Risk, Capacity & Safeguarding Practice Questions

Question 1

A 27-year-old woman presents with amenorrhea, weight loss, and excessive exercise. Her BMI is 16 kg/m². She has bradycardia and hypotension. What is the most serious immediate risk?

Accepted Answer

Cardiac arrhythmias

Answer

Osteoporosis

Answer

Renal failure

Answer

Hypothermia

Answer

Electrolyte imbalance

Question 2

A 40-year-old woman presents with recurrent episodes of palpitations, sweating, and tremor lasting 10-15 minutes. These occur 2-3 times per week with no obvious trigger. Physical examination and ECG during an episode are normal. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Hyperthyroidism

Answer

Cardiac arrhythmia

Answer

Pheochromocytoma

Answer

Caffeine excess

Question 3

A 31-year-old woman presents with amenorrhea, weight loss, and lanugo hair. Her BMI is 15 kg/m². She denies having an eating disorder. What is the most serious immediate risk?

Accepted Answer

Cardiac arrhythmias

Answer

Osteoporosis

Answer

Renal failure

Answer

Hypothermia

Answer

Infection

Question 4

A 67-year-old man presents with confusion and agitation 2 days after hip replacement surgery. He sees insects crawling on the walls and is oriented only to person. His medication includes morphine PCA. Vital signs are stable. What is the most likely diagnosis?

Accepted Answer

Postoperative delirium

Answer

Alcohol withdrawal

Answer

Dementia

Answer

Sepsis

Answer

Fat embolism

Question 5

Which of the following best describes the principle of 'best interests' under the Mental Capacity Act 2005 when making decisions for a person who lacks capacity?

Accepted Answer

The decision must consider the person's past and present wishes, feelings, beliefs and values, alongside other relevant factors

Answer

The decision that the healthcare professional believes is medically optimal

Answer

The decision that the patient's family unanimously agrees upon

Answer

The decision that involves the least restrictive option in all circumstances

Answer

The decision that is most cost-effective for healthcare services

Question 6

A 25-year-old man is assessed following discharge from a psychiatric ward where he was treated for a first episode of psychosis. He describes hearing voices telling him he is worthless and should kill himself. He states he doesn't believe the voices but finds them distressing. He has good insight into his illness, is adherent to medication, and has strong family support. He denies any suicidal ideation or intent. What is the most appropriate risk classification?

Accepted Answer

Low-moderate risk - command hallucinations are present but other protective factors exist

Answer

Low risk - he has insight and denies suicidal intent

Answer

Moderate risk - command hallucinations require intensive monitoring

Answer

Moderate-high risk - first episode psychosis carries inherently high suicide risk

Answer

High risk - command hallucinations to self-harm require immediate hospitalization

Question 7

A 57-year-old woman with no significant past medical history is diagnosed with motor neurone disease. She has full cognitive capacity and, after detailed discussion with neurology, wishes to make an Advance Decision to Refuse Treatment (ADRT) to refuse ventilation if she develops respiratory failure. Which of the following statements regarding her ADRT is correct?

Accepted Answer

An ADRT for refusing life-sustaining treatment must be in writing, signed, and witnessed

Answer

An ADRT for refusing life-sustaining treatment must be verified by two independent doctors

Answer

An ADRT is only valid if the patient currently lacks capacity

Answer

An ADRT cannot refuse treatment that would be given under the Mental Health Act

Answer

An ADRT automatically becomes invalid if the patient is subsequently detained under the Mental Health Act

Question 8

During a suicide risk assessment, a 48-year-old man with recurrent depression describes detailed plans to end his life by carbon monoxide poisoning in his garage. He has purchased necessary items and set a date for next week. However, he states he will delay this if his daughter visits from abroad as planned in 10 days. Which of the following best describes the significance of this conditional delay?

Accepted Answer

It represents a protective factor but does not significantly reduce imminent risk

Answer

It indicates low suicide risk as he is making future plans

Answer

It suggests he is seeking attention rather than genuinely suicidal

Answer

It indicates ambivalence and opportunity for therapeutic intervention

Answer

It negates the significance of his detailed planning

Question 9

A 66-year-old man with frontotemporal dementia presents with disinhibited behaviour and poor judgment. His family reports he has been making unusual financial decisions, including giving away large sums of money to strangers. A capacity assessment for financial decisions is requested. He insists he has 'plenty of money' and can do what he likes. Which component of the Mental Capacity Act functional test is he most clearly failing?

Accepted Answer

Using or weighing the information as part of decision-making

Answer

Understanding information relevant to the decision

Answer

Retaining the information

Answer

Communicating his decision

Answer

Appreciating the consequences of his decisions

Risk, Capacity & Safeguarding

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