Ethics and Communication Prometric Style Questions – 50 Cases with Answers

What this deck covers

Ethics and Communication — Prometric Style Questions, Set 1 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Choosing against the family’s wish
2. What the code should contain
3. One bed and two children
4. Keeping a promise to a family
5. What the parents must be told
6. Refusing the machine he needs
7. The tap the parents will not allow
8. The frightened boy on the list
9. The teenager who came alone
10. A threat made in the consulting room
11. The school on the telephone
12. Bruises before he can crawl
13. What the junior doctor must do
14. Before the sentence is spoken
15. Pitching it at the right level
16. Taking a result down the phone
17. Handing over by telephone
18. The missed loss at the first visit
19. The same failure four times
20. Errors at the sharp end
21. Caught before it reached the child
22. Wording for the incident policy
23. Bleeding after a painkiller
24. Hair loss on correct treatment
25. Where the doses go wrong most
26. An unexpected rash after treatment
27. What the regulator is for
28. The aims of the programme
29. Naming the act precisely
30. What continues when treatment stops
31. A request to stop the ventilator
32. What makes a study legitimate
33. Recruiting for the trial
34. Whose judgement is most at risk
35. Noticing her own reaction
36. Asked to do another job
37. Deciding whether he can decide
38. The antibiotic that cannot help
39. The dose that was ten times too high
40. Who should do the translating
41. The watch offered in thanks
42. A colleague who should not be working
43. Bleeding, and the family says no
44. The question she asked the nurses
45. Looking back after the harm
46. Pausing before the knife
47. Incidents that should be impossible
48. Declining the routine schedule
49. Fixing yesterday’s entry
50. A request for everything

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Acting in the patient’s best interest, Veracity, The patient is under eighteen years of age, Waiting until the diagnosis is certain before acting, Accept it verbally and act on it at once, Discipline the doctor who saw the child, Any bad outcome of an illness, Paediatric patients, Higher patient numbers and faster discharge only, Extubate him, as the mother has decided, The investigator paid by the manufacturer, That he agrees with the recommended option, Use the sister, since she is willing and fluent, Transfuse him, as it is necessary to save his life.

Clinical pearls from this deck

• A decision you disagree with is not evidence of lost capacity. Capacity is about the process of deciding, never about the answer reached.
• Ask whether an action is lawful and whether it is right as two separate questions. They usually agree, and the interesting cases are the ones where they do not.
• When you cannot give both children what they need, write down how you decided. A recorded, consistent process is the only defence a tragic allocation has.
• Never promise a family something you do not control. A broken promise costs more trust than the bad news it was meant to soften.
• Always tell a family what happens if they do nothing. It is the comparison that makes every other number in the conversation mean something.
• The child is the patient, not the family. When a refusal will cost the child his life, the decision has left the parents’ hands.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Ethics and Communication case decks · pediatric reference values.