively. The health professional should be
aware of the following general guidelines of professional conduct in the medical professions:
Non-Discrimination: This includes discrimination against the client (political, religious,

racial, sexist, culturalist, etc.) or discriminatory remarks about any persons in front of the
client.
Confidentiality: Any dealings between client and professional are to be kept strictly
confidential.
Maintenance of standards: The professional should uphold the standards of care
demanded by the medical profession, even in the face of time constraints or other limited
resources.
Advocacy: The professional usually represents a professional body with certain ethical,
moral and legal codes of practice. Apart from adhering to these codes, criticism of
colleagues, their practises or criticism of the professional body or its codes in front of a
client is considered unprofessional.
Information and Consent: The professional has an obligation to keep the client informed
of all proceedings and important issues concerning that client and in certain cases the
clients formal consent is required. Client information and informed consent do not fall
within the scope of this lecture, however.
What is required of the Health Professional in terms of knowledge of professional

conduct? ?
At this level it is not important to know in detail about all the legal and ethical issues which
influence the relationship between health professional and patient. It is important, however,
to know that they exist. Health Professionals should be able to recognise what is blatantly
inappropriate professional conduct, based on the general guidelines above and then what
might be the most appropriate way of dealing with a patient. Read and discuss the following
examples:
Example: 1

Category: Professional Conduct

Scenario:
You are a nurse working on a ward. One of your new patients is a young lady who keeps
demanding your attention, asking for a glass of juice, for an extra pillow, etc. You are very
busy and she is taking up much of your time and not allowing you to look after your other
patients. How do you handle the situation?
Choices:
a) You tell her loudly across the ward that you are busy.
b) You gently tell her that you acknowledge that she has certain requests but that you do
have to share your time between a number of patients and ask for her understanding.
c) You ignore her requests and continue with your work.
d) You tell her sternly that she is not the only patient on the ward and that you cant
continually come when she calls.
e) You tell her that if she doesnt stop calling you, youll ask for her to be moved to another
part of the ward.
Answer:
Discussion: This question deals with the difficulties of maintaining professional conduct in
the face of time constraints and a demanding patient. With effective communication it is
usually possible to gain their understanding of your situation as in response (b). The
remainder of the responses all indicate a lack of correct interpersonal communication as they
are rude and impart no information to the patient.
Example: 2
Category: Professional conduct
Scenario:
You are a nurse caring for an elderly patient in a nursing home who is gravely ill. Every time
you see this patient, he tells to you that he thinks he is on the wrong medication, as he is not
getting better. He has on numerous occasions made it clear to you, as well as to other staff
members, that he does not believe the doctor has made the right diagnosis and that the
medication is having no beneficial effect on him. He has also stated that he believes the
doctor to be completely incompetent. However, when the doctor comes to see him he never
discusses the matter with him. What should you do?
Choices:
a) You inform the doctor of the patients complaints.
b) You inform the patient that he should discuss his concerns with his doctor at length and
that you will be happy to ring the doctor to come and see the patient.
c) You tell the patient that his remarks are uncalled for and that he should keep his opinions
to himself.
d) You agree with the patient that some doctors do not know what they are doing.
e) You ignore the patients complaints and comments, putting it all down to the fact that he
must have senile dementia.
Answer:
The preferred answer (b).
Discussion:
This scenario deals with appropriate professional conduct in a difficult setting. Often it is not
possible to resolve a patients complaints, but effective interpersonal communication will help
to resolve the situation. Choice (b) is the preferred answer because the patients doubts need

to be discussed with him and his fears alleviated. As his doubts are directed at the doctor and
his method of treatment, it is best that the doctor be called to review the patient and discuss
the matter with him. Answer (a) does nothing to immediately address the patients concerns,
choice (c) is rude, choice (d) is unprofessional, while choice (e) totally ignores the patients
concerns.
Example: 3
Scenario:
You are a nurse and one of your patients, an elderly man is about to be released from
hospital. While he is waiting for the release forms to be processed you bring him a list of
instructions written by his doctor. The list contains information regarding his medication and
diet, for the next couple of days. He has a look at what his doctor has written and then tells
you that he finds it impossible to decipher the doctors handwriting. What do you tell him?
Choices:
a) You tell the patient that you shall take the list back to the doctor, with the message that
the patient cannot read his handwriting, but you may not be in time to see him before his
release.
b) You tell the patient that all doctors are hopeless and have illegible handwriting.
c) You tell the patient that this is not your problem and that he should contact the doctor.
d) You tell the patient that when you see the doctor you shall ask him to phone the patient
at home.
e) You tell the patient that you shall phone the doctor from the nurses station to get all the
relevant instructions and ask the patient to wait until you return.
Answer:
The preferred answer is (e)
Discussion:
Before the patient has left the hospital he is still officially in your care and it is your duty to
make sure, that all instructions issued by the doctor are clear to the patient, even if it means
a slight delay in leaving the hospital. This is why (e) is the preferred answer, as (a), (b) and
(d) are not at all helpful and (c) means you are relinquishing your professional responsibility
towards the care of this patient.
3.2 Prioritising Skills:
What do we mean by prioritising skills?

In an ideal world, there would be unlimited resources available to the healthcare profession
and everyone would have unlimited access to the best possible healthcare.
Discussion: What resources can you think of in the healthcare industry?

Answers might include:
Hospitals or hospital beds

Medications
Doctors, nurses and other health professionals
The time of healthcare professionals
Expensive equipment such as X-ray machines

Unfortunately, we live in a world where healthcare resources are restricted - there are many
more patients than doctors, and not every hospital can have fancy, expensive equipment and
hospital staff and general practitioners have time constraints in dealing
with individual patients.
Prioritisation is the assessment and implementation of strategies for the most effective use of
limited resources. For the health professional it is important to recognise how the
prioritisation of time and tasks within a hospital setting affects the interaction between
patients and health professionals.
The following examples all illustrate the need to balance appropriate patient care with:
The needs of each patient

The needs of other patients
The needs of other hospital staff
Time constraints
Example: 1
Category: Prioritising skills
Scenario:
You are a young general practitioner working in a coastal town. Many of your patients are
holiday-makers, who use your services only when on holiday. A young man who lives on the
coast and has been a patient of yours for a couple of years, makes an urgent appointment to
come and to see you. He has a severe stomach upset and requires medication. He brings
with him to the consultation two of his friends, both holiday-makers who have the same
symptoms of stomach upset. The two friends have no appointment to see you. You have a
full list of patients, all of which have made appointments. What do you do?
Choices:
a) You consult the patient who has made the appointment and then tell his friends that you
have a waiting room full of patients. The best you can do is to try and fit them in at the end
of the day.
b) As they have all come in to see you together, you say nothing about the other patients
who are waiting to see you. You examine your regular patient first and then examine his
friends briefly and give them each a prescription for their condition.
c) You tell the patients friends to speak to the receptionist, who does all the bookings, to ask
her to fit them in as soon as possible and tell them that they may have to wait a while.
d) You tell the friends to see another doctor as you are really fully booked and cannot
inconvenience your regular patients for patients who see you when they are on holiday.
e) You tell your receptionist to tell the youngsters that they should seek help from another
doctor as you are too busy.
Answer:
Discussion:
In a medical practice, unexpected situations often arise. In this case, the two youngsters who
have come along with their friend are not really critically ill, and can afford to wait until the
receptionist can fit them into the doctors schedule, without inconveniencing too many
patients. Therefore (c) is the preferred answer. Other patients may feel unfairly treated is
you see all three together as in choice (b). However you do have a duty of care to these
patients, and should not have to refer them to someone else or ask them to come back
unless there is absolutely no other option. Thus choices (a), (d) and (e) are not the preferred
answer.

Example: 2
Category: Prioritising Skills
Scenario:
A patient with depression comes to see you, her GP. You have diagnosed her depression
some time ago and essentially she has come to get another prescription for her medication.
You have a child waiting in the consulting room next door, who is in a lot of pain and who
needs your attention. The lady who is with you is telling you at length about her sister who
seems to be suffering from depression also. She rambles on and on and you know that you
need to cut her visit short to attend to the child. What do you say to her?
Choices:
a) You interrupt her, excuse yourself and say that you have a very urgent case next door
which requires your immediate attention.
b) You interrupt her to write out her prescription, then excuse yourself and say that you have
an urgent case to attend to next door.
c) You interrupt her and tell her that you cannot spend more time with her as you have an
urgent case to attend to.
d) You listen to all her problems until she is finished and simply let the child wait.
e) You ask her if she can wait for half an hour or more, as there is an urgent case you need
to attend to first and that you will finish your talk with her later.
Answer:
Discussion:
Prioritising skills are important when determining where to focus immediate attention, to
benefit patients under your care the most. The lady in question essentially only needs a
prescription renewed, so there is no point in making her wait and to continue any further
irrelevant discussion with her. The patient in serious discomfort who is waiting for your care
should take priority in this situation. Thus (b) would be the most appropriate choice.
Example: 3
Scenario:
You are a doctor working in the psychiatric ward in a public hospital. The ward has an open
plan and patients often just wander about in the common area. You are about to see a
patient for a planned consultation before another staff meeting. You are accosted by a
patient in the corridor, who proceeds to tell you at length about a last suicide attempt. You
are running late and would like to complete your sceduled consultation before the staff
meeting. What do you say to this patient?
Choices:
a) You excuse yourself, tell the patient that you have a consultation, but promise to speak to
her later.
b) You listen to the patient for a short time and then excuse yourself.
c) You tell her that you are in a great hurry and cannot speak with her right now.
d) You mention to her that she has told you all this before and that you are in a hurry.
e) You tell her that you have an appointment and then a staff meeting and have no time to
listen to her story again.
Answer:


Discussion:
This situation needs to be handled very delicately with appropriate communication, to ensure
that the patient that approached you in the corridor does not feel rejected, even though you
have little time at the moment. It would be more beneficial for you to organise an
appropriate time for yourself and the patient to discuss her problems. By doing so you not
only prove to her that you want to help, but also prioritise your attention regarding patients.
Thus the preferred choice would be (a).
END OF LEARNING MATERIAL
+++++++++++++++++++++++++++++++++++++++++++++++++++++++
COMMENCEMENT OF SIX (6) TIMED TRIAL TESTS
This is a strictly timed trial test. Time allowed is 45 minutes.
PERSONAL DEVELOPMENT
EMPATHY
Question: 1
Category: Empathy
Scenario:
You are a resident doctor rushing to get to a ward round when a patient calls out to you and
asks you to fetch him a glass of water. You are already running late. What do you do?
Choices:
a) Ignore him and continue on your way. You cannot afford to be late and someone else
can attend to the patient.
b) You tell the patient to ask the nurse, as that is his/her job.
c) You fetch the glass of water despite knowing that you are already late and your senior
colleagues as well as your patients will be waiting.
d) You apologise and explain that unfortunately you are running late and that you will pass
the request on to the patient's nurse.
e) You say, "Sure, I'll get it now" and hurry off to your ward round.
Question: 2
Category: Empathy
Scenario:
You are a nurse looking after an elderly patient who has forgotten to bring her bed slippers
to hospital. She complains to you of having cold feet when she sits out of bed or goes to the
bathroom. She asks you if there is anything you could do to help her. What is your
response?
Choices:
a) You say, "No, I'm sorry. The hospital does not provide bed slippers for its patients".
b) You say, "Sure I'll go and buy you some and you can consider it a present".
c) You offer to phone her family and ask whether a visiting family member could pick up her
pair from home and bring them in for her.
d) You tell her that her cold feet are not a problem medically and she should just tolerate
them.
e) You advise her to discuss the issue with her family when they next visit in two days time.
Question: 3

Category: Empathy
Scenario:
You are a nurse looking after a teenage boy who is awaiting a major operation to remove a
bone tumour near his knee. He is very anxious as he has never had an operation before and
is worried that he may not be able to walk normally again. As you are preparing him for his
operation, he starts crying. What do you do?
Choices:
a) You have other patients to prepare for their operations and hurriedly rush off and get on
with your duties.
b) You sit down with him for as long as you can, listen to his concerns, and try to reassure
him that he will most probably make a good recovery and will be able to walk again given
time.
c) You tell him not to be silly and that he is old enough to be brave and handle the situation.
d) You sternly tell him to pull himself together and that if he does not have the operation
the tumour might kill him.
e) You quietly leave his room so that neither of you will be embarrassed.
Question: 4
Category: Empathy
Scenario:
You are a nurse working in the paediatric ward of a large hospital. All your patients receive
regular visits from family and friends. However, one of the boys in your care has not once
had anyone visiting him and appears to be very lonely. What can you do to help?
Choices:
a) You ring the boys parents and inform them, that their son seems depressed and sad and
ask if there is anything you can do to help.
b) You ring the parents and ask them why they do not visit their son.
c) You ignore the situation and decide to wait and see what happens.
d) You tell the boy that you find this state of affairs very disappointing.
e) You ask other staff to visit the boy so that he does not feel that lonely.
Question: 5
Category: Empathy
Scenario:
You are a surgical nurse working in the operating theatre. A twelve year old girl, who has a
sarcoma in her lower femur needs to have a knee replacement. Because of the seriousness
of the operation the parents are allowed to accompany their daughter to just outside the
operating theatre. The young girl is sedated and seems calm. Suddenly the mother starts to
cry and gets more and more hysterical about the consequences of such a drastic procedure
on her daughters future. The husband tries to calm his wife. The young girl is getting
increasingly alarmed. What should you do?
Choices:
a) You quietly steer the mother away from the daughters bed-side and calmly reassure her
that the best course of treatment for her daughter is being followed and that she is in good
hands. Once the mother has calmed down you take her back to the daughter side.
b) You tell the mother to pull herself together, as her crying is upsetting the young patient.

c) You tell the mother that she will have to leave immediately as the young girl is not to be
upset just before the operation.
d) You let the husband deal with the situation at hand.
e) You quietly explain to the mother in front of the daughter that her daughter is in good
hands, that the correct treatment procedure is being followed and that she needs to calm
down for the sake of her daughter.
Question: 6
Category: Empathy
Scenario:
You are a nurse working for the Blue Nursing Service. You have to pay a visit to an old mans
apartment, who is in need of nursing care. The old man lives in a block of units that mainly
has elderly residents living there. Once you have treated the old man and are about to leave,
you find two other elderly residents waiting outside his door. Both are complaining about
various ailments and are asking for your treatment. What should you do?
Choices:
a) You should tell them that your time has been carefully scheduled for the day, that you will
however ring up the service and ask for another nurse to be sent out to them as soon as
possible.
b) You ask the patients what is wrong with them and then decide on a course of action to
help them.
c) You tell them that you have a very busy schedule and will try to schedule them in for the
following day.
d) You ignore the two elderly people and continue on your way.
e) You tell them that you are in a hurry and ask them to phone the Blue Nursing Service
themselves to organise a visit by one of the nurses.
Question: 7
Category: Empathy
Scenario:
You are a male nurse accompanied by an orderly, working in the orthopaedic ward. Your
patient, an elderly man who has had a hip-replacement has an epidural in place to fight the
intense pain. Every three hours he needs to be rolled over and have his back rubbed with
ointment to prevent bed-sores. However the patient is in pain and persistently refuses to be
turned. What are you to do?
Choices:
a) You carefully explain to the patient that even though he experiences pain, it is vital to the
recovery process, that you perform the task of rubbing down his back regularly.
b) You tell the patient that he should try to accept the pain and the fact that you have a duty
to perform.
c) You carefully explain to the patient that he is obviously going to experience some
discomfort initially, but that on each occasion he will actually feel better.
d) You ignore his complaints and proceed with the task at hand.
e) You tell the patient that because he is experiencing pain you shall wait a day or two
before rubbing down his back.

Question: 8
Category: Empathy
Scenario:
You are a junior doctor working in a surgical ward. Your senior doctor informs you, that the
mother of a six year old patient has requested that a lump (ganglion) on her daughters wrist
be removed at the same time as the operation on her foot is being performed. When you go
to see the patient and her mother, you mention the added procedure. It becomes apparent
that the young patient is frightened of the added procedure and does not want the wrist
lump removed. The mother had told the senior doctor, that she did not want the added
procedure to be mentioned to her daughter. Now both the mother and the young patient are
upset. How should you handle this situation?
Choices:
a) You say that you only mentioned the added procedure, because your senior doctor asked
you to.
b) You explain to the patient that it is best to remove the lump at the same time as her other
procedure is being performed, as it entails only one anaesthetic and will not cause her any
extra discomfort.
c) You tell the patient that she must have the lump removed at the same time as the other
procedure as there is only one anaesthetic involved and obviously less cost involved.
d) You tell the patient that it is far more convenient for the doctor to perform both
procedures at once.
e) You ask the mother to please speak to the child and sort this issue out with her, before
any decision is made by the doctor regarding the lump in the wrist.
Question: 9
Category: Empathy
Scenario:
You are a nurse looking after a seven year old boy, who has recently been diagnosed with a
serious cancer. One afternoon he asks you if he is going to die. How do you respond?
Choices:
a) You tell the child truthfully: Most probably.
b) You tell him, that he is in hospital because the constant medical care and attention will
make him totally well again soon.
c) You assure him that he is not going to die.
d) You ignore the question and first discuss it with other staff members before dealing with
the issue.
e) You explain to the boy, that the constant medical care and attention from doctors and
nurses in hospital affords him the best possible chance of recovery.
Question: 10
Category: Empathy
Scenario:
You are a junior doctor who is rostered off for the afternoon. At 11.00 AM you visit an elderly
patient who has been under your care for a few weeks, and is having an operation that
afternoon. The old man asks you if you could please spend some time with him, as he is very
anxious about his operation, and would like to ask you a few questions. You spend a while

with the patient, and then decide to go home as you have an arranged commitment to
attend to. The old man desperately asks if you cant stay longer. What do you say to the
patient?
Choices:
a) You tell the patient that unfortunately you have a prior commitment and cannot be at the
hospital that afternoon.
b) You tell the old man that you have a previous commitment, which you will try to reschedule. If this is possible, you will spend more time with him.
c) You tell the old man that you have to go, however if he has any more questions you will
get another doctor to answer these for him.
d) You say nothing about a previous commitment, but simply agree to stay with the patient
as long as possible and answer any more questions he might have.
e) You say that you are feeling very ill and cannot stay long, as you have worked very long
hours.
Question: 11
Category: Empathy
Scenario:
You are a nurse caring for a child who has just undergone an operation on her spine. She is
required to wear a back brace to support the spine for a few months. The little girl did not
previously know that she would be required to wear a brace. She is very upset and refuses to
wear it. How should you deal with this situation?
Choices:
a) You call her doctor, explain the situation to him and let him deal with the issue.
b) You tell her that she has no choice in the matter and that she has to wear the brace.
c) You tell her that you will discuss the matter with her parents and that they will force her
to wear the brace.
d) You carefully explain to her why it is essential she wear the brace and then coax her into
putting it on.
e) You tell her that she has been so brave up until now and explain to her why the brace is
necessary for her full recovery.
Question: 12
Category: Empathy
Scenario:
You are a young nurse working in an orthopaedic ward. One of your patients, a nine year old
girl has just undergone a biopsy of a tumour in her lower leg, on her tibia. The girls parents
passed away two years ago, and the only person who takes care of her is her grandmother.
The little girl is very anxious about the whole procedure and is waiting for someone to
reassure her about her condition. She has overheard the doctor discussing the case with her
grandmother. When you come to see her next, she asks you what does it mean to: have the
limb amputated? How do you respond?
Choices:
a) You explain to the young patient what amputation means, but not to worry about such
things now as the doctor has not made any definite diagnosis yet.
b) You tell her that amputation means that a limb is partly or totally removed.
c) You brush the girls question aside, and tell her to not worry so much.

d) You explain to the girl that at this stage the doctors are not sure what the outcome of the
biopsy may be, but that whatever the outcome, she is receiving the best possible care.
e) You tell her that if the outcome is not good, the doctors are going to have to remove her
lower leg, she should however not worry about the situation now.
Question: 13
Category: Empathy
Scenario:
You are a junior doctor in a childrens ward. One of your patients is a three-month-old infant
requiring an operation, which has been scheduled for the morning of the following day. It is
late afternoon, when you find out that the operating-theatre has been double booked and the
little girls operation is cancelled. You have to tell the parents who have been anxiously
awaiting the procedure as their little girl is very ill.
Choices:
a) You tell the parents, that the operating theatre has been double-booked and that the
operation has to be re-scheduled.
b) You tell the parents that there has been a mix-up in the operating schedules, that these
things sometimes happen and that the little girls operation must be re-scheduled.
c) You tell the parents, that the operating theatre has been double-booked and that you shall
ensure that the operation on their little girl receives top priority.
d) You tell the parents that mistakes will happen and unfortunately their little girls operation
will just have to wait.
e) You explain to the parents what has taken place, reassure them that the condition of their
daughter is in no way life-threatening and that you will ensure that her operation takes place
at the soonest possible time.
Question: 14
Category: Empathy
Scenario:
You are a doctor in a public hospital. You are asked to see a patient in the orthopaedic ward,
who is very paranoid about his condition and the hospital environment as a whole. You know
from his chart, that apart from some nasty fractures, there is nothing seriously wrong with
this patient. In the middle of the consultation the patient starts becoming really aggressive.
What do you say to him?
Choices:
a) You tell him to calm down, or you cannot examine him.
b) You tell him to calm down, that there is nothing to worry about and that he will soon feel
better again.
c) You tell him that you will come back when he has calmed down and walk away.
d) You calm him down and tell him that the discomfort and general anxiety he is feeling is
quite normal and that he will soon feel better again.
e) You tell him that his aggressive behaviour will not achieve anything and will only make
him feel worse in the long run.
Question: 15

Category: Empathy
Scenario:
You are a nurse looking after a patient who needs daily blood tests, to monitor for the sideeffects of her medication. Because of the frequent needle pricks the patients arm is very
discoloured, with bruising under the skin. The patient in the next bed also needs frequent
blood tests, but her arm is not bruised at all. The patient with the discoloured arm feels that
the nurse who collects the blood is not conducting her tests properly and refuses to let her
draw any more blood. What do you say to the patient?
Choices:
a) You explain to the patient that you are sorry for her discomfort, but that the tests are
necessary and that the bruising will eventually go away.
b) You apologise to the patient for the discomfort and ask her to please be patient a while
longer as the tests are necessary, while she is on the specific medication and although the
nurse is doing a good job, some people bruise easier than others.
c) You tell the patient that you are very sorry about her discomfort, that some people bruise
easier than others and that the nurse is simply doing her job.
d) You tell the patient to stop being difficult and that the tests are necessary for her general
well-being.
e) You tell the patient that if she refuses the blood tests, she must take full responsibility of
the resulting consequences, as her medication needs monitoring.
Question: 16
Category: Empathy
Scenario:
You are a nurse on a ward round with a group of doctors and medical students. The
consultant doctor interrupts the ward round to go off and answer his pager. In the meantime
the medical students start chatting with the junior doctors and laugh among themselves quite
loudly. They are all standing near the bed of a patient who has been in severe pain all night
and has just managed to fall asleep. The patient wakes up and asks you what is going on
and that he cannot sleep with such a racket going on. What do you tell him?
Choices:
a) You tell the patient in a loud tone of voice, so that the doctors are sure to hear it, that you
are sorry the racket woke him up.
b) You tell the patient in a loud tone of voice that the doctors did not know that he was
sleeping and had been up all night.
c) You tell the patient to try to go back to sleep and tell the group to move away from the
patients bed.
d) You ask the group politely if they can move slightly away from this patients bed, as he
has been up all night with severe pain and then tell the patient to try and sleep again.
e) You tell the patient that you will complain to the consultant doctor.
Question: 17
Category: Empathy
Scenario:

You are a nurse on a medical ward. the ward is filled mainly with older patients, however
there is one young girl on the ward suffering from leukemia. No one really comes to visit her.
She has been quite rude to some of the nursing staff and consequently most of the staff are
a little cool towards her. You know however that she is basically frustrated as she has no one
to talk to. You are busy with her chart one day when one of the blood nurses is very short
with the girl after she makes a fuss about having blood taken again. When the blood nurse
leaves, you notice the young girl crying. What do you say to her?
Choices:
a) You tell her that if she started being a bit nice to people, everyone would be nice to her in
return.
b) You lecture her about how she should not lash out at people continually.
c) You ask her if she has any family who you could phone to come and cheer her up.
d) You tell her that it must be very frustrating for her to have to suffer the constant blood
tests, but that she should soon get better again.
e) You tell her that you can understand her frustration, that many patients get really angry
about their condition, but that with care and time, things should get better again.
Question: 18
Category: Empathy
Scenario:
You are a junior doctor on a surgical ward-round. The last patient you and the surgeon see,
is scheduled for a complicated operation the next day. As you are both turning away to leave,
you notice out of the corner of your eye, that this patient has burst into tears. You are due in
theatre in ten minutes. What do you say to the patient?
Choices:
a) You pretend not to notice her tears and cheerfully wave good-bye.
b) You pretend not to notice her tears and leave.
c) You turn to her, tell her not to worry about anything and to get as much rest as possible
before the operation.
d) You ask the patient if there is anything you can do to help. You are due in theatre in ten
minutes, but you can come back. Or, should you send someone else to talk to her.
e) You tell the patient that you are due in theatre in ten minutes, but that you shall ask one
of the nurses to come over to speak to the patient at once.
Question: 19
Category: Empathy
Scenario:
You are a nurse looking after a patient in hospital. Visiting hours are about to start. You
patient tells you that she doesn't wish to see her family today. As walk back to the nurses
station, you see that patient's family, waiting to be admitted to the ward. What do you do?
Choices:
a) You decide that this is not an issue for you to resolve and you go off on your tea break.
b) You decide that this is not an issue for you to resolve and allow the family to visit the
patient.
c) You tell the family to go home.

d) You approach the family and explain that them that the patient wishes not to be disturbed
today, and offer to answer any queries.
e) You go back to your patient and coerce her into seeing her family.
Question: 20
Category: Empathy
Scenario:
It is lunchtime. You are a nurse looking after a male patient who is a vegetarian. He
complains to you that for the third time this week he has received a non-vegetarian meal and
that he is very hungry. What do you say to him?
Choices:
a) You tell him that you will see what you can do after you have had your own lunch.
b) You apologise and say that you will contact the catering staff when you have time.
c) You apologise and say that you will contact the catering staff immediately to see if they
can send up the correct meal.
d) You immediately phone the catering staff and tell them that they are incompetent.
e) You tell him that he should take the matter up with the catering staff when they bring his
next meal.
Question: 21
Category: Empathy
Scenario:
You are a nurse looking after an Asian man. He complains to you that this "western" hospital
food is bland and tasteless and asks if you can do anything about it. What do you say to him?
Choices:
a) You tell him that he is in a hospital and not in a hotel.
b) You tell him politely that you provide nursing care only and that solving this sort of
problem is not in your job description.
c) You offer to go to an Asian take-away restaurant and buy him some Asian food.
d) You tell him that an Asian diet will only make him ill and that he should eat what the
hospital provides.
e) You suggest that his family might be able to bring him some food from home (as long as
this does not conflict with his medical dietary requirements).
Question: 22
Category: Empathy
Scenario:
You are a junior doctor working on a surgical ward. One of your patients has been in the
operating theatre longer than expected. You notice that his family members who are waiting
in his room seem to be getting very anxious about the delay. What do you do?
Choices:
a) You ignore them and continue with your work. You are too busy to talk to relatives.

b) You go and tell them that you are aware of the delay but they shouldnt worry or
complain because delays occur often in large hospitals.
c) You go and chat to the family casually and try to distract them from the fact that the
patient is not yet back from his operation.
d) You talk to the nurse looking after the patient and ask her to go and pacify the family.
e) You approach them and reassure them that delays in theatre for a variety of reasons are
not uncommon. You offer to contact the theatre and find out how things are progressing if
the patient is delayed much longer.
Question: 23
Category: Empathy
Scenario:
You are a junior doctor on a ward round with your senior colleagues. Together, you go to
see an elderly female patient. The senior doctor examines her and then discusses her case
with the other staff in attendance. It is evident to you that she has not understood any of
the discussion and therefore does not clearly know what is wrong with her or what the
treatment plan is. What do you do?
Choices:
a) You continue on the ward round if the patient had any questions, she would have
asked.
b) You tell the patients nurse to talk to the patient if necessary.
c) You return to the patient after the ward round has ended, sit down and discuss her illness
and treatment in words she can understand, and then ask whether she has any questions.
d) You continue with your busy schedule and do not talk to the patient it will not make a
difference whether she knows whats going on or not.
e) You pat the patients hand and quickly tell her not to worry about any details you and
other doctors will take care of everything.
Question: 24
Category: Empathy
Scenario:
You are a nurse looking after a room with four male patients. At breakfast time one of the
patients is usually still asleep. In the bed next to this patient is an overweight patient with a
very large appetite, who is not satisfied with the amount of food provided. He regularly takes
the sleeping patients food. The other patients in the room have complained about the food
thief.
Choices:
a) You ignore the situation and decide since the sleeping patient does not bother to wake up
for breakfast, it serves him right.
b) You speak to the obese patient in front of all the other patients and tell him that he
should abide by the allocated food quantity.
c) You ask to speak to the obese patient privately and tell him that you will have a word with
the kitchen staff, to see if they can supply him with a larger helping of food, if he agrees not
to take the sleeping patients food.
d) You announce loudly to all patients in the room that they should keep an eye out for the
fat food thief.
e) You tell the other patients in the room that the sleeping patient is responsible for seeing
that his own meal is not stolen.

Question: 25
Category: Empathy
Scenario:
You are a male nurse working in the oncology (cancer) ward. You are looking after three
terminally ill patients. One of the patients is mentally unstable and tends to express opinions
to all in the room rather volubly. He constantly speaks about his own and everyone elses
demise and that there is no hope left. Although the other two patients realise that this man is
mentally unstable, the continuous references to death are upsetting to them. You have
noticed this and feel that you should do something.
Choices:
a) You have the patient moved to a private room, where he does not upset any other
patients.
b) You tell the other patients to ignore the old man.
c) You tell the other patients that the old man is demented and does not know what he is
talking about.
d) You explain to the patient that what he is saying to the other patients is disturbing and
upsetting them.
e) You tell the old man to keep his opinions to himself.
Question: 26
Category: Empathy
Scenario:
You are a physiotherapist working in a hospital caring for patients in the Orthopaedic ward.
One of your patients has had a serious shoulder injury, suffering discomfort. The patient feels
great pain relief when you are exercising and massaging his shoulder and he asks you to
spend some extra time with him. You are already running late on your morning schedule and
have several patients waiting for you to attend to them. What do you tell him?
Choices:
a) You tell the patient that you do not have extra time for him.
b) You tell the patient that you will do your best to alleviate his discomfort until your next
visit with him, but that you have other people who need your care.
c) You tell the patient that he should not be so demanding and that you have other patients
to attend to.
d) You tell the patient that you would stay a bit longer if he gave you $50.
e) You tell the nurse to massage the patients shoulder.
Question: 27
Category: Empathy
Scenario:
You are a nurse in a hospital working the night-shift. A teenage boy, who has just had his
tonsils removed is in your care. The youngster is sharing a ward with three other patients.
Visiting hours are over, it is late and most patients are asleep. The boys father has arrived,

explaining that he has travelled for many hours and due to work commitments has no other
opportunity to visit his son. What should you do?
Choices:
a) You tell the boys father that visiting hours are over and to return the following day.
b) You tell the boys father, that he may wake the other patients and may not be admitted to
the room.
c) You tell the father that you will check to see if his son is awake and if so you are prepared
to make an exception regarding visiting hours.
d) You tell the father to wait, as breakfast will be served in a couple of hours.
e) You offer to let the father sleep in the ward lounge until the next morning.
Question: 28
Category: Empathy
Scenario:
You are a junior resident working in the emergency department in a public hospital. It is
about 9.30 am, you have just finished the night shift after working 13 hours. It has been
unusually busy in the emergency ward, as there were a couple of problem cases. You are
exhausted and longing to go home to sleep. As you are about to leave, a young couple
whose daughter you attended to the previous evening accost you, regarding her medical
condition. They launch into a lengthy discussion, despite the fact that you explained
everything to them in detail the previous evening. What should you do?
Choices:
a) You tell them politely that you have finished your shift and are now going home after a
long night.
b) You tell them that you are in a hurry to go home and that they should speak to another
doctor.
c) You briefly answer all their questions again and refer them to another doctor who has
started on the next shift.
d) You tell them that you refuse to give them any information as your shift has finished and
you are too tired.
e) You tell them that you have explained everything to them at length and have nothing
more to say to them.
Question: 29
Category: Empathy
Scenario:
You are a senior resident doctor working in the cancer ward. It is your lunch break and you
are on the phone with your wife, who is very ill at home. One of the nurses comes rushing up
to you, asking you to please come and help with a patient. He is in urgent need of more pain
medication. The patient is under the care of the other resident on the ward, but the nurse
has been unable to locate the other resident. What do you tell her?
Choices:
a) You interrupt your phone-call, tell her that this is not your patient and ask her to page the
other resident doctor working on the patients ward.
b) You tell her that you have your own troubles concerning your wife and she should stop
bothering you.

c) You tell her that you are on the telephone and ask her to wait.
d) You tell her that this is your private time and that the patient should wait until after your
lunchbreak.
e) You interrupt your phone-call, enquire about the urgency of the situation and then make
your decision whether to attend to this patient immediately or not.
Question: 30
Category: Empathy
Scenario:
You are a midwife in a labour ward. A pregnant lady complains to you that the airconditioning is turned on too high. She cannot adequately cover herself as she is in labour.
Meanwhile she is freezing, which is making her even more uncomfortable, than she already
is. The air-conditioning is centrally controlled and there is nothing you can do about it. What
should you say to her?
Choices:
a) You tell her that the air-conditioning is centrally controlled so unfortunately it cannot be
turned down, but offer her additional blankets to loosely cover her.
b) You tell her that there is nothing you can do about the air-conditioning and she will just
have to suffer the discomfort.
c) You tell her that you are really sorry about the additional discomfort, but there is nothing
you can do about the air-conditioning.
d) You offer to get her a blanket to cover her.
e) You tell her that her labour is quite advanced and that she will soon forget about feeling
cold as the pain intensifies.
Answer:1
The preferred response is (d)
Discussion:
This question deals with the issue of empathy towards the patient. However, since you, the
doctor, have certain time constraints, it is appropriate to pass on the request rather than
keep your other commitments waiting. Hence answer c) is not appropriate here. Ignoring
patients (answer a), or lying to them (choice e), lacks empathy and is rude. Choice b) also
shows a lack of empathy towards the patient.
Answer:2
The preferred response is (c)
Discussion:
This problem centers around empathy. Ignoring the patients plight (choices a and d) is not
empathic. Buying gifts for patients (choice b) may be considered to be kind but is
professionally inappropriate. The most empathic and appropriate course of action would be
to promptly alert the patient's family and enlist their help, rather than allow the patient to
remain uncomfortable for a further two days. Hence answer e) is not correct here either.
Answer:3
Discussion:
This question deals with compassion and understanding. As a professional dealing with the
care of patients, you are often required to help them with their emotional and psychological

concerns. Responses (a), (c) and (d) dismiss the patients need for reassurance and lack
empathy. Response (e) avoids dealing with the issue. Response (b) demonstrates caring
and concern the little extra time taken to reassure the patient can go a long way towards
allaying his fears.
Answer:4
Discussion:
As a nurse you may often encounter situations where some conflict or difficulty exists
between a patient and their family. There is not much you can do in this situation, but offer
compassion and a willingness to talk about things and to help. Therefore (a) is the preferred
choice, as you are not meddling in the familys affairs, but are just pointing out the situation
at hand. The courses of action proposed in (b) and (d) are professionally inappropriate,
choice (c) is uncompassionate and choice (e) may not be a practical solution in a busy
hospital environment.
Answer:5
Discussion:
As a health-care professional, you will often be faced with emotional outbursts from patients
family members. A patient may be in a serious condition, which is distressing and disturbing
for the family. It is likely that the patient will certainly be apprehensive and may also be
frightened about the impending procedure. An empathic attitude and plenty of reassurance
will often help ease this difficult situation. If you can reassure and calm the parents, they in
turn can reassure the child and help normalise what is at best a harrowing experience.
Therefore, choice (a) is the preferred course of action. Answer (e) may cause a further
outburst in front of the patient. Choices (b) and (c) are rude and not empathetic at all.
Choice (d) does not deal adequately with the situation as the husband is also anxious.
Remember that both parents do not have much experience with situations such as this and
you do.
Answer:6
Discussion:
This scenario requires you to deal with a situation with maturity and professionalism, taking
into account your duty of care towards your other scheduled patients, as well as
consideration for the feelings of those in need of your help. Option (a) covers the interests of
your arranged patients for that day, and also provides the people in need of nursing care,
asking you for your services, a solution to their problem. The other options do not take into
account your obligation as a nurse towards your patients, and they do not provide the people
in need of nursing care with aid.
Answer:7
The preferred answer is (a)
Discussion:
This situation between patient and nurse can be resolved through empathy and appropriate
communication skills. It is the nurses duty of care to treat the patient as best possible. By
explaining carefully to the patient that although he may not be comfortable with the
procedure it is necessary for a speedy recovery, will prevent further discomfort and will be
beneficial, the patients resistance to the treatment can be broken down. Thus answer (a) is
the correct choice.
Answer:8

The correct answer is (d).

Discussion:
This scenario deals with a lack of communication skills between health care workers. It is not
the senior doctors fault that he did not inform you about the added procedure, however it is
also not your mistake for mentioning it to the patient. The situation can easily be resolved
through effective communication with mother and patient.
Answer:9
Discussion:
This scenario deals with a high degree of empathy as well as excellent communication skills.
You are not absolutely certain about the patients future prospects, but you know that a
positive realistic outlook can only aid recovery. It is therefore best to assure the patient in an
empathetic manner that he is being provided with the best possible chance of recovery. Thus
the preferred choice is (e).
Answer:10
Discussion:
This situation requires you to deal with a certain degree of empathy and act in a professional
manner towards one of your patients. It is obvious that this patient places a lot of trust in
you, and even spending a few minutes more before attending to your other commitment may
mean a lot to the patient. Thus the correct answer is (b).
Answer:11
Discussion:
This scenario deals with communicating effectively with the patient in order to explain a
specific situation and the reason for an action. A certain degree of empathy is involved from
the nurse towards the patient. Handled correctly the nurse can make the patient understand
the situation and see the benefit of co-operation, which is why (e) is the preferred option.
Answer:12
Discussion:
This situation requires you to deal with a delicate situation with empathy and
professionalism, as well as consideration for the feelings of the patient causing the dilemma.
By reassuring the patient that she is receiving the best possible care you can alleviate her
distress. Therefor (d) is the preferred answer.
Answer:13
Discussion:
Administrative mistakes may sometimes occur in the day to day running of any institution.
This can sometimes prove embarrassing for hospital staff and cause distress for patients and
loved ones. This scenario requires appropriate communication with the young patients
parents. By explaining the situation to them, apologising for any inconvenience and
reassuring them about their daughters condition, which is why (e) is the appropriate answer.
Answer:14


Discussion:
Patients sometimes display symptoms of stress and anxiety in a hospital environment, related
to treatment procedures as well as their illness and symptoms. This situation should be
handled with empathy and understanding by health care professionals at all times. This is
why (d) is the preferred answer, while answers (a), (b), (c) and (e) are harsh and callous.
Answer:15
Discussion:
Often the course of treatment prescribed involves discomfort to the patient.
As treatment is however unavoidable, it is important to illicit co-operation by carefully
explaining the mode of treatment and by showing empathy for the resulting discomfort
caused. Answer (b) is therefor the preferred answer to (a) and (c). Answers (d) and (e) are
harsh and do not take the patients feelings into account.
Answer:16
Discussion:
This scenario deals with a conflict situation for you the nurse. Do you have enough empathy
for the patient to tell the doctors to keep down the volume of their conversation, or do you
give the patient some excuse, as reprimanding the junior doctors in front of the medical
students might embarrass them. Answer (d) is the appropriate choice, as it ensures peace
and quiet for the patient and avoids a direct confrontation with the doctors.
Answer:17
Discussion:
In this situation it is important to show understanding for the patients feelings and emotions.
She is obviously alone and frustrated. By reaching out to her as in answer (e) she may come
out of her shell and communicate her problems.
Answer:18
Discussion:
Often patients experience periods of anxiety and depression especially before an operation. It
is essential to calm and reassure the patient, as a positive state of mind is important for a
speedy recovery. In this case it is important the doctor shows empathy towards the patient
even though he is due in theatre he offers to come back, to comfort the patient. Therefor (d)
is the preferred answer.
Answer:19
The preferred answer is d).
Discussion:
This question is about showing compassion for the patient's family while still respecting the
wishes of the patient. Simply avoiding the issue demonstrates a lack of proper interpersonal
communication skills and for this reason choice a) is not correct.
To ignore the wishes of the patient is inappropriate, and hence answer b) is not correct
either. Simply telling the patients family to go home without any explanation, as in answer
c), is unprofessional and rude. In choice e), the wishes of the patient are not being
respected, which in this case is again a demonstration of poor communication skills.

Answer:20
The preferred answer is c).
Discussion:
This question is about showing compassion, by not leaving the hungry patient to wait
unnecessarily for a meal which he is entitled to. Answers a) and b) and e) not only show a
lack of compassion for the hungry patient, but also show poor communication skills, as they
lead the patient to believe that you dont really care about his predicament. Being abusive
towards the catering staff, as in choice d), again indicates a lack of appropriate
communication skills as well as problem solving ability, as this course of action does nothing
to solve the problem at hand.
Answer:21
The most appropriate answer is e).
Discussion:
This question deals with respecting peoples opinions and tastes, as well communicating
effectively with people, even though they may be rude or critical (in this case of western food
culture). Choice a) would constitute poor communication, as you are being at best
inappropriate and at worst rude. Avoiding the problem is not correct either (as in answer b).
Answer c) is professionally inappropriate avoid answers which are not appropriate or
practicable in a real world situation, even though they may look like appropriate responses at
first. Answer d) would constitute lying to the patient and is thus not acceptable either.
Answer:22
Discussion:
Patients are sometimes late returning from their operations for a variety of reasons ranging
from the operation not starting on time, to the operation actually taking longer because there
have been problems and the patient is in trouble. Waiting relatives will tend to assume the
worst and will be very anxious. Response (e) is the most empathic it communicates
understanding of the familys feelings and concerns and the desire to reassure them.
Answer:23
Discussion:
Most patients, especially in this day and age, want to be informed about their illness, the
nature of the treatment, and their chances of recovery. Apart from being considerate by
informing patients of the above, it is an obligation to ensure that your patient understands
what is being done to her, even if this takes considerable time. Response (c) allows you to
achieve this while not disrupting the ward round.
Answer:24
The preferred option is (c).
Discussion:
You may be faced with situations where the conduct of someone else is entirely
inappropriate. In these cases it is always important to maintain proper professional conduct
and resolve the issue in a fair and reasonable manner. In this case the best course of action
might be to reason with the patient as in choice (c). Choices (a) and (e) are not adequate
solutions and choices (b) and (d) are professionally inappropriate.
Answer:25


Discussion:
This scenario needs to be dealt with in a compassionate and tactful manner. It is futile to try
and discuss the situation with the mentally unstable person, or reason with him. Answers (d)
and (e) are therefore not applicable. This patient cannot be made to understand that his
comments are upsetting to the other patients, which is why answer (a) is the preferred
choice in this particular situation. Choices (b) and (c) do not address the emotional distress
that is being caused to the other two patients in the room and are thus incorrect.
Answer:26
Discussion:
This scenario deals with the difficulties of being altruistic while being restrained by other
commitments. You have an equal obligation towards all patients and with effective
communication it is often possible to gain the patients understanding of your duties. Answer
(b) is an effective manner of communicating the situation to your patient without making
them feel that they have received an inappropriate amount of care, which they may perceive
to be the case in choices (b) and (c). Choices (d) and (e) are both professionally
inappropriate.
Answer:27
Discussion:
You will often have to deal with situations which are out of the ordinary. Visiting hours are
scheduled at certain hours for the benefit of patients and for the efficient running of a
hospital such rules should be adhered to. In this case, considering the fathers length of
travel and his predicament due to work commitments, an exception could be made, which is
why (c) is the preferred choice.
Answer:28
Discussion:
Patients and family members have a right to be fully informed about their medical condition.
Sometimes things need to be explained more than once in order to calm any fears or to
clarify particular issues. Answer (c) is the preferred choice. In this case the young doctor is
tired, but a little patient communication can still go a long way to reassure the parents of the
young girl before referring them to someone who can answer their questions in more
detail. Answers (a) and (b) are evasive and answers (d) and (e) are unprofessional and rude.
Answer:29
Discussion:
Ideally, the resident doctor, whos care the patient is under, should take care of this
situation, but if he cannot be located, then it is up to you to assess the situation. Locating the
other resident may take a long time, while the patient is suffering. Choice (e) is preferred as
the most altruistic course of action over choice (a). Choices (b), (c) and (d) show no empathy
for the patients condition. Remember also that as a doctor, you still have a duty of care to all
patients, regardless of whether they are under your direct care or not.
Answer:30

Discussion:
This scenario involves the unfortunate discomfort of one patient, that can not be directly
seen to. If you had to turn off the airconditioning then perhaps other patients who are
comfortable with it on might complain. Thus you can not place other patients comfort at risk,
just to please one patient. Through effective communication, she can be made to understand
the situation.
This is a strictly timed trial test. Time allowed is 22.5 minutes.
PERSONAL DEVELOPMENT
HONESTY
Question: 1
Category: Honesty
Scenario:
You are a nurse looking after a young male patient who shares a room with five other
patients. Each afternoon his girlfriend comes in to visit him and you notice that their displays
of affection cause the other patients to be uncomfortable. However, you are embarrassed at
approaching the young couple. What do you say to them?
Choices:
a) You sternly tell them to behave themselves.
b) You politely explain that their actions are causing others to feel awkward and discuss
alternatives such as going out for a walk during visiting hours (if medically possible).
c) You laugh it off the other patients should accept that they are in a shared room.
d) You tell them loudly in front of the other patients to stop their actions.
e) You wait until the patients parents visit and then complain to them about the situation.
Question: 2
Category: Honesty
Scenario:
You are the senior nurse on a ward and notice that the new female doctors brief attire is
causing discomfort and embarrassment to some of the elderly patients. One elderly lady
complains to you and asks you to discreetly say something to the doctor. You are afraid that
if you do there may be repercussions for all the nursing staff on that ward. What do you tell
the patient?
Choices:
a) You tell the patient that you will confront the doctor and berate her for her inappropriate
dress sense.
b) You tell the patient that you cannot really tell the doctor what to wear and she should just
accept the way the doctor dresses.
c) You tell the old lady that times have changed and that this dress style is now fashionable.
d) You tell the patient that you have received no other complaints and that she should just
accept the way the doctor dresses.
e) You tell the patient that you cannot really tell the doctor what to wear and that if she feels
uncomfortable she should take it up with the doctor herself.
Question: 3
Category: Honesty

Scenario:
You are the clinical nurse consultant working in a busy hospital ward. You have noticed that
one of the nurses working under you suffers from a distinctly unpleasant body odour. You
know that the patients on the ward have also noticed this. One patient in particular has
raised the issue with you and feels that this is a hygiene issue in a hospital environment. He
has asked if you can have a quiet word to the nurse. What should tell him?
Choices:
a) You tell the patient you will say something to her if other patients complain as well.
b) You tell the patient to discuss his concerns with the nurse herself.
c) You tell the patient you will say something to her, having already decided not to say or do
anything.
d) You tell the patient it is not your place to discuss his concerns with the nurse and that he
should lodge a complaint with the charge nurse.
e) You lie to the patient and say that you have already approached the nurse in question
about the problem.
Question: 4
Category: Honesty
Scenario:
You are a nurse working in the paediatric ward in a large hospital. One of your patients is a
young boy who may have meningitis.
To confirm the diagnosis, a lumbar puncture has to be carried out. This procedure involves
sticking a needle into the spine and can be very painful. The boy is worried about the
procedure and complains that the last time he had to have an injection, the nurse assured
him that it would not hurt. However, he thought the experience was terrifying and very
painful. When the doctor comes into the room and prepares the syringe for the procedure,
the boy sees how large the needle is and starts crying and screaming that he does not want
the injection. What do you do?
Choices:
a) You calm the boy down and tell him that this procedure is really necessary to see what
illness he has. You tell him that the doctor will be very careful and that it will soon be over.
b) You tell the boy that he must calm down, or else the doctor might hurt him even more.
c) You tell the boy that everyone can hear the commotion he is creating because of a needle
prick and that he should be brave.
d) You calm the boy and tell him that he will not feel a thing.
e) You ignore the patients yelling telling him to hold still, so that the doctor can proceed.
Question: 5
Category: Honesty
Scenario:
You are an intern on a ward round in the infective diseases ward of a large city hospital. You
have just seen a patient with a highly infectious disease. You are required to wash your
hands before seeing each patient, but on this occasion you forget to wash your hands before
seeing the next patient. Your next patient asks you if you have washed your hands, as he is
worried about contracting another infection. What do you tell him?

Choices:
a) You lie and say that you have, not wanting to waste time.
b) You say that you have, making a mental note not to forget again.
c) You admit that you have not washed your hands and proceed with the examination.
d) You admit that you have not washed your hands and go off to wash them before
examining this patient.
e) You make an excuse to leave the room and quickly go and wash your hands before
returning.
Question: 6
Category: Honesty
Scenario:
You are a medical student who is trying to insert a drip into a patient. The patient keeps
referring to you as the young doctor and you are actually not sure whether the patient
knows that you are only a medical student with little experience. After two unsuccessful
attempts, you are hesitant to carry on, but the senior doctor has informed you that he wants
you to conduct the procedure. It is obvious that the patient is getting upset at being made to
suffer this discomfort. How should you proceed?
Choices:
a) You apologise to the patient and tell him not to worry, as you are very good at this.
b) You tell the patient that you have performed this procedure hundreds of times and are
just having a bad day.
c) You apologise to the patient, and tell the patient that you would rather get someone more
experienced to conduct the procedure.
d) You tell the patient that you are aware he is not comfortable with the situation, however it
has to be done.
e) You tell the patient that you are just learning and that if you fail again, the procedure will
not be performed at all.
Question: 7
Category: Honesty
Scenario:
You are a young doctor inserting a catheter into an old man. You are having great difficulty
with the procedure. The patient is constantly complaining to you about the painful process.
You suddenly become agitated by the situation and tell the patient harshly to keep quiet. You
notice that the old man is very offended by your conduct. How do you handle this situation?
Choices:
a) You lie to the patient and tell him you actually said something else.
b) You apologise for your rudeness and hope the patient forgets about the situation.
c) You wait until you have completed the procedure. Then you apologise to the patient and
tell him that you are having a bad day.
d) You tell the patient that you were talking to someone else and that he must be a little
hard of hearing.
e) You tell the old man that his constant complaining has brought on this situation.
Question: 8
Category: Honesty

Scenario: You are a doctor on a hospital ward. Every medical student assigned to a doctor
has a log book, in which all procedures completed by the student have to be signed for by
their supervisor. One of the medical students assigned to you asks you to sign for certain
procedures, which you know he has not done during the term. You agree to sign the
logbook. Later one of your patients approaches you. She says she has seen the logbook while
the student went back to talk to her and asks why you have signed a document stating that a
student examined her when she remembers no such incident. What do you say to her?
Choices:
a) You tell the patient that these things are not taken seriously by anyone and that you just
wanted to help the medical student.
b) You tell the patient that you made a mistake and that you thought the student had
examined another patient, which you signed for.
c) You tell the patient that you made a mistake and that you will send the student back to
examine her.
d) You tell the patient that this is not your signature.
e) You tell the patient that the document was confidential and that she had no right looking
at it in the first place.
Question: 9
Category: Honesty
Scenario:
You are a female junior nurse in a general ward. Whenever you do your rounds, you
encounter one particular patient, an elderly male, who is always overly friendly to you and
who lately has taken to hugging you and trying to kiss you. You feel increasingly
uncomfortable with this. What should you tell him to stop his advances?
Choices:
a) You tell him in all honesty that you do not feel comfortable with his advances.
b) You tell him, that you find his conduct embarrassing and to leave you alone.
c) You tell him that he is embarrassing you in front of the other staff members and you
would rather he keeps his distance.
d) You tell him that this conduct is inappropriate for you in a work environment.You explain
to him that you appreciate his friendliness, however you feel his advances are inappropriate.
e) You lie and tell him that you are claustrophobic and hate being hugged by anyone.
Question: 10
Category: Honesty
Scenario:
You are the head nurse in a cardiac ward. It has come to your attention that one of the
patients regularly smokes in the ward bathroom block. Smoking anywhere in the hospital
building is not allowed. You confront the patient. He says that he is just too sick to go
outside, however he is unable to give up smoking. What are you to do?
Choices:
a) You tell him categorically that he may not smoke within the confines of the hospital
building.

b) You tell him that you know it is hard not being allowed to smoke, especially if the craving
is strong, but that unless he smokes outside, there is really nothing you can do about the
situation.
c) You tell him that there is nothing you can do about the situation, rules are rules and
everyone must abide by them.
d) You tell him that if it comes to your attention again that he is smoking in the bathroom
you have no choice, but to call security.
e) You tell him that this is a good chance for him to stop smoking, which will be better for his
health in the long run anyway.
Question: 11
Category: Honesty
Scenario:
You are a GP in a busy practice. On this particular morning the receptionist has actually
double booked a number of patients as you are leaving to go on holiday the next day. A
patient comes to see you. He rambles on and on about issues totally unrelated to his health
and you are unable to even get a word in edgeways. What do you tell him?
Choices:
a) You interrupt him, tell him that your time is limited and ask him why he has come to see
you.
b) You interrupt him and politely tell him that you have a waiting room full of people and
therefor have a limited time to spend with each patient, could he please come to the point of
his visit.
c) You tell him that you have a waiting room full of people and would he please come to the
point or else you will never get through seeing everyone.
d) You tell him you have plenty of time and listen for twenty minutes to everything he has to
say, despite having other patients that are waiting.
e) You tell him you have an urgent procedure in the next room and ask him to wait. You
then proceed to see your other patients in the room next door.
Question: 12
Category: Honesty
Scenario:
You are a GP in a busy practise. A 17-year-old girl comes to see you with her mother. As part
of your history taking and related to the complaint that brought the girl to you in the first
place, you have to ask some intimate questions. You are concerned that the girl will not
answer truthfully with her mother present. How do you handle this situation?
Choices:
a) You tell the mother that there is some paperwork to be filled out in the reception area and
it would save time if she left the room to complete that while you have a brief word with her
daughter.
b) You ask the mother if she would be kind enough to do you a favour. You send her on an
errand to the reception area so that you can speak to the daughter in private.
c) You ask the mother if she would please leave the room while you have a chat with the
daughter in private.
d) You tell the mother that the daughter asked you before if she could see you alone. You
hope that the daughter does not contradict your statement.

e) You tell both mother and daughter that it is important you take down an accurate history
and state that the girl may not feel comfortable answering all questions in front of her
mother.
Question: 13
Category: Honesty
Scenario:
You are a nurse working in the general ward. One of the nurses, whom you dislike intensely,
complains that her expensive, very distinctive pen has gone missing and she thinks it was
taken by a patient. You have a pretty good idea, who may have taken the pen, although you
did not actually see the theft. You are alone with this particular patient one day and the
drawer of the patients bedside table is open. You see the pen protruding from under some
clothes. What do you say or do?
Choices:
a) Because you really dislike the nurse you decide to say nothing to the patient - let the
nurse find out for herself who stole the pen.
b) You decide that it is easier not to get involved at all and keep quiet about what you saw.
c) You tell the patient that you saw the nurses pen in his drawer.
d) You confront the patient about the very distinctive pen, which you could not help but
notice in the drawer and tell the patient that you shall have to report the matter to security.
e) You confront the patient about the very distinctive pen, which you could not help but
notice in the drawer and ask the patient if he will speak to the nurse concerned about the
matter.
Question: 14
Category: Honesty
Scenario:
You are a nurse on a surgical ward in a public hospital. One day you accidentally forget to
give a patient the anti-nausea drug that was written up with his pain relieving medication
(nausea is a very common side effect of some pain medications), as you are tired, having
just finished a very busy night shift. As a result of your oversight the patient becomes really
nauseous. None of the doctors or nursing staff know about your oversight (as patients can
still experience nausea despite having had medication to prevent it). You decide not to fill out
an incident report and not to tell anyone about your oversight. However, a couple of days
later, the patient questions you about the episode of severe nausea. What do you tell him?
Choices:
a) You tell him that it is a common reaction to some pain relieving medications.
b) You tell him that you forgot to give him an anti-nausea drug and that these mistakes
sometimes happen, as the nursing staff have so many things to think of.
c) You tell him that you forgot to give him an anti-nausea drug. You apologise and say that
you were tired from working a night shift.
d) You tell him that another nurse forgot to give him an anti-nausea drug and you apologise
on the other nurses behalf.
e) You tell him that you did give him an anti-nausea drug and that it obviously didnt work.
Question: 15

Category: Honesty
Scenario:
You are a male nurse working in the orthopaedic ward. One of your patients is about to be
discharged from hospital. His wound needs fresh dressings three times a day and you give
the patient a couple of special large dressings to take home with him. He tells you that he
would like a couple more and you go to fetch them. By chance you find out from two other
nurses that the young man has been asking various nurses to supply him with additional
dressings, ointments and bandages for days now and that by this stage he must have quite a
stockpile of supplies. What do you say to the patient?
Choices:
a) You go back to him and tell him that there are no more of the special dressings left.
b) You go back to him and tell him that there are no more of the special dressings left, but
that by now he should have quite a collection as you have heard that other nurses have also
supplied him with dressings.
c) You get him what he wants and dont worry about what the other nurses told you. After
all, the hospital has enough supplies.
d) You ask the patient if there is a reason why he needs so many dressings and bandages
and relate to him what the other nurses have told you.
e) You confront the patient with the fact that he has been dishonest and demand all the
other supplies back from him, or you shall have to call security.
Answer:1
Discussion:
This scenario requires you to deal with an awkward situation with maturity and
professionalism, as well as consideration for the feelings of the patient and his girlfriend.
Response (b) attempts to gain their understanding as well as respecting their autonomy and
freedom.
Answer:2
Discussion:
It is often inappropriate to criticise senior staff members, especially when it is of a personal
nature. If a patient complains, one should always be honest and explain that sometimes
more will be achieved if the patients deals directly with the staff member whom they have a
problem with or lodge a formal complaint.
Answer:3
Discussion:
It is difficult to give constructive criticism to other staff members, especially if it concerns a
personal matter. If placed in an embarrassing situation that might not be appropriate for you
to deal with, it is important to be honest with the the persons involved and refer them to a
person who can deal with the situation, which is why (d) is the preferred answer. Option (b)
is inappropriate and option (a) does nothing to address the patients concerns. Options (c)
and (e) are clearly dishonest.
Answer:4

Discussion:
It is often necessary to perform painful medical procedures on children. Honest
communication is essential to establish a sense of trust between health practitioner and
young patient. In answer (a) the nurse communicates honestly with the patient and
reassures the patient as much as possible, which is often all that can be done in this
situation. Choice (b) is likely to ensure the patients mistrust of both you and the doctor.
The remaining answers are either dishonest or avoid dealing with the patients distress.
Answer:5
The appropriate answer is (d)
Discussion:
It is important to be honest in the face of making a mistake. In this case the health
professional has made an honest mistake and there is the temptation to cover it up as in
choices (a) and (b). This would be both medically dangerous in this case and dishonest to the
patient. Choice (d) is the preferred response in this case.
Answer:6
Discussion:
This situation requires you to communicate honestly with your patient. The patients wellbeing is still your prime objective, thus to get someone more experienced to conduct the
procedure as in (c) might be the most appropriate course of action after all. Answers (a) and
(b) show blatant dishonesty.
Answer:7
Discussion:
This question deals not only with inflicting discomfort to the patient, but also one of
impatience on the side of the doctor. An appropriate resolution of the problem at this stage
requires honesty and professionalism on your behalf. By communicating with the patient and
explaining the situation to him, it is likely that he will understand you.
Answer:8
Discussion:
In this situation the patient has essentially caught the doctor in the act of being dishonest.
The only correct thing to do in this situation would be for the doctor to send the student back
to examine the patient as in (c), thus validating the signature in the logbook. All other
choices are dishonest or evasive.
Answer:9
Discussion:
This situation requires a direct and completely honest approach with the patient. The patient
should be informed that you do not feel comfortable with this behaviour, thus making choice
(d) the correct answer. Answer (b) may hurt the patients feelings, while choice (e) is
blatantly dishonest.
Answer:10
Discussion:

As a nurse you are often required to deal in a firm and friendly manner with certain
situations. The patient smoking in the hospital has to be made aware of the fact that his
actions are not acceptable, and that through effective communication a reasonable
arrangement can be made.
Answer:11
Discussion:
Every health professional encounters patients who are overly talkative and do not realise that
the health professionals time is limited. These patients are best dealt with in a polite, but
honest and direct fashion. Option (b) is a polite and honest way of interrupting the patient
and proceeding with the consultation. Option (d) is dishonest to the detriment of the doctor
and the patients who are waiting, whereas option (e) is dishonest and professionally entirely
inappropriate.
Answer:12
Discussion:
As a doctor your prime responsibility is directed towards your patient. Any interference in the
way of attaining information from the patient or considering the correct course of treatment
needs to be removed. Especially younger patients are often reluctant to reveal certain
information in front of family members. It is important to be honest and direct in your
request, which is why (b) is the preferred answer. Note that answer (e) is worded in such a
way that it might offend the mother as it implies that the daughter may not trust her mother.
Answer:13
Discussion:
Situations involving dishonesty by a patient may occasionally arise in hospitals. It is important
to try and solve the issue amicably with as little commotion as possible. It is not necessary to
involve the hospital security immediately, but rather to attempt to get the matter settled
between the parties concerned. Therefore (e) is the preferred answer.
Answer:14
Discussion:
This scenario deals with the nurse being faced with a potentially embarrassing situation,
(apart from the issue of medically negligent behaviour towards the patient). The temptation
is to cover up the initial mistake as in options (a), (d) and (e), but this is dishonest. In this
case an apology and honest explanation might win the patients understanding, as in answer
(b).
Answer:15
Discussion:
This scenario deals with potential dishonesty by a patient, however there might be an
innocent explanation, for example that the patient thought he might need to change
dressings more often than was indicated to him.
The best way to deal with this situation is with an honest and direct approach such as in
choice (d). Options (a) and (b) show dishonesty on the part of the nurse. Choice (e) is
extreme while option (c) avoids dealing with the problem.


COMMUNICATION SKILLS
CONFLICT RESOLUTION
Question: 1
Scenario:
You are a nurse looking after two elderly gentlemen in a shared room. One of the men is fast
asleep and is snoring loudly. Consequently the other man is unable to fall asleep and he
complains to you, telling you to do something about the other man's snoring. What course of
action do you take?
Choices:
a) You refuse to wake the snoring patient.
b) You apologize sincerely, and leave to continue with other duties
c) You wake the snoring patient and tell him to be quiet.
d) You wake the snoring patient and kindly ask him to sleep on his side.
e) You tell the first patient that it would not be appropriate to wake the other patient and
rather offer the first patient some earplugs.
Question: 2
Scenario:
You are a receptionist at a doctor's surgery. It has been a very busy morning. A patient, who
has been waiting for an hour, approaches you and complains that the waiting time to see the
doctor is unacceptably long. What do you tell him?
Choices:
a) You tell him that this is not your problem - the doctor is responsible for the delays.
b) You offer a sincere apology and explain that the delay has been caused by circumstances
beyond your control.
c) You tell him that you are not the doctor and it is not your fault.
d) You lie to him and say that his name is next on the appointment list.
e) You tell him not to complain, as there are people who have been waiting longer than him.
Question: 3
Scenario:
You are a nurse looking after a room of patients in a ward, including a young man. A couple
of the older patients complain that the young man often turns his television up too loud and
disturbs them. They do not feel comfortable asking him to lower the volume. What do you
say to them?
Choices:
a) You tell them that if they feel strongly, then they should confront him about the problem
when it occurs.

b) You tell them that they are in a shared room and should accept that things might be a
little uncomfortable.
c) You tell them to complain to the nurse on duty when the volume gets too loud.
d) You tell them that you will speak to the young man and point out the patients who have
complained about him.
e) You offer to speak to the young man, explain that the noise disturbs the other patients,
and see whether you can come to some arrangement agreeable to all.
Question: 4
Scenario:
You are a nurse working in a cancer ward. One of your patients is on a very high dose of
pain medication and is suffering from hallucinations as a result. He often shouts and swears.
The patient in the room next to him asks you to tell the patient to shut up. What do you tell
her?
Choices:
a) You explain to her that the other patients behaviour is a result of his medication and that
the best you can do is try to relocate her to another room.
b) You explain to her that the other patients behaviour is a result of his medication and that
there is nothing you can do about it.
c) You complain to her that the staff has had to put up with the situation for weeks.
d) You tell her to be more sympathetic towards the other patient and to be thankful that she
is not also hallucinating.
e) You placate her by telling her that you will see what you can do, knowing full well that
you cannot do anything.
Question: 5
Scenario:
You are a nurse caring for two elderly male patients. One of the patients spends most of the
day reading books. The other patient has a small portable radio, which he listens to all day.
The patient reading the books is not happy about the constant noise, complaining that he
cannot concentrate. He has spoken to the man with the radio, who has paid no heed to his
requests for some peace and quiet. The man complains to you. What do you say?
Choices:
a) You ignore the situation and hope that they will resolve the problem.
b) You threaten to report the complaining man to the clinical nurse consultant.
c) You explain to both patients that they have to be considerate of each other, and ask the
man with the radio to turn down the volume.
d) You tell the man with the radio that you have to confiscate it, if he does not turn down
the volume.
e) You tell the man reading the books to read out loud.
Question: 6

Scenario: You are a nurse looking after four male patients of different ages, sharing a room
and adjoining bathroom. One of the younger patients regularly leaves the bathroom in a
most terrible state, with towels lying on the floor, the basin dirty and the toilet left in an
unsanitary condition. After this has happened a few times, the other patients complain to
you. What action do you take?
Choices:
a) You tell the patients to discuss the matter among themselves and to come to an
agreement.
b) You speak to the young man and explain to him that all patients in the room have the
right to a neat, clean bathroom. He should try to leave the bathroom in the way he would
wish to find it.
c) You tell the young man in question not to be so dirty.
d) You ignore the situation altogether, because it has nothing to do with patient-care.
e) You ask the head-nurse to speak to the young man.
Question: 7
Scenario:
You are a nurse looking after a young boy who has just undergone an operation to insert a
metal plate, to mend the splintered bones in his arm. Having to spend a few days in hospital,
he is sharing the ward with three elderly patients, who have all undergone large procedures
and are consequently in need of rest. It is the boys 10th birthday. The whole family has
come to visit, to give him a small party in hospital. The elderly patients all complain to you
about the commotion.
Choices:
a) You ask the family to leave the room and return in a day or two.
b) You politely explain the situation and ask the family to be as quiet as possible, in order
not to disturb the other patients.
c) You tell the older patients not to be so heartless.
d) You ignore the complaint and hope the noise does not carry on too
long.
e)You tell the older patients that they have no right to complain as the boy is entitled to have
visitors.
Question: 8
Scenario:
You are a nurse caring for four middle-aged female patients, who are sharing a room and
bathroom. One of the ladies, very conscious of her appearance and presentation, occupies
the bathroom regularly every morning for very lengthy periods, while applying her make-up.
During this time none of the other ladies in the room are able to use the bathroom and either
wait, or are forced to use another bathroom in an adjoining ward. After the second morning
all the ladies in the room are complaining about the situation. What do you do?
Choices:
a) You tell the ladies to sort the conflict out amongst themselves.

b) You wait for the bathroom to be occupied by the lady and then insistently knock on the
door, telling her to hurry up and vacate the bathroom as soon as possible.
c) You discuss the situation with the lady in question, explaining to her that there are three
other patients, who have to use the same bathroom. You further explain that if everyone is
considerate it will make things so much more pleasant for all sharing the room.
d) You tell all patients in the room that they are not allowed to spend more than ten minutes
in the bathroom.
e) You tell the lady to let everyone else use the bathroom first.
Question: 9
Scenario:
You are a nurse looking after four patients in the orthopaedic ward. One of the patients is a
young girl who had to undergo a knee operation. Another patient in the room is an old lady
who has had a hip-replacement. The old lady talks, moans and screams so loudly in her sleep
every night that everyones sleep is disturbed. The young girl in fact cant sleep at all and is
frightened. Her parents have started complaining bitterly. What do you do?
Choices:
a) You tell the old lady that she is being most inconsiderate and is keeping the entire ward
awake.
b) You discuss the situation with clinical nurse consultant and try to organise the young girl
to swap beds with someone on the ward who is willing to swap.
c) You ask the doctor to give the old lady more sleeping pills every night in the hope that she
will sleep more deeply.
d) You tell the young girl that there is nothing you can do.
e) You ignore the situation in the hope that the old lady will fall into a normalised sleeppattern.
Question: 10
Scenario:
You are a young nurse in the childrens ward at a public hospital. You are in charge of a ward
with six boys, between the ages of eight and thirteen years. One boys has had his tonsils
removed and is in some discomfort. His mother has informed you that her son is constantly
being teased and bullied by all the other boys. How best should you handle the situation?
Choices:
a) You ignore the mothers complaint, as the child might be over-reacting.
b) You tell the other boys to stop bullying the child, or you will make sure that they will not
get their meals that evening.
c) You tell the mother that bullying does not happen in hospitals and that her child might be
lying.
d) You tell the mother that this problem does not fall within your job description.
e) You explain to all the boys in the room that the boy being teased is not well, just like
them, and has a right to be left in peace in order to fully recover.

Question: 11
Scenario:
You are a nurse caring for a middle-aged female patient in an Orthopaedic ward. She is
sharing a room with two elderly ladies. The middle-aged woman has varied sleep patterns,
whereby she usually sleeps more during the day than at night. During her hospital stay, she
likes to watch television until late at night. The two elderly ladies are complaining that they
are unable to fall asleep due to the distraction of the television. What are you to do?
Choices:
a) You discuss the problem with the middle-aged patient and appeal to her feeling of
consideration towards the other two patients in the room.
b) You tell the patient causing the disturbance that she may not watch television while other
patients are trying to sleep.
c) You ignore the complaint and decide not to let the patient sleep during the day so that she
will be worn out by nightfall.
d) You offer the elderly patients sleeping tablets and eye-masks.
e) You have the television disconnected by the hospitals maintenance engineer.
Question: 12
Scenario:
You are a young nurse looking after a room with eight patients in a respiratory ward,
including an old man. All the other patients are either commenting or actively complaining
about the elderly mans incessant snoring at night. This either disturbs their sleep, or keeps
them awake altogether. What should be done?
Choices:
a) You ignore the complaints.
b) You inform the other patients that this is an old man and speaking to him would hurt his
feelings.
c) You tell the patients that they should sort the matter out amongst themselves.
d) You explain the situation to the old man and offer to try and get him a private room.
e) You offer to distribute ear plugs to all the patients who have complained.
Question: 13
Scenario:
You are a nurse working for a pathology laboratory. It is your duty to visit the homes of
those patients who require blood tests and are unable to get to the appropriate medical
centres. One of your patients is an elderly lady, whom you visit on a weekly basis at an
arranged time. Whenever you get to her house, she is either still in the bath, on the phone or
otherwise occupied. You do not have the time to stand around waiting for her. What do you
say to her?
Choices:

a) You tell the lady that you have many other patients to visit. As she has agreed on the
arranged time for you to come to see her, she should try to be ready for you, otherwise it
makes you late for the rest of the day.
b) You ask the lady if she wants you to come at another time.
c) You tell her that you will see her at the end of day after you have attended to all other
patients.
d) You tell her that if she is not punctual, you cannot call any more.
e) You tell her to hurry up so you can get on with your work.
Question: 14
Scenario:
You are a nurse in a maternity ward. Under your care is a young woman who has given birth
to twins. Not only the adoring husband, but many relatives and friends are constantly
bringing her flowers. Sharing the room with the young woman are two other ladies. One of
them suffers from hayfever. As a result of the many flowers she is constantly showing signs
of hayfever. She is complaining about her reaction to the many flowers. How do you handle
the situation?
Choices:
a) You remove all the flowers from the room and inform the mother of the twins that she
may not receive any more flowers.
b) You tell the patient suffering from allergies, that there is actually nothing you can do, as
everyone is allowed to receive flowers in hospital.
c) You ignore the complaints of the patient with hayfever and hope the mother of the twins
will not receive any more floral gifts.
d) You offer the patient medication to alleviate the allergies.
e) You discuss the situation with the patient receiving the flowers and ask if the flowers can
be kept at home for her by her family.
Question: 15
Scenario:
You are a day-nurse working in the orthopaedic ward. One of your patients has very strong
religious convictions and believes that it is his duty to preach about his beliefs to all the other
patients sharing his room. They are privately complaining to you about the infringement of
their privacy. What should you do?
Choices:
a) You tell the patient that you and everyone else respect his views, but to please keep his
opinions to himself.
b) You tell the patient that he should not preach to anyone and to keep his opinions to
himself as others may not agree with him.
c) You tell the patients who are complaining that they should sort the problem out amongst
themselves.
d) You tell the patient that this is a hospital ward and although everyone respects his
opinions, this is not the place to try to convert anyone.
e) You ignore the situation.

Question: 16
Scenario:
You are a physiotherapist, doing rounds in an orthopaedic ward. One of your patients is a
young male football player who has had his knee reconstructed. On a daily basis his knee has
to be exercised. He however consistently refuses your treatment and says that he will do the
exercises himself. What are you to do?
Choices:
a) You tell him that he is under your care and it is your responsibility to post-operatively treat
him on the instructions of his doctor.
b) You tell him that to refuse treatment is his decision, but he must bear the consequences.
c) You tell him that he has no choice in the matter as the treatment is compulsory and
proceed to exercise his leg.
d) You tell the patient that you respect his wishes and shall confer with his doctor to plan a
course of action.
e) You tell the patient that you have no time for difficult patients and that he will just have to
go without physiotherapy.
Question: 17
Scenario:
You are a nurse working in a nursing home. You have a conflict situation between two old
men who share a room. One of the men is constantly complaining to you that the other man
is using his false teeth instead of his own. You have to resolve this situation, what should you
do?
Choices:
a) You tell the man who is complaining to you that he should put his false teeth in a
concealed place unknown to the other man, in order to resolve this situation.
b) You tell the man who is complaining that he should resolve this issue himself.
c) You speak to both men together, explain to them that this issue must be resolved and
then show each one a specific place to put his false teeth so as to prevent any more mix-ups.
d) You speak to both men separately and advise them to put their teeth in a specific place to
resolve the situation.
e) You tell the man complaining that if you have to spend time sorting out all nursing home
patients false teeth you would never get your work done.
Question: 18
Scenario:
You are a nurse on the childrens ward. There are a few computer game consoles on trolleys
which can be wheeled to the childrens beds so that they can play computer games to pass
the time. Generally the children seem to share the consoles around equally, or the mums
make sure, that all kids get a go. One of the boys however tearfully complains to you that he
never seems to get a go on the consoles. What do you tell him?

Choices:
a) You tell him that you will speak to the other kids to let him have a turn.
b) You tell him that you will tell the other kids not to leave him out.
c) You speak to all the children together to say that everyone should have an equal turn on
the consoles and that they should not leave anyone out.
d) You tell him to ask his mother to sort out the problem.
e) You tell him that you shall speak to each child individually to say that everyone should
have an equal turn on the consoles and that they should not leave anyone out.
Question: 19
Scenario:
You are a junior resident doctor working in a public hospital. One of your patients, admitted
to your ward with a serious fracture, really dislikes the senior doctor you are working for.
Apparently she has had a bad experience of some sort with him in the past. When she
realises that the senior doctor she dislikes will be attending to her, she sends for you and
insists that she be transferred immediately to another hospital. As she is a public patient she
cannot be given another bed and cannot be transferred. What do you say to her?
Choices:
a) You explain to her that she cannot be transferred as she is a public patient and that she
must just tolerate the senior doctor.
b) You explain to her that she will have to deal with her dislike of the doctor.
c) You tell her that she cannot be moved at all and that she shall have to deal with her
dislike of the doctor.
d) You explain to her that she cannot be transferred as she is a public patient.
e) You tell her that she should speak to the senior doctor about the matter.
Question: 20
Scenario:
You are a nurse in a childrens ward. It has just been discovered that one of your young
patients has head lice and requires treatment for it. The mother of the child in the next bed
wants her child moved. The hospital is full and all beds are occupied. What do you say to the
mother?
Choices:
a) You explain to her, that unfortunately there are no other beds available and the child
cannot be moved.
b) You explain to her that there are no other beds available for the child to be moved, but
every effort will be made to protect her child from contracting the head lice.
c) You tell her that every effort will be made to contain the head lice.
d) You tell her that the parents of the other children in the ward are also concerned, there
are however no additional beds available, but every effort will be made to contain the head
lice.
e) You tell her that the other parents are also worried, but that there is actually no cause for
concern.

Answer:1
Discussion:
In this case, waking the sleeping patient to appease the other patient is not appropriate, and
it is best to communicate this to the patient in a direct and honest fashion. In this case it
would be more appropriate to help the patient who is still awake.
Thus answers c) and d) are not the best answers in this case. However, to simply refuse to
wake the sleeping patient without explanation (choice a), indicates poor communication
skills. Likewise, simply apologizing without attempting to help the patient (answer b), does
not constitute effective communication and achieves nothing.
Answer:2
The preferred answer is ( b).
Discussion:
Effectively communicating with people when circumstances are out of your control can be
difficult. In this situation the most effective and appropriate approach is honesty and
empathy for the frustrated patient. Shifting the blame (choices a) and c), constitutes poor
communication. Lying to the patient is inappropriate (answer d), and being confrontational
with a frustrated patient (e) also shows poor interpersonal skills.
Answer3:
Discussion:
As a nurse, you sometimes have to deal with conflicts that arise between your patients. Most
patients will respond positively if you politely explain the situation to them and attempt to
negotiate an arrangement that will keep everyone happy, as in response (e).
Answer:4
Discussion:
This question deals with interpersonal communication in a difficult setting. Often it is not
possible to resolve a patients complaint, but effective communication will help them to
understand and therefore accept the situation. Therefore choice (a) is a better answer than
choice (b). Answer (d) is inappropriate and rude, whereas choice (e) would constitute lying to
the patient.
Answer:5
The preferred answer is (c)
Discussion:
This is a conflict situation between two patients. As a nurse you have the choice whether to
ignore the situation or to help resolve the conflict. By choosing to ignore the situation, both
patients wellbeing and comfort are being compromised. Answer (c) is the preferred answer.
It is far better to speak in a polite and friendly manner to both parties concerned and to
negotiate a compromise between the patients, which will ensure a comfortable hospital
environment, than to ignore the problem (a), or aggravate it (e). Threatening the man (b)
will not resolve the issue in the short term and choice (d) is not appropriate either as you
have no right to confiscate personal property.
Answer:6

Discussion:
This scenario requires you to deal with an awkward situation with maturity and
professionalism, as well as consideration for the feelings of the patient causing the dilemma.
Response (b) attempts to gain the young mans understanding, as well as respecting his own
freedom. The response merely points out to the patient the importance and need for
consideration to the other patients in the room, thus making everyone happy. Answers
(a),(c),(d) and (e), may present a temporary solution, do however not address the issue at
root cause.
Answer:7
Discussion:
In dealing with conflicts between patients it is important to try to resolve the conflict with
compromise, while also being aware of the rights of each party. The older patients are
entitled to a quiet ward environment as much as the young patient is entitled to have
visitors. Thus choices (c) and (e) are not correct. Patients tend to respond positively if you
politely explain the situation to them and attempt to negotiate an arrangement to suit all
parties involved. Option (b) takes into account the interests of all concerned, without
favouring any party.
Answer:8
Discussion:
This is a situation where you have to step in and resolve a conflict situation. Most patients
tend to respond positively, if the matter is discussed with them and an arrangement is
negotiated that will keep everyone happy. By pointing out politely how a lack of consideration
is affecting the other patients, the ladys cooperation is sure to be enlisted. Answers (a) will
bring about further conflict amongst the patients, whereas answers (b) and (e) will cause
acute embarrassment to the lady in question. Answer (d) is unrealistic and not workable.
Answer:9
Discussion:
This question deals with conflict resolution and compassion. The older patient is, without
intention on her part, disturbing the other patients sleep and it would be cruel to berate her
regarding her nocturnal vocalisations (a). Option (c) is not appropriate as this is not a clinical
problem and the doctor may disagree, whereas choices (d) and (e) do not address the
conflict situation at all.
Answer:10
Discussion:
In this situation your diplomatic people-skills are required. The emotional wellbeing of one of
your patients is being seriously compromised. Answer (e) is the preferred answer, because
you are not just reprimanding the other boys, but hopefully enlisting their cooperation and
understanding. Answer (d) is incorrect because by taking no action the boys comfort and
recovery are compromised. Choice (a) and (c) indicate that you do not believe the child or its
mother. Without adequate grounds and investigation this is certainly inappropriate. Choice
(b) constitutes entirely inappropriate behaviour.
Answer:11

Discussion:
As a nurse caring for patients you have to be capable of handling complaints to the
satisfaction of all parties concerned. Answer (a) is the most appropriate way of solving this
problem in order come to an agreement. Answers (b), (d), and (e) are all inappropriate as
they unfairly deal with the issue from only one partys point of view. Choice (c) is inhumane.
Answer:12
Discussion:
The question deals with a conflict situation where one individual is singled out by a group. By
communicating with this patient and explaining the situation to him, it is likely that he might
understand the impact of his snoring on everyone else in the room, and will not be offended
if moved to a another part of the ward, or a private room, if one is available.
Ignoring the issue, as in choices (c) and (e), is not correct, and offering to give everyone else
in the ward ear plugs (e) is not a practical solution either.
Answer:13
Discussion:
As a nurse you are sometimes required to deal in a firm and friendly manner with certain
situations. The service you provide is a community service, which involves the cooperation of
all concerned. In this case the lady has agreed for you to see her at a regular pre-arranged
time. If she is then unavailable, it is your duty to tell her that you have an equal obligation to
all patients and have an allocated amount of calls per day to make. You can only spend a
minimum amount of time with each patient.
Answer:14
The preferred option is (e).
Discussion:
In this case, the wellbeing of all patients is your prime responsibility. Every patient in the
hospital environment has the right to feel comfortable. Although there is no rule about
receiving flowers in hospital, they are in this case however causing a great discomfort to one
of your patients. Option (a) is too drastic as there is no discussion with the patient
concerned. Choices (b) and (c) do nothing to help the patient with allergies, while choice (d)
is only a short term measure. Option (e) is the most fair and democratic approach as it
explains the situation to the mother of the twins and tries to find a solution that proves to be
most beneficial for all parties concerned.
Answer:15
Discussion:
This is a conflict situation between patients. As a nurse you have the choice of becoming
involved or ignoring the situation at hand. By choosing to ignore what is happening, the
comfort of your patients is being compromised. The preferred answer is therefore (d), while
(c) and (e) do not address the complaint. Answers (a) and (b) are too direct and harsh.
Answer:16
Discussion:
As a health care professional, it is your obligation and responsibility to attend to the needs of
all patients who fall under your duty of care. This however can often be made very difficult if
the patient does not want to accept your care. This situation can only be resolved through

appropriate communication, explaining to the patient the importance of your treatment with
respect to speed and quality of recovery. Thus the correct answer is (a).
Answer:17
Discussion:
This conflict between the two patients can be resolved, through effective communication, and
professionalism on your behalf. To avoid a re-occurrence of the problem the best solution is
to allocate a specific place for each patient to put his belongings.
Answer:18
Discussion:
As a health care worker it is your duty to see that everyone under your care is comfortable
and content. In the childrens ward games are often shared around to occupy the youngsters
and it is important to ensure that no patient is left out. To speak to all the children together
ensures their combined co-operation. Therefor (c) is the preferred answer.
Answer:19
Discussion:
This situation requires professionalism and integrity from you the nurse. The patients private
problems with the senior doctor have nothing to do with you. It is simply your duty to make
the patient aware of the regulations concerning patient transfers. Answer (d) is therefor the
preferred answer.
Answer:20
Discussion:
In this situation it is important to keep the prime objective of nursing-care in mind. You are
occasionally required to deal with patients who unwillingly are presenting problems for other
patients. By explaining to
the mother that you are doing your best to contain the lice and to make sure that the other
patients will not be infected, is the obvious response you can give to her.
COMMUNICATION SKILLS
APPROPRIATE COMMUNICATION
Question: 1
Scenario:
You are a nurse working on a general ward. One of your patients, a middle-aged man in a
shared room, requires regular oral administration of medication, as instructed by his doctor.
You have privately been informed by one of the other patients, that as soon as you leave the
room the man spits out the pills you have given him. What should you tell him?
Choices:
a) You inform the patient that you will tell the doctor that he spits out the tablets he should
be taking.

b) You confront the patient with the information you have and explain carefully to him that it
is in his best interest to take the medication prescribed by his doctor.
c) The next time you have given the patient his medication you unobtrusively observe his
actions. If the allegations made are true you speak to him concerning the need to follow his
treatment plan carefully and that it is in his best interest to follow the doctors orders.
d) You tell the patient that you suspect that he is not taking his medication and that you
shall have to report him to the doctor, as this may have very serious repercussions for his
recovery.
e) You explain to the patient the importance of taking the prescribed medication and then
decide to stay with the patient until you have seen him swallow all the tablets prescribed and
give instructions to the other nursing staff to do the same.
Question: 2
Scenario:
You are the nurse looking after a patient in the emergency department. He is yet to be seen
by a doctor. He tells you that he has to go outside for a cigarette. You understand his
impatience but the doctor may well come to see him while he is outside. What do you tell
him?
Choices:
a) You tell him that he is not allowed to go for a cigarette while at the hospital, and that he
will simple have to wait or leave.
b) You tell him that smoking is bad for his health and prohibit him from going outside.
c) You explain to him that while he has been waiting for a while, a doctor may well come
along to see him any moment and it would be unfortunate if he were not present at the time.
d) You tell him that the doctor will be in to see in five minutes, knowing full well that the
wait may be longer.
e) You sternly tell him to exercise some control and discipline.
Question: 3
Scenario:
You are a male nurse in an orthopaedic ward. You have a young man in your care who has
undergone an operation to remove a bone cancer from his right hip, and has had extensive
reconstructive surgery. The patients catheter has recently been removed, but he is still to be
confined to his bed in order to rest his hip. He refuses to use the bed pan, however, and
insists on walking to the bathroom. The patient tells you he has to go to the toilet now and
tries to get out of bed. What do you tell him?
Choices:
a) You firmly tell the patient that he may not get up and that he has to use the bedpan.
b) You arrange for an orderly to help aid the young man to the bathroom and to stay there
with him.
c) You tell the patient that you need the doctors consent on the issue and will speak to him
in the morning, when he does his rounds.
d) You tell the young man not to be difficult and to stay in bed, or else you will break his
good leg.

e) You tell the patient that he may use the bathroom, but that he may get dizzy and
nauseous when getting up, and that he may severely injure his operated hip if he has a fall.
Question: 4
Scenario:
You are a young nurse working for a pathology laboratory. It is your duty to draw blood on a
regular basis from patients who are unable to get to the appropriate medical centres. Most of
your patients are either bed-ridden or elderly people who have trouble getting around. Every
month you have to visit an old man, who is very querulous and difficult. Whenever you
attempt to get a blood sample from him, the old man jerks his arm away, inflicting injury
upon himself. He then blames you for being inefficient and incompetent. Every visit is an
ordeal for you. What should you do?
Choices:
a) You tell the old man to keep quiet and to keep still whilst you are trying to take blood.
b) You explain to the old man why you have to take blood from him, that you do not wish to
hurt him and that if he holds completely still it will make your job a lot easier.
c) You complain to your superior and refuse to see the old man again.
d) You explain to the old man, that you are an experienced nurse and that you will make this
procedure very painful if he does not keep still.
e) You apologise to the old man and tell him that you are trying to do your best.
Question: 5
Scenario:
You are a home-care nurse, working for the Blue Nursing Service, a non-profit, Christianbased organisation offering its services to the community. One of your elderly patients who
needs regular care lives alone and is very lonely. It is obvious that she looks forward to your
visits tremendously and tries to draw them out under any pretext. While you do not mind
spending some extra time with this lady, she does however make you regularly late for other
home-care visits. What should you do?
Choices:
a) You tell the lady that you are in a hurry and have to go.
b) You stay with the lady for a while and explain to her that you enjoy seeing her, but that
you have a very busy schedule and have many other patients to attend to and thus cannot
be with her for too long.
c) You stay with this lady and make yourself late for other appointments.
d) You tell the lady that you might have some more time on your next visit.
e) You arrange for another nurse to care for the old lady.
Question: 6

Scenario:
You are a receptionist working at a Medical Centre. It is late afternoon and past closing time.
You have been run off your feet all day and are very tired. The doctor still has two patients
waiting to see him. He is at the moment consulting with a young female patient. She has
taken up a lot of his time already and the other two patients are becoming very impatient.
What should you do?
Choices:
a) You buzz the doctor and tell him that he is running very late.
b) You apologise to the patients and tell them that the doctor has been fully booked all day,
with several emergencies cropping up in between, but should not be much longer.
c) You tell the two remaining patients that it may be best for them to come back another
time.
d) You ignore the two waiting patients and hope that they will not complain to you.
e) You remark to the two remaining patients, that you would also like to go home and that
this particular doctor is usually running late.
Question: 7
Scenario:
You are a male nurse looking after four patients in an orthopaedic ward. One of your
patients, a middle-aged man, is constantly pressing his call button for extra attention. He has
had a small procedure done on his foot, and should not be in too much discomfort. He does
however constantly seek extra attention and pampering from all nursing staff, complaining
about everything, from the pillows in his bed, the air-conditioning, the food, the other
patients in the room etc. What do you say to this patient?
Choices:
a) You tell him to stop bothering you and that you will attend to him later on.
b) You perform all his requests and hope that he stops harassing you.
c) You explain to the patient that his wellbeing and comfort are your prime concern.
However, you feel that he is not in any discomfort and is taking up time that you should be
spending with other patients.
d) You explain to the patient that his wellbeing and comfort are your prime concern.
However, you have many duties to perform and he should try to be reasonable when
pressing the call-button.
e) You have a maintenance engineer disconnect his call button.
Question: 8
Scenario:
You are a young doctor working on a surgical ward. Two of your patients have undergone
surgery. Both of these patients are still in recovery and need to stay there for some time. The
families of both patients are anxiously waiting to speak to you when you leave the operating
theatre. The first family rush towards you with questions about the well-being of their son,
taking up much time with questions. The other patients father and wife are nervously
standing by, obviously in a great hurry to speak to you, the father mumbling that he urgently
needs to get back to work. What do you do?

Choices:
a) You briefly explain the outcome of the operation to the first family, then excuse yourself
for a moment to speak to the father and wife of the other patient. You then return to the first
family and answer any questions.
b) You briefly explain the outcome of the operation to the first family, then excuse yourself
and speak to the father and wife of the other patient for a long time before leaving the ward.
c) You ask the relatives of the second patient to phone the surgeon for information later that
day.
d) You abruptly end your conversation with the first family and speak to the father and wife
who are waiting for you.
e) You call both families together and explain the results of both procedures to all of them.
Question: 9
Scenario:
You are a surgical resident in a large hospital. You have nearly completed your rounds in the
ward, with only one more patient to see. This patient is about to undergo major surgery the
next day, to remove a large cancer from his colon. He is very concerned about the operation.
Although everything about his condition, the operation and post-operative care has already
been explained to him at length previously, he again has many of the same questions to ask
you. You are scheduled for an important meeting and are already running very late. What do
you tell your patient?
Choices:
a) You tell the patient that you are in a hurry and have no time right now.
b) You tell the patient that you have already explained everything to him and that you have
other matters to attend to.
c) You tell the patient that you will answer his questions again before he undergoes the
operation and arrange a time to see him after the meeting.
d) You tell the patient that he shall have to come to terms with his condition and that there
are many people suffering from the same cancer.
e) You answer his questions again at length and miss your meeting. When questioned about
your conduct, you tell your superiors that your patient takes precedence over any meeting,
no matter how important.
Question: 10
Scenario:
You are a young, busy, unmarried general practitioner. You have finished all your
consultations at the surgery for the day, but you still have three home visits to attend to.
Your first port of call is an elderly lady, who has severe arthritis. She has been your patient
for a number of years. Once you have examined the old lady and have given her a
prescription, she shows you to the kitchen and says that she has cooked you dinner,
because, she says, you have no one to look after you. You are very embarrassed, as you still
have two other house calls to make. However, you do not want to upset this lovely old lady.
What should you tell her?
Choices:

a) You decline her offer, apologise and say that you have other patients to see.
b) You thank the lady and ask her to put the food in a container, so that you can take it with
you and eat it later.
c) You thank the lady for the unexpected gesture, then kindly explain to her that you
appreciate her thoughtfulness. However you are not allowed to take food from her and
besides, you usually manage quite well on your own.
d) You accept the offer, hurriedly eat the dinner and let the other patients wait.
e) You explain to the lady that this situation puts you in a professional and personal dilemma
and it would be best if she didnt cook you dinner again.
Question: 11
Scenario:
You are a paediatric nurse caring for a little girl who is gravely ill. She needs around-the-clock
attention and various different medications to be administered. You have heard the parents
mention to the doctor that they are very much against all medicines and try to approach all
health problems through alternative methods. The parents do, however, reluctantly concede
that in this case their little girl needs conventional treatment for her condition. Every time
you give the prescribed medications to their daughter, however, the parents complain and
ask many questions about whether the medication is really necessary and what the harmful
side-effects are. It is obvious to you that the little girl is greatly distressed by the constant
arguing. What are you to do?
Choices:
a) You tell the parents that the medication and medical treatment their daughter is receiving
has been prescribed by her doctor and that they should speak to him.
b) You ignore them and continue to give the girl the various medications.
c) You tell the parents that you only give the patient their prescribed medication. It is not
your position to give them any information at all.
d) You tell the parents that alternative therapies are nonsense and that they should be
grateful for the treatment that their daughter is getting.
e) You tell them at length what is being given to their daughter, even though you are not
sure about all the facts pertaining to her management.
Question: 12
Scenario:
You are a nurse working in the paediatric ward of a large hospital. One of your patients, a
ten-year old little girl, has had a biopsy on a bone tumour in the lower right femur. The
biopsy report indicates that the tumour is malignant. When you come to her bedside the next
day, she asks you what the word malignant means. She overheard a conversation between
visitors, who thought she was asleep and were discussing her case. Although she was unsure
of the meaning of the word, she found the content of the conversation distressing. What
should you say to her?
Choices:
a) You tell her that she does not have anything to worry about and that you are doing your
best to make her better.
b) You tell her that the visitors she overheard must have been discussing someone else.
c) You explain to the little girl what the word malignant means. However, this does not
mean that if someone has a malignant tumour they will not get better and fully recover.

d) You tell her that malignant cancer is cancer that spreads through the body and destroys
various body organs, and that people with it usually die early.
e) You tell her that the best person to explain it to her would be her doctor and that she
should ask him on the ward round tomorrow.
Question: 13
Scenario:
You are a young doctor assessing a patients chest and breathing. While you are trying to
listen to the chest with your stethoscope, the nurse continues to ask the patient several
questions. When the patient is speaking you cannot listen to his breathing as you only hear
his voice drowning out everything else. What do you say or do?
Choices:
a) You ask the nurse to leave you both alone, so that you can get on with your assessment.
b) You tell the nurse to be quiet.
c) You tell the patient to be quiet.
d) You explain to both of them, that it is much easier to listen to the chest, if the patient is
not speaking and ask if they would please oblige.
e) You tell them, that you will come back when they have finished their conversation.
Question: 14
Scenario:
You are a young, happily married doctor, working in a medical centre. One of your patients is
a very attractive young woman in her late twenties. You have noticed over the last couple of
weeks that her visits to you, all concerning very minor ailments, have increased in frequency.
You are in fact slowly gaining the impression that she has amorous intentions towards you.
There is nothing medically wrong with her and she seems to try and spend as much time as
possible in consultation with you, where she tries to draw you into conversations about nonmedical topics and is very flirtatious. What do you say to her?
Choices:
a) When she comes for a consultation again, you examine her thoroughly and tell her that
you cannot find anything wrong with her. You try to find out if there is another underlying
reason for her visits, which you may have missed, such as depression or abuse.
b) You tell her that it would be best to get a second opinion and refer her to another doctor.
c) You tell her that she is wasting your time, as she is perfectly healthy.
d) You tell your receptionist to let the young lady know that you are too busy to see her.
e) You confront the young lady and ask her if she is sexually interested in you.
Question: 15
Scenario:

You are a junior doctor at the end of an overnight shift. You are in the middle of dealing with
a patient who is recovering well, but has been very irritable lately, when your pager beeps.
You tell the patient that you have to answer this call and if it is urgent you may have to come
back and see him later. The patient becomes very irate and starts verbally abusing you,
telling you that you have not finished with him yet and that he obviously isnt important
enough for you to have the courtesy to finish dealing with him. What do you say to him?
Choices:
a) You tell the patient that although his care is important to you, there are other patients
that also require your care and that you will be back to see him as soon as you can.
b) You tell the patient that although his care is important to you, this call may be of a more
urgent nature than his problems are right now.
c) You tell the patient that you must answer this page and that you will certainly be back to
see him soon.
d) You tell the patient that you must answer this page and that he is not exactly the sickest
person in hospital at the moment.
e) You say that you will come back and see him as soon as possible, just to appease him,
knowing full well that you can leave him to be taken care of by the regular day staff in the
morning.
Question: 16
Scenario:
You are a nurse doing your rounds with a surgeon. You notice that he takes very little time to
answer properly any questions his patients put to him. His manner is short and brusque. This
rushed approach clearly disturbs some of the patients and they complain to you about it.
What are you to do about this situation?
Choices:
a) You tell the patients, that there is not much you can do about the situation and keep your
opinions about the doctors manner to yourself.
b) You explain to the patients that the doctor seems brusque because he has a very full
schedule, but that he is actually a very good doctor and well respected.
c) You go back to the patients who seemed to have questions and if possible, try to answer
their queries.
d) You tell the patients that you shall ask the doctor if he could perhaps spend more time
with them, as it is obvious that some of them wish to discuss their health concerns with him.
e) You tell the patients that if they have questions they should insist on an answer from the
doctor, as he is a very good doctor who only seems brusque because he has a full schedule.
Question: 17
Scenario:
You are a junior doctor working in a childrens ward and are called to speak to the father of a
patient. The father wants to take the child home, because he feels that he can look after the
child equally well at home. Although the child is only on oral medication, it would however be
better to observe him for another twenty-four hours. What do you say to the father?
Choices:

a) You bluntly tell the father that he can take the child home if he wishes, but that it is
against medical advice and he will have to take full responsibility, should any consequences
arise.
b) You accuse the father of behaving in a negligent, uncaring manner towards his son.
c) You explain to him that he obviously has his sons best interests at heart and that he will
therefore understand that it would be best to keep the child in hospital for a while longer for
observation.
d) You call security and have the father removed from the hospital as he is causing trouble.
e) You carefully explain to the father that although he wishes to take his son home, he really
has no choice in the matter as he needs to abide by the doctors decision to keep the young
patient for observation.
Question: 18
Scenario:
You are a nurse working on a general ward. One of your patients, an old man of seventy-six,
has emphysema. He is constantly spitting out phlegm. The old man does not spit the phlegm
into the container provided however, but on the floor. You have pointed out the container
provided to expectorate into on various previous occasions but your patient ignores your
request. How should approach the situation?
Choices:
a) You tell your patient that he better start spitting into the provided container, or else you
will have to inform the doctor about his bad behaviour.
b) You carefully explain to the patient that his conduct is not appropriate.
c) You wait until the end of the day, then give the patient a cloth and a bucket and tell him
to clean up his mess.
d) You carefully explain to the patient that his conduct is not appropriate and ask if there is
any particular reason why he keeps spitting on the floor and not in the container provided.
e) You tell the man that if he does not stop making a mess next to his bed, you are going to
inform his family about his bad behaviour and get them to reprimand him.
Question: 19
Scenario:
You are a doctor working in an antenatal clinic, where pregnant ladies come for medical
check-ups. An appropriate physical examination is a routine part of each consultation. During
one consultation, a patient, who does not speak English very well, agrees to the physical
examination, but when you start examining her abdomen, she suddenly slaps you. What do
you say to her?
Choices:
a) You tell her that to examine her abdomen, to determine the position of the baby, is part
of the examination, which she agreed to in the first place.
b) You tell her that her behaviour is inappropriate and childish.
c) You ask her why she slapped you.
d) You immediately apologise and ask if she understood what you meant when you first
asked if you could examine her.
e) You immediately apologise but remind her that she did agree to be examined by you.

Question: 20
Scenario:
You are a nurse working on a general ward. One of your patients, who has been hospitalised
for some time is moved to another ward, which is old and quite decrepit. The hospital is filled
to capacity and another patient is moved to your patients room, as the bed is needed. Your
patient is very unhappy about this situation and complains bitterly to you. What do you tell
her?
Choices:
a) You tell her that you fully understand how she must be feeling, but that this situation is
totally out of your hands, as you are not in charge of the process of allocating beds.
b) You tell her that you fully understand how she must be feeling, but that this situation is
totally out of your hands, as you are not in charge of the process of allocating beds, you will
however find out who could be contacted to do something about the situation.
c) You tell her that the bed is needed by someone in a far worse state of health and that she
should be glad that she is feeling better.
d) You tell her not to worry about anything, as she will leave the hospital soon anyway.
e) You tell her that this situation is out of your hands and that she should speak to someone
in the hospital administration.
Answer:1
Discussion:
This scenario deals with appropriate communication and action in a difficult situation. As a
nurse it is your duty to ensure that all instructions by the doctor are meticulously and
conscientiously carried out. By implying to the patient, that you are aware of what is going
on regarding his intake of medication and then explaining the importance of accepting the
appropriate treatment protocol, as well as making sure that the doctors orders are properly
carried out, the situation may be resolved. Thus the most accurate answer is (e).
Answer:2
Discussion: This question deals with communicating with the patient in order to explain a
situation or a reason for directing their action. Smoking is bad for ones health (b) and not
smoking does require some control (e), but these are not the main reasons for stopping the
patient in this instance. Responses (a) and (d) are inaccurate. Response (c) explains the
situation and is likely to gain his understanding.
Answer:3
Discussion:
You may sometimes have to deal with patients who wish to take matters into their own
hands, unaware of the possibly harmful consequences. It is up to you to explain to the
patient why their behaviour might cause them harm, as reasoning with them will certainly
give a better result than simply giving them orders (a) or being inappropriate (d). Choice (b)
may still not be the safest option and choice (c) avoids dealing with the issue at hand.
Answer:4


Discussion:
You may often have to deal with patients who are difficult and querulous, and who may be
quite demanding or even rude to you. It is important to always communicate appropriately
with these patients, explain why you are doing a procedure and how they can help you, as
this will make it easier for both the carer and the patient. Choice (a) is inappropriately and
rude, choice (d) is diabolical and certainly incorrect, while in choice (e) there is no further
information or explanation given to the patient.
Answer:5
Discussion:
This situation requires compassion and empathy from you. Answer (b) is the correct answer
because it addresses the problem in a polite and friendly manner, explaining that you have
many other patients, who also look forward to your visits and who need care and attention.
Certain situations have to be dealt with in a manner as not to compromise the patients
emotional well-being. Choices (a), (c), (d) and (e) do not deal with the needs of all patients
under your care.
Answer:6
Discussion:
This situation requires good communication and some reassurance. It is your duty not to
discredit the doctor in any way. By explaining the situation to the two waiting patients, as in
choice (b), you are communicating effectively and avoiding an embarrassing confrontation.
Responses (a), (c) and (e) are may be viewed as being unprofessional, while (d) does not
deal with the issue at all.
Answer:7
Discussion:
This scenario deals with the issue of communicating appropriately and effectively with a
patient who is unreasonably demanding. By telling the patient that you have his wellbeing at
heart, but that there are others requiring your serious attention, you may gain his
understanding and cooperation regarding your position. Choice (d) is therefore the preferred
answer. Choices (a) and (e) are professionally inappropriate, while choice (b) does not
resolve the issue at hand. Choice (c) is incorrect, as making an unfounded judgement about
the patients wellbeing is not appropriate.
Answer:8
Discussion:
As a health care practitioner you need to be able to communicate with patients families,
often under distressing circumstances. It is always important to be calm and reassuring.
Illness and suffering affect not only the patient, but also the families involved. The preferred
choice (a) gives you time to talk to both parties and allows the father to leave after hearing
the news in brief. Choices (b) and (d) imply that the needs of the second family are being put
above those of the first, which is not correct.
Answer (c) ignores the immediate needs of the second patients family, while answer (e)
violates the rights of each family to discuss this news with you in private.
Answer:9

Discussion:
Every patient has the right to fully understand his or her medical condition and any
procedures that are about to be undertaken. It is essential that the patient is content and
feels satisfied about his or her depth of understanding, regarding any operative procedures.
It is the duty of every health care professional to ensure this, even if it means explaining
things to the patient several times. Every medical practitioner also has a responsibility to their
colleagues and other patients, however. If it is possible to see the patient at a more
appropriate time and not miss other commitments, then this is the obvious course of action.
Thus choice (c) is the preferred answer over choice (e). Choices (a), (b) and (d) do not deal
with the patients queries and constitute unprofessional conduct.
Answer:10
Discussion:
As a doctor, effective communication with patients is essential, especially when delicate
situations arise. In this particular case, the doctor does not wish to upset the old lady or hurt
her feelings. On the other hand, the old ladys gesture, although kind, is rather
presumptuous. The young doctor has to explain to her that he has a duty of care towards his
other patients and may not be neglectful of them.
Answer:11
Discussion:
As a health-care practitioner you often have to deal with difficult patients as well as difficult
family members. However, patients and family members have the right to be informed about
treatment and medication received in hospital. It is natural for the parents in this scenario to
be concerned about the wellbeing of their daughter. They are in favour of alternative
treatments, and they are entitled to this opinion. It is inappropriate for you to criticise this
opinion, hence choice (d) is incorrect. Choices (b) and (c) constitute inappropriate
communication, as to give some information or reassurance before referring them to the
doctor would be helpful and comforting. Choice (e) is certainly inappropriate as you do not
know all the facts and are not qualified to give expert medical advice.
Answer:12
Discussion:
It is your duty to be open and honest with your patients and to address patients questions
regarding their health status to the best of your ability. Although the situation may be very
difficult, due to the seriousness of the patients condition, it is however possible to give an
honest answer without upsetting the patient as in (c). Answers (a) and (b) are not truthful.
Answer (d) is far too harsh and shocking to the patient, whereas choice (e) is evading the
issue.
Answer:13
Discussion:
Sometimes people can unintentionally irritate you and it is then tempting to be curt and rude.
It is far easier for others to comply with your wishes if they understand your reasons.
Therefore a quick explanation can go a long way as in (d). The other responses may be
interpreted as being rude.
Answer:14


Discussion:
You may be confronted with situations where the patients behaviour is suspect but not
inappropriate. In this scenario the doctor suspects the patient has amorous intentions,
because she keeps coming to see him, although there is obviously nothing wrong with her.
She has however not displayed any overtly inappropriate behaviour and to confront the
patient with the issue may result in embarrassment for the doctor, the patient, or both
(hence option (e) is incorrect). Answers (b) and (d) are attempts to evade the issue and the
doctor might miss an important psychosocial issue that the patient has not been able to
communicate directly. Choice (c) is dismissive and rude. In choice (a) the doctor acts
professionally by ruling out other potential problems rather than jumping to conclusions.
Answer:15
Discussion:
As a junior doctor, many demands may be made on your time, especially when you are
working on the wards after hours. Patients may not always understand that you may be
called away at any time to attend to a more urgent case and may even take it as a personal
affront if it does happen.
The best strategy is to explain the situation to the patient as politely as possible and arrange
to come back if you are indeed called away, as in choice (a). Choice (d) is impolite and
answer (e) is dishonest.
Answer:16
Discussion:
This situation is a typical communication problem between patient and health care worker.
The method of communication the doctor chooses with his patients is not your concern as
you are the nurse. It is unprofessional for you to speak behind the doctors back to patients,
however if the patients feel inadequately informed, it is within your duty of care to answer
any of their queries. Therefore (c) is the preferred answer.
Answer:17
Discussion:
This situation deals with appropriate communication with the patients guardian. It is your
duty of care towards the patient to inform the guardian of the consequences of his intended
actions. Thus the preferred answer is (c), as you explain carefully to the boys father that his
son has a more effective and complete chance of recovery by staying in the hospital.
Answer:18
Discussion:
The situation requires you to deal with the patient in a firm professional manner but also with
compassion. For the nurse there are issues of hygiene as well as hospital standards to
consider, but also that the patient may not have understood your request. Through effective
communication the nurse may sort out the problem. Thus the answer is (d). The other
choices do not adequately address the problem at hand.
Answer:19
The preferred choice is (d).

Discussion:
In this scenario, the doctor correctly asked for permission to do the examination, but it is
possible that the lady, whose English was not very good, did not fully understand what the
doctor meant. In this case it is best for the health professional to apologise for any
discomfort and ask if the patient did not understand what was asked as in (d) and then make
sure that adequate explanation is given. The other choices do not address the situation
adequately. Note also that if a patient agrees to something she doesnt understand, then this
is not a proper (informed) consent.
Answer:20
Discussion:
As a health care professional it is your duty to see to the well-being of all patients under
your care. Any upheaval and additional worry may have a negative effect on a patients
health. Situations where patients have to be moved because the beds are needed are not
uncommon in public hospitals, but can be dealt with in a fashion which is not too disruptive
for the patients concerned. This is why (b) is the preferred answer.
PROFESSIONAL DEVELOPMENT
PROFESSIONAL CONDUCT
Question: 1
Scenario:
You are a female nurse looking after a middle-aged man on the orthopaedics ward. One day
he seems frustrated and suddenly tells you that he thinks you are ugly and that he hates it
here. What is your response?
Choices:
a) You burst into tears and verbally abuse the patient.
b) You tell him that you may be ugly but at least you are not crippled.
c) You ignore the patient's outburst and try to find out what is frustrating him.
d) You ignore the patients outburst but refuse to anything for him for the rest of your shift.
e) You tell the patient to keep his opinions to himself.
Question: 2
Scenario:
You are a male resident doctor in a labour (obstetrics) ward of a hospital. A Muslim lady
arrives at the hospital in labour. She refuses to be examined by a male doctor because of her
cultural background. However, you are medically required to examine her. What do you do?
Choices:
a) You ask the patient if she would agree to be examined by a female doctor instead, and try
to find a female doctor on duty to perform the examination.
b) You tell the patient you will refuse to admit her to hospital if she does not submit to the
examination.

c) You order her to submit to an examination.

d) You tell her that in Australia she should be willing to adapt her cultural practices.
e) You feel sorry for her and admit her to hospital without an examination.
Question: 3
Scenario:
You are a doctor in a busy general practice surgery. You see a male patient, but speaking to
him is made very difficult by the presence of his two children, who are being loud and rowdy.
Their mother is present as well, and cannot seem to control them. You are slowly losing
patience. What do you say to the family?
Choices:
a) You ask the family to come back tomorrow if the children are well behaved.
b) You tell the children to shut up or else you will be forced to smack them.
c) You tell the patient and his wife that if they cannot control their children, they should not
bring them to the surgery.
d) You suggest that the mother might like to take the children outside for a moment while
you have a few minutes alone with the patient.
e) You tell the patient that you cannot see him today and ask him to come back alone some
other time.
Question: 4
Scenario:
You are a doctor on a ward and are sitting at the nurses station busily writing in your
patients charts. The phone rings and you answer it. It is the daughter of one of the
patients, phoning to see how his is. You arent actually looking after the patient so you do
not know. What do you say to the relative?
Choices:
a) You tell them that you are not looking after the patient and that you are too busy to find
out how the patient is.
b) You explain that you are not the patients doctor but will try to find the doctor or nurse
looking after the patient so that they can talk to her.
c) You tell her that she has phoned the wrong ward, planning not to answer the phone
when she calls again.
d) You tell her that she has phoned at a busy and inconvenient time and ask her to phone
later.
e) You do not know the patient but he is most likely well so you go ahead and tell his
daughter that he is fine.
Question: 5


Scenario:
You are a doctor working in the emergency department and you are inserting a drip into a
patient. You are having difficulty when a senior nurse comes along and tells you in front of
the patient that your technique is all wrong. The patient tells you that he thought all along
that you were doing something wrong, because the procedure was very painful. What do you
say to the patient?
Choices:
a) You tell the patient that you know what you are doing and that the nurses comments
were really inappropriate, especially in the patients presence.
b) You tell the patient that you are the doctor, you know what you are doing and will not
accept criticism from a nurse.
c) You tell the patient to wait, while you talk to the nurse in private, then drop what youre
doing and ask the nurse to step outside with you.
d) You assure the patient that you have done this many times, and although you are being
careful, this procedure is often painful.
e) You tell the patient that this is an incompetent nurse and to ignore her.
Question: 6
Scenario:
You are a nurse working on a ward. One of your new patients is a young lady who keeps
demanding your attention, asking for a glass of juice, for an extra pillow, etc. You are very
busy and she is taking up much of your time and not allowing you to look after your other
patients. How do you handle the situation?
Choices:
a) You tell her loudly across the ward that you are busy.
b) You gently tell her that you acknowledge that she has certain requests but that you do
have to share your time between a number of patients and ask for her understanding.
c) You ignore her requests and continue with your work.
d) You tell her sternly that she is not the only patient on the ward and that you cant
continually come when she calls.
e) You tell her that if she doesnt stop calling you, youll ask for her to be moved to another
part of the ward.
Question: 7
Scenario: You are a nurse looking after a young patient on the childrens ward. The
patients parents come to visit at 5 pm and ask if they can speak to the doctor. The doctor is
not on the ward at present. What do you tell them?
Choices:
a) You tell them that the doctor is not around and ask them to try again tomorrow.
b) You tell them that the doctor usually only comes to see the patient during ward rounds
and that they should make a concerted effort to be present at those times.
c) You tell them to try and phone the doctor from home over the next few days.

d) You tell them that you will go and look for him, and then avoid dealing with them for the
remainder of your shift.
e) You offer to try to contact the doctor now, and if unsuccessful, arrange a meeting time for
the following day.
Question: 8
Scenario:
You are a nurse doing rounds with a young intern. An elderly lady needs a drip inserted. The
intern, keen for the experience, undertakes the task. You are observing the procedure. It is
difficult for the young man to find a suitable vein. After several unsuccessful attempts it is
quite obvious that he is finding the task very difficult. The patient is becoming more and
more distressed. What do you tell her?
Choices:
a) You tell the lady that you will try to find a more senior doctor, then push the young intern
aside and tell him that he is not carrying the procedure out properly.
b) You tell the patient not to worry and then ask the young doctor to stop hurting the old
lady.
c) You keep quiet and hope that the young doctor will eventually find a vein.
d) You tell the patient that the intern is not very capable and offer to call the IV service to
insert the drip for her.
e) You tell the patient that this can be a complicated procedure but that she is in good
hands.
Question: 9
Scenario:
You are a nurse caring for an elderly patient in a nursing home who is gravely ill. Every time
you see this patient, he tells to you that he thinks he is on the wrong medication, as he is not
getting better. He has on numerous occasions made it clear to you, as well as to other staff
members, that he does not believe the doctor has made the right diagnosis and that the
medication is having no beneficial effect on him. He has also stated that he believes the
doctor to be completely incompetent. However, when the doctor comes to see him he never
discusses the matter with him. What should you do?
Choices:
a) You inform the doctor of the patients complaints.
b) You inform the patient that he should discuss his concerns with his doctor at length and
that you will be happy to ring the doctor to come and see the patient.
c) You tell the patient that his remarks are uncalled for and that he should keep his opinions
to himself.
d) You agree with the patient that some doctors do not know what they are doing.
e) You ignore the patients complaints and comments, putting it all down to the fact that he
must have senile dementia.
Question: 10


Scenario:
You are a twenty-five year old female doctor working in a large public hospital. Not only are
you very attractive, but you also look much younger than your actual age. It happens to you
frequently that patients either question your ability and competence, or simply assume that
you are too young to be a doctor. One of your patients, an elderly man, questions everything
you say in front of the nurses and then tells them later that he does not believe what you are
saying to be correct, as you cannot possibly have enough experience. How should you react?
Choices:
a) You ignore him all together.
b) You explain to him in a friendly manner that you are a qualified doctor, that you have
studied the required curriculum and that he need not question your decisions.
c) You ask the nurse to speak to him.
d) You tell him that your qualifications are adequate enough to handle his particular case.
e) You tell him that he has the right to a second opinion and that you will ask another doctor
to see him.
Question: 11
Scenario:
You are a junior doctor working on an orthopaedic ward and one of your patients has just
had a major back operation. He needs an X-ray to assess his progress. You fill out the correct
form and hand it to the receptionist to organise the X-ray. The following day when you see
the patient, you ask the nurse to see the X-ray. She takes you aside and tells you that the
clinical nurse consultant first wanted to discuss the need for further X-rays with the senior
doctor on the ward. The patient has realised that there seems to be a problem concerning his
X-rays and wants to know what is going on. What do you say?
Choices:
a) You tell the patient that sometimes nurses wrongly take it upon themselves to override
doctors orders.
b) You tell the patient that this is a small misunderstanding and not to worry about it, the Xrays will be done as you ordered.
c) You tell the patient, that you shall seek out the nurse concerned and ask that in the future
she check with you directly if she has a query regarding any tests.
d) You tell the patient that the X-rays are not urgent at all and shall be done in due course.
e) You say nothing and take the patient to the X-ray department yourself.
Question: 12
Scenario:
You are a young intern in a public hospital. It is Christmas and you have been rostered to
work over the Christmas days in order to have New Years Eve and New Years Day off from
work. You feel a bout of the flu coming on already on Christmas Eve, but decide that you
must go to work, in spite of your condition. On Christmas Day you are running a temperature
and feeling terribly ill, coughing severely. You know that to call on one of your colleagues at
this time of the year would ruin their Christmas, so you go to work after all. Several patient

comment that you are not well and one patient asks you whether you would not infect
everyone around you. What do you say to her?
Choices:
a) You tell her that you have no choice in the matter and that someone has to look after the
patients.
b) You tell her that you are taking some strong medication for your condition and you should
be better in a couple of hours.
c) You tell her that you have no choice in the matter, but that the risk of infecting the other
patients is very low.
d) You tell the patient that you cannot inconvenience any of your other colleagues at this
time, so you have no choice but to work, but that the risk of infection is very low.
e) You tell her that you are not really ill at all and that you look and sound worse than you
are.
Question: 13
Scenario:
You are a senior nurse working in a private hospital. A patient complains to you that one of
the nurses working on your ward pays no attention to her appearance and often comes to
work looking really untidy and unkempt, portraying an unprofessional image. One or two
other patients have also remarked on this. How should you handle this situation?
Choices:
a) You tell the patient that this nurse obviously does not care about the hospitals
professional conduct, but that you shall speak to her about paying more attention to her
appearance.
b) You tell the patient that the hospital has certain standards to uphold and you shall make
suggestions to the nurse about neatening her appearance.
c) You tell the patient that you have told this nurse several times already to tidy up her act.
d) You tell the patient that she needs to make a formal complaint to the hospital
administration about the nurse.
e) You tell the patient that you shall speak to the nurse concerned.
Question: 14
Scenario:
You are a nurse and one of your patients, an elderly man is about to be released from
hospital. While he is waiting for the release forms to be processed you bring him a list of
instructions written by his doctor. The list contains information regarding his medication and
diet, for the next couple of days. He has a look at what his doctor has written and then tells
you that he finds it impossible to decipher the doctors handwriting. What do you tell him?
Choices:
a) You tell the patient that you shall take the list back to the doctor, with the message that
the patient cannot read his handwriting, but you may not be in time to see him before his
release.
b) You tell the patient that all doctors are hopeless and have illegible handwriting.
c) You tell the patient that this is not your problem and that he should contact the doctor.

d) You tell the patient that when you see the doctor you shall ask him to phone the patient
at home.
e) You tell the patient that you shall phone the doctor from the nurses station to get all the
relevant instructions and ask the patient to wait until you return.
Question: 15
Scenario:
You are a doctor working in the emergency section of a large hospital. You are very busy one
night with all the staff worked off their feet. While you are doing an assessment on a patient
another staff member rudely questions your judgement in front of the patient. You
immediately notice, that the patient seems to be quite astounded by the derogatory remark
directed at yourself. How should you handle this situation?
Choices:
a) You ignore the comment, continue with your work and later privately tell the patient that
this particular doctor has a very bad bed-side manner.
b) You tell the patient that you do not agree with the doctors comments.
c) You tell the patient that the other doctor is out of line and you will have a word with him
later.
d) You ask the patient why he is alarmed and tell him that this happens sometimes when all
staff members are stressed.
e) You talk to the patient privately and tell the patient that everyone has had a really busy
night and apologise.
Question: 16
Scenario:
You are a senior nurse attending to a female patient in the company of two young interns. A
very attractive young nurse who works on your ward walks by.The two young doctors make
loud comments about the nurses good looks in front of you and the patient. The patient a
middle-aged lady is obviously embarrassed by the comments and tells you that she finds
such behaviour out of place. How should you react?
Choices:
a) You tell her to ignore their comments.
b) You explain to the patient in front of the young doctors, that their remarks were uncalled
for.
c) You later privately tell the patient that you have decided to inform the resident doctor
about their inappropriate behaviour.
d) You tell her that you shall speak to the two young doctors in private about their
behaviour.
e) You apologise to the patient in front of the two doctors subtly embarrassing them.
Question: 17

Scenario: You are a nurse in the cancer ward of a public hospital.Your elderly mother is a
patient in the ward and is under your care. Because you are her daughter, she constantly
calls for you and wants extra attention, requiring you to spend more time with her than with
any of the other patients under your care. Other staff members and patients have noticed
this and you feel that you must speak to your mother about the issue. What do you say to
her?
Choices:
a) You carefully explain to the patient, your mother, that you need to give equal attention to
all patients under your care and cannot be seen to favour a family member in any way.
b) You carefully explain that you do not have extra time to spend with her, as you have
other patients under your care as well.
c) You carefully explain that you need to give equal attention to all patients under your care
and cannot be seen to favour a family member in any way, but that you can spend extra time
with her when you are off duty.
d) You reprimand the patient, your mother, and tell her that you do not wish to get into
trouble with the ward sister over this issue.
e) You tell her that you are not allowed to spend any extra time with her.
Question: 18
Scenario:
You are a junior doctor admitting a patient for day-surgery. The patient complains to you at
length how, when she saw the specialist surgeon who was to operate on her that day, he
was really rude and very brusque with her. She asks you what you think of this particular
doctor. How should you answer her?
Choices:
a) You tell her that this doctor comes across to patients as being brusque, but that he is a
very good doctor and that she could not be in better hands.
b) You tell her that sometimes doctors come across as being brusque or rude, because they
have a lot on their minds.
c) You tell her that you are sure that the doctor did not mean to be rude and that she must
be imagining it.
d) You tell her that this particular doctor is sometimes rude to patients, but that he is
actually a very good doctor and that she could not be in better hands.
e) You tell her that you totally agree with her.
Question: 19
Scenario:
You are a GP in practise with five other doctors. Some patients see whoever is available
when they come in. One patient tells you that he saw one of your colleagues, who happens
to be a friend of yours, the previous day and then proceeds to tell you at length, what a
complete idiot he thinks your colleague is. What do you tell him?
Choices:
a) You tell him that you do not wish to discuss your colleagues.
b) You tell him that it is unprofessional conduct, for you to discuss a colleague with him.

c) You tell him that this colleague is actually a dear friend of yours and that you dont think
him an idiot at all.
d) You tell him that your colleague is known to be a very thorough doctor, who is very
popular with all the other patients.
e) You tell the patient that if he thinks this particular doctor to be an idiot, to rather always
see one of the other doctors instead.
Question: 20
Scenario:
You are a nurse looking after a patient who has just returned from an operation. He
complains that he is very itchy (a common side effect of the pain killers used during and after
an operation) and is becoming distressed by it. He asks if there is any medication that you
can give him to relieve the itch. What do you say to him?
Choices:
a) You apologise and tell him that you are unable to give him the medication without a
doctors order.
b) You reassure him that the itch is a common side effect and that it will wear off
eventually.
c) You suggest that he try to distract himself from the itch and take his mind off it.
d) You tell him that there are medications to relieve the itch but that they must be
prescribed by the doctor before you can administer them. You offer to contact the doctor as
soon as you can.
e) You tell him that the itch is a common side effect of the pain killer and that if he wants
adequate pain relief he should be willing to accept the itch.
Answer:1
The preferred answer is c).
Discussion:
The patient is frustrated and is letting his frustration out on the people around him. As a
professional caretaker it is important not to take such outbursts seriously, but rather to try to
ascertain what the root cause might be. Neglecting or refusing to care for a patient in any
way is professionally negligent, thus answer d) and e) are incorrect. Being verbally abusive or
derogatory towards a patient is unprofessional and uncaring. For this reason answer a) and
b) are unacceptable responses.
Answer:2
Discussion:
This question is about balancing respect for other people's culture and modesty with
professional responsibility. A female doctor could perform an examination and presumably
this would be more acceptable to the patient. This would fulfil the medical requirement, as
well as not impinge on the patients modesty. Refusing to admit the patient, as in choice b),
if she refuses to be examined, is threatening to the patient, apart from being ethically
inexcusable. Ordering the patient to perform some action is completely unprofessional and
demonstrates very poor interpersonal communication skills. Answer d) shows a failing to
respect the patients culture, which is inappropriate, whereas admitting the patient without
an examination (choice e), is professionally inappropriate.

Answer:3
Discussion:
Being rude to the family, directly or in an applied manner, is inappropriate and certainly
demonstrates a lack of proper interpersonal communication skills, and threatening violence to
the children is totally unacceptable. Hence choices a), b) and c) are incorrect. Answer (e) is
not truthful and is also professionally inappropriate. Asking the children and the mother to
wait outside for a short while is an acceptable alternative.
Answer:4
Discussion:
This questions deals with understanding the concerns of patients relatives for their wellbeing. Response (b) demonstrates an effort to help the relative. Response (a) and (d)
dismiss the validity of her concern while (c) and (e) are blatant lies.
Answer:5
Discussion:
This question deals with the difficult situation when conflict arises between staff members. It
is important to handle the situation with professionalism, while still providing care for the
patient. Response (d) reassures the patient, while dealing with the situation professionally.
Although the nurse behaved in a most unprofessional manner, the doctor should deal with
her behaviour privately, as the well-being of the patient is a priority. Answers (a), (b), (c) and
(e) display unprofessional behaviour from the doctor.
Answer:6
Discussion: This question deals with the difficulties of maintaining professional conduct in
the face of time constraints and a demanding patient. With effective communication it is
usually possible to gain their understanding of your situation as in response (b). The
remainder of the responses all indicate a lack of correct interpersonal communication as they
are rude and impart no information to the patient.
Answer:7
Discussion:
It is natural for parents to be concerned about their childs progress in hospital and to want
to be updated on events as soon as possible. It is unreasonable to make them wait for the
doctor indefinitely as in responses (a), (b) and (c). Response (d) is unkind. Response (e)
communicates caring, compassion, and the willingness on your part to help the parents.
Answer:8
The correct answer is (e).
Discussion:
This scenario deals with the difficult situation where conflict may arise between staff
members in front of a patient. It is important to handle any such situation with
professionalism and diplomacy, whilst still providing the highest level of care for the patient.
It is never appropriate to embarrass a team member or colleague in front of a client or
patient. In this case, criticising the intern will simply make the patient more distressed and
the intern more nervous. Reassuring the patient as in choice (e), will calm the patient down
and thus make the interns task easier.

Answer:9
The preferred answer (b).
Discussion:
This scenario deals with appropriate professional conduct in a difficult setting. Often it is not
possible to resolve a patients complaints, but effective interpersonal communication will help
to resolve the situation. Choice (b) is the preferred answer because the patients doubts need
to be discussed with him and his fears alleviated. As his doubts are directed at the doctor and
his method of treatment, it is best that the doctor be called to review the patient and discuss
the matter with him. Answer (a) does nothing to immediately address the patients concerns,
choice (c) is rude, choice (d) is unprofessional, while choice (e) totally ignores the patients
concerns.
Answer:10
Discussion:
As a doctor your professional ability may sometimes be doubted by patients. In that case it is
necessary to reassure the patient of your position and responsibility as a doctor. However,
the patient may have a genuine concern and certainly has the right to a second opinion.
Confirmation of what you have already told him by a more senior doctor may also result in
the patient having more trust in your ability.
This is why option (e) is the preferred answer over options (b) and (d). Choices (a) and (c)
avoid dealing with the situation.
Answer:11
Discussion:
There are times when nursing staff will have concerns, often valid, about medical plans for a
patient. There may even be times when the correct protocol for querying a procedure may be
disregarded by a staff member. The clinical nurse consultant in this scenario was arguably
wrong in going over your head to query the patients management plan. However, the breach
in protocol should still be dealt with professionally and appropriately, as in answer (b) as the
patient need not know the full extent of what has taken place.
Answer:12
Discussion:
When working in the medical profession, many unexpected situations may arise. It may
happen that health care professionals become ill and in spite of this have to do their duty in
hospital especially during the Festive Season and public holidays. It is up to the health care
professional to determine whether he is able to carry out his duties concerning patients as it
is often very difficult to find a replacement doctor. At the same time no harm may come to
the patients coming into contact with the doctor. The preferred answer is (d) because it
reassures the patient, while explaining the situation to her at the same time.
Answer:13
Discussion:
What this situation constitutes is a clear lack of professional conduct by a nurse looking
unkempt and slovenly. Patients have a right to complain about anything which meets with
their disapproval. Through appropriate communication skills, the nurse can be made to
understand the importance of her appearance in a professional environment such as a

hospital. Thus (e) is the preferred answer. Answers (d) and (a) are too harsh and would
probably create conflict between the two nurses, whereas (b) and (c) do not resolve the
situation through effective communication.
Answer:14
Discussion:
Before the patient has left the hospital he is still officially in your care and it is your duty to
make sure, that all instructions issued by the doctor are clear to the patient, even if it means
a slight delay in leaving the hospital. This is why (e) is the preferred answer, as (a), (b) and
(d) are not at all helpful and (c) means you are relinquishing your professional responsibility
towards the care of this patient.
Answer:15
Discussion:
This situation deals with professional conduct. Conflicting opinions between health
professionals should never be voiced in front of patients, as this is unsettling and confusing.
The preferred answer is therefor (e) as all other answers are unprofessional.
Answer:16
Discussion:
This situation deals with inappropriate professional conduct from the two doctors. You have
noticed that the doctors behaviour embarrassed the patient. It is however not your place as
the nurse to say anything in way of reprimand to the doctors. Answer (a) is therefor
appropriate.
Answer:17
Discussion:
It is your duty as a nurse to see to each patients needs and not to favour specific patients or
family members. In a case such as this it is understandable if the mother wants special
attention from her daughter, who happens to be working on the ward where she is a patient,
which is why (c) is the preferred answer.
Answer:18
Discussion:
As a nurse you sometimes have to deal with patients who are not happy with the amount of
time spent with them by their doctor. It is up to you to reassure the patient, discuss any
further queries and to act in a professional manner towards other health professionals. It is
not up to you to discuss your personal opinion or those of others with the patient.
Answer:19
Discussion:
This situation requires you to deal with the patient in a manner that does not evoke any
conflict. Your priority is to ensure the patients comfort and well being, however it is also
important that you uphold your colleges reputation as a professional medical practitioner.
Thus the correct answer is (d).

Answer:20
Discussion:
Itchiness caused by the narcotic pain killers given after an operation can be quite distressing
to the patient and there are effective remedies to relieve it. This question deals with the
issue of the nurse not being able to prescribe medication herself. Trying to help the patient
quickly and effectively as in response (d) by reassuring the patient (this is important) and
then contacting the doctor, is appropriate. The remainder of the responses do nothing to
alleviate the patients distress. Choices (a), (b) and (c) do nothing to address the patients
problem, while (e) is entirely inappropriate.
This is a strictly timed trial test. Time allowed is 22.5 minutes.
PROFESSIONAL DEVELOPMENT
PRIORITISING SKILLS
Question: 1
Scenario:
You are a young general practitioner working in a coastal town. Many of your patients are
holiday-makers, who use your services only when on holiday. A young man who lives on the
coast and has been a patient of yours for a couple of years, makes an urgent appointment to
see you. He has a severe stomach upset and requires medication. He brings with him to the
consultation two of his friends, both holiday-makers who have the same symptoms of
stomach upset. The two friends have no appointment to see you. You have a full list of
patients, all of which have made appointments. What do you do?
Choices:
a) You consult the patient who has made the appointment and then tell his friends that you
have a waiting room full of patients. The best you can do is to try and fit them in at the end
of the day.
b) As they have all come in to see you together, you say nothing about the other patients
who are waiting to see you. You examine your regular patient first and then examine his
friends briefly and give them each a prescription for their condition.
c) You tell the patients friends to speak to the receptionist, who does all the bookings, to ask
her to fit them in as soon as possible and tell them that they may have to wait a while.
d) You tell the friends to see another doctor as you are really fully booked and cannot
inconvenience your regular patients for patients who see you when they are on holiday.
e) You tell your receptionist to tell the youngsters that they should seek help from another
doctor as you are too busy.
Question: 2
Scenario:
You are a hospital physiotherapist treating a football player who has had a kneereconstruction. You have to see this gentleman on a daily basis to put him through a
schedule of routine exercises, which will aid his recovery. Every time you come to see him he
has visitors from his football team who distract your patient from concentrating on his
movements with loud comments and jeers. What should you do?

Choices:
a) You politely ask the visitors to leave the room while you are attending to the patient.
b) You politely explain to the visitors that it is obvious that the patient is distracted from his
exercises while they are present and to please either wait outside or not disturb him.
c) You ignore the rowdy visitors and try your best to work with your patient.
d) You joke along with the mans friends, realising that your patient is not getting the most
out of his physiotherapy, but at least he is being kept in good spirits.
e) You tell the patient to ask his friends to leave while you are treating him.
Question: 3
Scenario:
You are a nurse in a hospital ward. One of your patients an elderly lady has lost her glasses.
She only uses them to read and is getting very bored. For some time she has been badgering
the staff to find her glasses. She accosts you and asks you to also help locate them. You are
extremely busy. What do you say to her?
Choices:
a) You tell her that you will keep your eyes open for her glasses.
b) You tell her that you are extremely busy right now, but that you will keep your eyes open
for her glasses.
c) You tell her that you are certain that the glasses will be found in due course.
d) You tell her that the staff are all very busy and that she should stop badgering them.
e) You ask her why she doesnt have a spare pair of glasses, which she could have used until
the lost ones were found.
Question: 4
Scenario:
You are a nurse working in a medical ward at night. One patient is constantly pressing his
buzzer, asking for glasses of water, an extra pillow, and making other small requests. You
are just about adjust the height of one end of the bed for him so that he can see the
television easily, when the patient in the bed next to him starts complaining of a mild
backache and asks you to arrange some pain medication. Who you attend to first and what
do you say?
Choices:
a) Your first priority is to the man in pain and you tell the patient who makes constant
requests to be patient while you call the doctor.
b) Your first priority is to the man you were attending to and you let the man with the
backache wait, as the pain is not severe.
c) You explain to the patient who wanted his bed adjusted that you would like to arrange
pain relief for the other patient, but that you will return to adjust his bed as soon as you can.
d) You explain to the patient who wanted his bed adjusted that you would like to arrange
pain relief for the other patient and that he will have to wait, as his request is obviously not
that important.
e) You explain to the patient who has the backache that you would like to arrange pain relief
for him, but that you are already attending to the other patient and that he should wait.

Question: 5
Scenario:
A patient with depression comes to see you, her GP. You have diagnosed her depression
some time ago and essentially she has come to get another prescription for her medication.
You have a child waiting in the consulting room next door, who is in a lot of pain and who
needs your attention. The lady who is with you is telling you at length about her sister who
seems to be suffering from depression also. She rambles on and on and you know that you
need to cut her visit short to attend to the child. What do you say to her?
Choices:
a) You interrupt her, excuse yourself and say that you have a very urgent case next door
which requires your immediate attention.
b) You interrupt her to write out her prescription, then excuse yourself and say that you have
an urgent case to attend to next door.
c) You interrupt her and tell her that you cannot spend more time with her as you have an
urgent case to attend to.
d) You listen to all her problems until she is finished and simply let the child wait.
e) You ask her if she can wait for half an hour or more, as there is an urgent case you need
to attend to first and that you will finish your talk with her later.
Question: 6
Scenario:
You are a doctor working in the psychiatric ward in a public hospital. The ward has an open
plan and patients often just wander about in the common area. You are about to see a
patient for a planned consultation before another staff meeting. You are accosted by a
patient in the corridor, who proceeds to tell you at length about a last suicide attempt. You
are running late and would like to complete your sceduled consultation before the staff
meeting. What do you say to this patient?
Choices:
a) You excuse yourself, tell the patient that you have a consultation, but promise to speak to
her later.
b) You listen to the patient for a short time and then excuse yourself.
c) You tell her that you are in a great hurry and cannot speak with her right now.
d) You mention to her that she has told you all this before and that you are in a hurry.
e) You tell her that you have an appointment and then a staff meeting and have no time to
listen to her story again.
Question: 7
Scenario:
You are a busy surgeon running a clinic at a public hospital. it is already late in the afternoon
and your clinic is running overtime by two or more hours. One of the patients waiting to see

you is someone you operated on a year ago. You know that this patient has travelled by bus
for a couple of hours to come and see you. He still has to catch the bus back that evening,
but will miss the last bus if you do not see him immediately. The man approaches you
between consultations and asks if you can see him soon. Several other patients overhear his
request. What do you tell him?
Choices:
a) You ask him to enter your treatment room and attend to him immediately.
b) You tell the other patients, that this man has travelled very far to see you and cannot
afford to miss his bus. You apologise to them and explain that you would like to see him
next.
c) You ask the man wait until it is his turn, as this is only fair, and hope that he still makes it
to the bus in time.
d) You lie and tell the other patients that this man is seriously ill and needs to be seen
immediately.
e) You tell the other patients that this man has travelled very far to see you and cannot
afford to miss his bus. You explain that since this makes him more important, you will see
him next.
Question: 8
Scenario:
You are a busy nurse attending to a patient who constantly makes demands on your time for
trivial things. You are about to go off on your meal-break, when this patient rings for you
again. You know that if you agree to do what she wants, you may be stuck with her for your
entire tea break. What do you tell her?
Choices:
a) You tell her that you are going on your meal-break now, but shall ask another staff
member to attend to her needs.
b) You tell her that this is your meal-break, but in spite of that you will quickly help her
anyway.
c) You find out what she needs, attend to it and then go on your meal-break.
d) You tell her that you are going on your break now and that you will see her when you
come back.
e) You tell her that you are going on your meal-break now.
Question: 9
Category: Prioritising Skill
Scenario:
You are a young nurse working on a ward, where the clinical nurse coordinator (CNC) is very
draconian, strict and widely feared amongst the nursing staff. You are just attending to a
patient, who is telling you about how she lost her husband tragically a couple of weeks ago.
While the patient is tearfully relating this to you, another nurse approaches you and tells you
that the CNC wants to see you in her office right NOW. What do you do?
Choices:
a) You immediately break off the conversation, leave the patient in her tearful state and go
to see the CNC.

b) You excuse yourself and say you must go to see the CNC as she expects the nurses to
jump when she calls.
c) You calm the patient down as best you can and when she seems to be under control of
her emotions again, you excuse yourself.
d) You tell the other nurse to tell the CNC that your patient is obviously more important and
that she will just have to wait.
e) You tell the other nurse to stay with the patient and then rush off to see the CNC.
Question: 10
Scenario:
You are a nurse working on a surgical ward. You are attending to a patient who can not walk
yet, after having had recent surgery. You are helping this patient to the bathroom. As you
pass by one of the beds, the occupant complains to you that she has asked to be given a bed
pan and is getting very annoyed about having to wait. She wants something to be done
about it right now. What do you do?
Choices;
a) You tell the patient waiting for the bed pan that you are quickly taking this patient to the
bathroom and will then come to help her.
b) You tell the patient waiting for the bed pan that you are busy with someone else.
c) You ignore the patient in the bed, as you can only do one thing at a time.
d) You take the first patient back to her bed and decide to get the bed pan first.
e) You apologise to the patient waiting for the bed pan and quickly use the buzzer by her
bed to ring for a nurse, then proceed to take the other patient to the bathroom.
Question: 11
Scenario:
You are a nurse who has been asked to attend a meeting of all the specialist doctors, who
see patients on your surgical ward. You have some statistics about patients on your ward,
which you have been asked to present. You want to arrive early, so that you can read
through your notes one more time. As you are about to leave for the meeting one of the
patients calls you over to tell you at length about the slight discomfort he is experiencing with
his urinary catheter. There is no other nurse close by. What do you say to him?
Choices:
a) You check to see that the catheter has not dislodged, then tell that everything seems to
be OK, you are about to go to a meeting but you shall come back as soon as the meeting is
finished to talk to him.
b) You tell him that you are on your way to a meeting.
c) You tell him that urinary catheters are invariably uncomfortable and he will just have to
bear it.
d) You tell him that you have no time to listen to him now, but you will send another nurse
to speak to him about alleviating his discomfort.
e) You decide that you will be late for the meeting and stay with the patient for as long as he
wants to talk to you.

Question: 12
Scenario:
You are a GP running a busy city practice. Your waiting room is filled with patients and it is
already late in the afternoon. A man is brought in by his friend. He is very drunk and is
bleeding from a cut on his forearm. The receptionist tells you that the mans cut is superficial
and not serious, but that he is being very loud and abusive and refuses to stay in the
treatment room, where he is supposed to wait for you to attend to his cut. The receptionist
cannot handle the man and other patients are getting upset. What do you do?
Choices:
a) You tell the man to behave himself or to wait outside.
b) You tell the man that unless he behaves, you are not prepared to treat him.
c) You tell the mans friend to calm him down and to see that he behaves.
d) You ask the man to calm down, tell him that he needs to wait in the treatment room and
that you will attend to him shortly.
e) You take his friend aside and ask him to stay with the man in the treatment room and
then ask the man to calm down, you will attend to him shortly.
Question: 13
Scenario:
You are a junior doctor working on a ward that looks after mothers following their deliveries.
For the past two days you have been wanting to assess a patient after her delivery. Every
time you come to see her, she has family visiting her. The patient wishes to be examined in
privacy, but when you ask her family to leave the room, they refuse, stating that you should
come back after visiting hours are over. The patient is due to go home that day and you have
no other time to see her. What do you say to the patient and her family?
Choices:
a) You explain to the patient that the assessment will occur now or never and that she
should be firm with her family.
b) You tell the patient that you cannot keep coming back and that you want her family to
leave the room so you can get on with the assessment.
c) You explain to the patients family that you need to assess her, that you have wanted to
do this several times in the past two days and that it is important that you have some
privacy.
d) You tell the patient that the assessment is not urgent and that you might just not bother
with it.
e) You angrily confront the patients family and tell them you shall call security if they
interfere with your duties again.
Question: 14
Category: Prioritising skills.
Scenario: You are a midwife working in a labour ward. It is the middle of the night and all
other staff are busy. You are alone with two women, both in labour. One of the women has
been put on a drip to facilitate labour. The other woman tells you to call the doctor, as she
urgently wants to ask him something. At the same time the woman with the drip starts

shouting that she cant stand the pain any longer and wants to change her position to get
comfortable. This is difficult because of the drip in her arm and she needs help. What do you
say to the ladies?
Choices:
a) You tell the first lady that you will call the doctor as soon as you have helped the other
lady, which will only take a minute. Then you help the woman with the drip get into a
comfortable position.
b) You tell the lady with the drip that you will attend to her as soon as you have called the
doctor, which will only take a minute.
c) You tell both women to stay calm and you will attend to them both in due time.
d) You tell both women to calm down and then proceed to the nursing station to call the
doctor.
e) You ask the first lady if you can possibly answer her question.
Question: 15
Scenario: You are a nurse working the night shift in the psychiatric ward of a public
hospital. While you are sitting in the nurses station one of your patients comes to you with a
long story of how she woke up, to see her father standing next to her bed. He told her that
she must go home right away. While you are listening to her, another patient rings the
buzzer for your attention. How do you handle the situation?
Choices:
a) You gently tell the lady that you will escort her back to bed and then give her some
medication to help her get back to sleep.
b) You escort the patient back to her bed and tell her that you will be right back with some
medication to help her get back to sleep. Then you attend to the other patient who rang the
buzzer.
c) You tell the patient that she should go back to bed and that you need to answer the
buzzer.
d) You tell the patient that her story is all nonsense and to go back to bed as you have to
attend to the patient who rang the buzzer.
e) You tell her that her story is a lot of nonsense and that she cannot go home now as it is
the middle of the night.
Answer:1
Discussion:
In a medical practice, unexpected situations often arise. In this case, the two others who
have come along with their friend are not really critically ill, and can afford to wait until the
receptionist can fit them into the doctors schedule, without inconveniencing too many
patients. Therefore (c) is the preferred answer. Other patients may feel unfairly treated if you
see all three together as in choice (b). However you do have a duty of care to these patients,
and should not have to refer them to someone else or ask them to come back unless there is
absolutely no other option. Thus choices (a), (d) and (e) are not the preferred answer.
Answer:2
The preferred answer is (b)

Discussion:
As a health care professional the wellbeing of your patient is your first priority. In this
situation the patient cannot be effectively treated, due to constant interruption from his
rowdy his friends. By communicating politely with the visitors, offering an explanation to
them and giving them the choice of leaving or being quiet, you will hopefully gain their
cooperation. Thus the best answer is (b). Options (c) and (d) show a lack of prioritisation of
your patients care.
Answer:3
Discussion:
This situation deals with empathy for the patient concerned. However, it also requires you to
understand your duties towards all other patients under your care. It would be highly
unprofessional for you to prioritise this patients personal needs while your other patients
require medical attention. Thus the obvious choice is (b).
Answer:4
Discussion:
In this scenario the nurse has to deal with demands by two patients and must prioritise one
of them. The man who has the backache will be in more discomfort than the man who needs
the bed adjusted to watch television. The preferred choice (c) involves explaining to the first
patient why you are leaving and that you will be back as soon as possible, before attending
to the patient in pain.
Answer:5
Discussion:
Prioritising skills are important when determining where to focus immediate attention, to
benefit patients under your care the most. The lady in question essentially only needs a
prescription renewed, so there is no point in making her wait and to continue any further
irrelevant discussion with her. The patient in serious discomfort who is waiting for your care
should take priority in this situation. Thus (b) would be the most appropriate choice.
Answer:6
Discussion:
This situation needs to be handled very delicately with appropriate communication, to ensure
that the patient that approached you in the corridor does not feel rejected, even though you
have little time at the moment. It would be more beneficial for you to organise an
appropriate time for yourself and the patient to discuss her problems. By doing so you not
only prove to her that you want to help, but also prioritise your attention regarding patients.
Thus the preferred choice would be (a).
Answer:7
Discussion:
In this scenario a particular patient has travelled far to see you. Answer (b) is the preferred
answer, as you should give priority to this patient due to his circumstances. Your other
patients have a right to an explanation however, hence answer (a) is incorrect. Choice (d) is
dishonest and choice (e) is incorrect, as this person is not more important than your other
patients.

Answer:8
Discussion:
As a nurse your primary priority is to ensure the wellbeing of all patients under your care. By
briefly attending to the ladies needs you are still fulfilling your duty of care towards her and
are prioritising your time appropriately. The preferred option is (c), as all other choices do not
encompass your duty of care towards the patient.
Answer:9
Discussion:
Your patients are your priority. Your primary duty of care should take precedence over other
distractions and thus answer (c) is the preferred answer. It is inappropriate to simply leave
the patient with another nurse in this situation as in option (d). Option (d) is not
professionally appropriate.
Answer:10
Discussion:
Often a situation might arise where your care is needed in two places simultaneously. Since
you are accompanying a patient to the bathroom, it would be highly unprofessional to
abandon her immediate needs for the patient making the complaint. Thus it is preferable to
call for another nurse to help you. Thus the most appropriate answer is (e).
Answer:11
Discussion:
Any complaint by a patient, however trivial, should not go uninvestigated. Catheters, tubes
and drips often cause discomfort and may also become dislodged. By quickly checking that
everything is in order, the nurse is not late for her appointment and can further reassure the
patient later on. Therefore (a) is the preferred answer.
Answer:12
Discussion:
As a healthcare professional your duty of care is towards every individual patient. One patient
should not be allowed to disrupt and disturb the smooth running of a practise through bad
behaviour, which is why (e) is the preferred answer.
Answer:13
Discussion:
As a health care worker you prime responsibility is to care for your patients. If family is
hindering you from carrying out your duty it is up to you to make this clear in a friendly but
firm manner, which is why (c) is the preferred answer. Answer (d) is medically negligent and
answer (e) is rude and inappropriate.
Answer:14

Discussion:
In this scenario it is necessary to prioritise the patients requests. The lady with the drip, who
is in discomfort, is your first priority, but the other lady should also be reassured that you will
call the doctor as soon as possible. Thus choice (a) is preferred. Choice (c) doesnt involve
any action being taken at all, while choice (e) does nothing to help the lady in pain.
Answer:15
Discussion:
As a health care worker your responsibility is towards all your patients. Here you have a
situation where two patients are demanding your attention at the same time. Answer (b) is
the preferred answer, as the needs of both patients are attended to. Answer (a) does not
deal with the patient ringing the buzzer, while choices (d) and (e) are professionally
inappropriate.
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for loss of profits, loss of
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the possibility of such
damages.
Where any law of any place implies in these Terms and Conditions any
term, condition or
warranty, and that law avoids or prohibits provisions in a contract
excluding or modifying the
application of or exercise of, or liability under such term, condition or
warranty, such term,
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Conditions but our
liability for any breach of such term, condition or warranty shall be
limited, at our option, to any
one or more of the following:
(a) if the breach relates to goods:
(i) the replacement of the goods or supply of equivalent goods;
(ii) the repair of such goods;
(iii) the payment of the cost of replacing the goods or of acquiring
equivalent
goods; or

(iv) the payment of the cost of having the goods repaired; and
(b) if the breach relates to services:
(i) the supplying of the services again; or
(ii) the payment of the cost of having the services supplied again;
but so that the total cost to us does not exceed the original price of the
goods or services
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The information contained on this Site is provided by us in good faith. The
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creates any warranty not expressly made in these Terms and Conditions.
For any other information or permission to use the material in this Site, contact
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Tertiary Prep Skills 2002-2004

UMAT SUPERPREP COURSES

PRE-COURSE STUDY MATERIALS

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

TIMED TRIAL TESTS...........

SECTION 2: COMMUNICATION SKILLS

Tertiary Prep Skills 2002-2004

Section2: Communication skills

2.1 Conflict resolution

3.1 Professional conduct

2.2 Appropriate communication

3.2 Prioritising skills

Section 1: PERSONAL DEVELOPMENT:

Tertiary Prep Skills 2002-2004

Reassuring: The ability to provide reassurance to another person is important. In a

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Honesty is an important issue in any professional healthcare setting, as honesty engenders

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Section 2: COMMUNICATION SKILLS:

Why is conflict resolution an important interaction skill?

How can conflict in a healthcare environment be resolved?

Focus on the Problem: It is important to focus on the relevant issues surrounding a

Explaining the situation (usually to a patient) so that any misunderstanding between

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Appropriate communication in a challenging situation:

Tertiary Prep Skills 2002-2004

Direct and Honest Approach: Issues or problems should be explained to patients in

Here are some examples:

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

What is Professional Conduct?

Why is it important that we relate to clients or patients in a professional manner?

Non-Discrimination: This includes discrimination against the client (political, religious,

What is required of the Health Professional in terms of knowledge of professional

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Category: Professional Conduct

Tertiary Prep Skills 2002-2004

What do we mean by prioritising skills?

Discussion: What resources can you think of in the healthcare industry?

Hospitals or hospital beds

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

The needs of each patient

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

The preferred answer is (a).

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004

Tertiary Prep Skills 2002-2004