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NMBA OBA OSCE study materials
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NMBA OBA OSCE practice questions

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Question 1Professional practice and ethical conduct

A registered nurse realises a colleague has documented a set of vital signs that were never actually measured. Under the NMBA Registered Nurse Standards for Practice, what is the nurse's primary professional obligation?

  1. Confront the colleague privately and require them to amend the documentation before the shift ends
  2. Wait until the next performance review cycle so that the matter is handled by the line manager
  3. Act on the concern by escalating it through the appropriate channel so that patient safety and professional accountability are addressed Correct answer.
  4. Record the concern in the patient's progress notes so that the family is informed at discharge

Explanation

Registered nurses are accountable for their own practice and must act when they identify that a colleague's conduct places people at risk. Falsified documentation is a serious breach, and the correct response is to escalate promptly through the proper governance pathway rather than to manage it informally.

Question 2Professional practice and ethical conduct

Which statement best describes the scope of practice of an enrolled nurse in Australia?

  1. The enrolled nurse may perform any activity that a registered nurse performs provided the patient consents
  2. The enrolled nurse is limited to personal care tasks and may not administer any medications
  3. The enrolled nurse provides delegated care and works under the direction and supervision of a registered nurse Correct answer.
  4. The enrolled nurse practises independently without any supervision once registration is granted

Explanation

Enrolled nurses practise under the direction and supervision of a registered nurse, with the level of supervision determined by context, competence and patient acuity. Their scope is not fixed to personal care and does not extend to unsupervised independent practice.

Question 3Professional practice and ethical conduct

A patient with capacity declines a prescribed blood transfusion and asks that the decision not be discussed with family. What is the most appropriate nursing action?

  1. Inform the family because they will need to support the patient through the decision
  2. Seek an urgent guardianship order because the refusal is likely to cause harm
  3. Ask the treating team to override the refusal in the patient's best interests
  4. Respect the refusal, document the discussion, and continue to provide all other care Correct answer.

Explanation

A competent adult has the legal and ethical right to refuse any treatment, even life-sustaining treatment, and confidentiality continues to apply. The nurse's role is to confirm the patient has capacity and is informed, document the decision, and maintain the therapeutic relationship.

Question 4Professional practice and ethical conduct

Under the NMBA standards, when is a registered nurse required to make a notification about another health practitioner?

  1. When the nurse reasonably believes the practitioner has placed the public at substantial risk of harm Correct answer.
  2. Whenever a colleague's practice differs from the notifying nurse's preferred approach
  3. Only after the nurse has obtained written permission from the employer's legal team
  4. Only when a patient has already lodged a formal complaint about the practitioner

Explanation

Mandatory notification obligations arise where a practitioner's impairment, departure from accepted standards or misconduct places the public at substantial risk of harm. Personal preference or mere difference in practice style does not meet that threshold.

Question 5Professional practice and ethical conduct

A nurse is asked to witness a patient's signature on a consent form for a procedure the patient does not appear to understand. What is the nurse's most appropriate action?

  1. Witness the signature because witnessing concerns only the authenticity of the signature
  2. Ask the patient's next of kin to sign the form on the patient's behalf
  3. Sign as witness and note in the record that the patient seemed confused
  4. Refuse to witness and arrange for the patient to be assessed and the procedure re-explained Correct answer.

Explanation

Witnessing consent requires the nurse to be satisfied that the patient appears to understand the information and is signing voluntarily. Where understanding is doubtful, the nurse should pause the process and ensure the patient is reassessed and the information re-explained.

Question 6Professional practice and ethical conduct

Which action best demonstrates the professional standard of practising culturally safe care?

  1. Referring all Aboriginal and Torres Strait Islander patients to a liaison officer without further assessment
  2. Ensuring care is delivered in a way that recognises and addresses power imbalances and the person's cultural needs Correct answer.
  3. Providing the same standardised information to every patient regardless of background
  4. Documenting the patient's cultural background in the record and proceeding with routine care

Explanation

Cultural safety requires the nurse to examine power relations and to shape care so that the person feels safe, respected and able to participate in decisions. It is an active process of adapting care rather than a documentation or referral formality.

Question 7Professional practice and ethical conduct

A nurse is offered a valuable gift by a patient's family after a long admission. What is the most professionally appropriate response?

  1. Decline the gift politely and explain the professional boundaries that guide the relationship Correct answer.
  2. Accept the gift because refusing would damage the therapeutic relationship
  3. Accept the gift privately and do not disclose it to colleagues or the employer
  4. Accept the gift only if it is shared among the whole ward team

Explanation

Accepting substantial gifts can create obligations and blur professional boundaries, so it is generally declined with warmth and explanation. Employers may permit token gestures, but the nurse should follow local policy rather than accept privately.

Question 8Professional practice and ethical conduct

Which situation is the clearest example of a nurse breaching the professional boundary of the therapeutic relationship?

  1. Explaining a procedure to a patient using an interpreter
  2. Providing personal care to a patient while maintaining respectful communication
  3. Disclosing the nurse's own intimate relationship problems to a patient during care Correct answer.
  4. Attending a patient's community fundraising event after discharge at the patient's invitation

Explanation

Therapeutic relationships are patient-focused, and disclosing intimate personal problems shifts the focus to the nurse's needs and risks role confusion. Boundary crossings of this kind are not justified by an intention to be friendly.

Question 9Professional practice and ethical conduct

Which of the following is the best example of maintaining patient confidentiality in everyday practice?

  1. Sharing clinical information only with members of the treating team who need it for care Correct answer.
  2. Leaving a patient's care plan visible at the nurses' station so any staff member can read it
  3. Discussing a patient's diagnosis in a lift with a colleague because no family members are present
  4. Posting a de-identified clinical photograph on a personal social media account

Explanation

Confidential information may be shared on a need-to-know basis within the treating team, and the nurse should use the least revealing setting possible. Casual discussion in public areas and personal social media are high-risk practices.

Question 10Professional practice and ethical conduct

A nurse is asked to perform a procedure for which they have received no training and no supervision is available. What is the most appropriate action?

  1. Ask a junior colleague who has observed the procedure once to assist
  2. Perform the procedure and report any adverse event afterwards
  3. Perform the procedure while reading the steps from a manual
  4. Decline to perform the procedure and inform the nurse in charge of the competence gap Correct answer.

Explanation

Nurses must practise within their competence and must not accept delegated activities for which they are not prepared. Declining and escalating is the professional response and protects the patient from avoidable harm.

Question 11Professional practice and ethical conduct

During a medication round a nurse notices they have given a patient another patient's medication. What should the nurse do first?

  1. Complete the round and then write an incident report at the end of the shift
  2. Assess the patient, inform the treating team, and complete an incident report Correct answer.
  3. Record the administration as given to the correct patient to avoid confusion
  4. Wait to see whether the patient develops any adverse effects before reporting

Explanation

After a medication error the immediate priority is patient assessment and clinical management, followed by transparent disclosure and incident reporting. Documenting inaccurately or delaying to observe would compound the harm and breach accountability.

Question 12Professional practice and ethical conduct

A patient discloses that they have been physically assaulted by their partner. What is the nurse's most appropriate initial response?

  1. Contact the partner to discuss the situation and seek their perspective
  2. Listen without judgement, ensure immediate safety, and offer referral to appropriate support services Correct answer.
  3. Document the disclosure but take no further action because the patient must decide independently
  4. Advise the patient to leave the relationship immediately as a condition of ongoing support

Explanation

The nurse's role is to respond with a trauma-informed, non-judgemental approach, prioritise immediate safety and connect the person with specialist support. Decision-making about the relationship remains with the patient.

Question 13Professional practice and ethical conduct

Which statement best explains the principle of open disclosure after a clinical incident?

  1. The patient should receive a timely, honest explanation of what happened and what will be done next Correct answer.
  2. Disclosure should occur only after the investigation has concluded and fault is established
  3. An apology should be avoided because it may be treated as an admission of legal liability
  4. The patient should be told only what the family agrees to disclose

Explanation

Open disclosure is a timely, honest and ongoing communication process with the patient and, where appropriate, their family. It includes an acknowledgement and explanation of what happened and what will be done to address it, and it is not contingent on a completed investigation.

Question 14Professional practice and ethical conduct

A nurse is caring for a patient whose religious beliefs mean they will not accept a particular treatment. The treatment is strongly recommended by the medical team. How should the nurse proceed?

  1. Withhold information about the consequences of refusal so the patient is not distressed
  2. Persuade the patient that the treatment is essential and that their religious view is unreasonable
  3. Respect the patient's decision, explore their concerns, and ensure the team understands the basis of the refusal Correct answer.
  4. Ask the family to override the patient's decision in the patient's best interests

Explanation

Respect for persons requires the nurse to accept a competent patient's values-based decision and to support informed deliberation rather than to coerce. Exploring concerns and communicating them to the team supports good care while preserving the patient's autonomy.

Question 15Professional practice and ethical conduct

A nurse is asked to be involved in a research project recruiting patients from their own clinical area. Which consideration is most important ethically?

  1. Ensuring participation is voluntary and patients do not feel coerced by their treating nurse Correct answer.
  2. Ensuring the nurse receives payment for each patient recruited
  3. Ensuring recruitment occurs only after the nurse's shift has finished
  4. Ensuring the researcher obtains consent from the family as well as the patient

Explanation

The central ethical concern is voluntariness, because patients may feel unable to refuse a request from the nurse providing their care. Recruitment should be structured to minimise coercion, for example through independent approaches.

Question 16Professional practice and ethical conduct

A nurse in a leadership role notices that a new graduate is consistently working through breaks and staying late. What is the most appropriate response?

  1. Ignore it because the graduate needs to build resilience early in their career
  2. Reassign the graduate's patients to other staff without any discussion
  3. Praise the graduate publicly so that others are motivated to work similarly
  4. Discuss workload and wellbeing with the graduate and review rostering and supervision arrangements Correct answer.

Explanation

Nurses in leadership roles are responsible for supporting safe practice and the wellbeing of staff, including those new to the profession. The appropriate response is to explore the causes and adjust systems such as rostering and supervision rather than to normalise unsustainable practice.

Question 17Professional practice and ethical conduct

Which of the following best describes the concept of patient advocacy in nursing practice?

  1. Persuading the patient to accept the treatment that clinicians consider most appropriate
  2. Acting to protect and promote the patient's rights, interests and wishes within the health system Correct answer.
  3. Representing the family's views when they conflict with the patient's expressed wishes
  4. Ensuring the patient complies with the care plan developed by the treating team

Explanation

Advocacy involves supporting the patient's rights, interests and expressed wishes, and raising concerns when these are not being met. It is not about enforcing compliance or substituting another party's preferences.

Question 18Professional practice and ethical conduct

A nurse is caring for an adolescent who asks that their parent not be told about a sexual health consultation. What is the most appropriate approach?

  1. Promise absolute confidentiality and document that no information will ever be shared
  2. Tell the parent because the patient is a minor and parental consent is always required
  3. Refuse to discuss confidentiality unless the patient agrees to involve a parent
  4. Assess the young person's capacity and follow the applicable state or territory law and local policy on confidentiality Correct answer.

Explanation

Confidentiality for minors depends on the young person's capacity and on the law and policy of the relevant jurisdiction. The nurse should assess capacity, support the young person and be clear about the limits of confidentiality rather than promise absolutes.

Question 19Professional practice and ethical conduct

A nurse is asked to complete a mandatory training module during a busy shift. What is the most appropriate way to meet the professional responsibility for continuing professional development?

  1. Ask a colleague to complete the module on the nurse's behalf
  2. Complete the module quickly during care delivery so that the requirement is met
  3. Defer the module and negotiate protected time so learning is completed properly Correct answer.
  4. Skip the module because mandatory training is not part of professional development

Explanation

Registered nurses must maintain competence through continuing professional development, and this requires genuine engagement rather than superficial completion. Negotiating protected time balances the learning obligation with safe care delivery.

Question 20Professional practice and ethical conduct

A nurse observes a colleague who appears to be impaired by alcohol at the start of a shift. What is the most appropriate action?

  1. Allow the colleague to work because the impairment has not yet affected patient care
  2. Remove the colleague from clinical duties and escalate immediately to the nurse in charge Correct answer.
  3. Discuss the concern with other colleagues before deciding whether to escalate
  4. Quietly tell the colleague to go home without informing anyone

Explanation

A nurse who is impaired poses an immediate risk to patient safety, and the observing nurse must act to remove that risk and escalate through the proper channel. Notification obligations may also apply to the regulator and employer.

Question 21Person-centred care and communication

A patient tells a nurse they feel frightened about an upcoming procedure. Which response best demonstrates active listening?

  1. Changing the subject to the consent form that needs signing
  2. Summarising the patient's concern back to them and asking what worries them most Correct answer.
  3. Reassuring the patient that the procedure is routine and nothing to fear
  4. Telling the patient other people cope with the procedure very well

Explanation

Active listening involves reflecting and summarising what the person has said and inviting them to elaborate, which shows the concern has been heard and understood. Reassurance, comparison with others, or diverting to paperwork all close down the conversation rather than explore it.

Question 22Person-centred care and communication

Which action best reflects the principle of person-centred care?

  1. Following the unit routine so that every patient receives identical care
  2. Prioritising tasks that are quickest to complete on the shift
  3. Planning care around what matters to the individual and their preferences Correct answer.
  4. Making decisions for the patient to avoid burdening them

Explanation

Person-centred care tailors decisions and care to the individual's values, preferences, and goals rather than applying a uniform routine. It also supports the person's right to be involved in decisions about their own care.

Question 23Person-centred care and communication

A patient with limited English is struggling to explain their symptoms. Which approach is most appropriate?

  1. Hand the patient a written leaflet and continue with other tasks
  2. Ask a family member to interpret all clinical information
  3. Arrange a professional interpreter and speak directly to the patient Correct answer.
  4. Speak more loudly and slowly in English until understood

Explanation

Professional interpreting services should be used for clinical conversations to ensure accuracy and confidentiality, and the clinician should address the patient directly rather than the interpreter. Using untrained family members risks errors and breaches of privacy.

Question 24Person-centred care and communication

What is the primary purpose of gaining informed consent before a procedure?

  1. To document that the patient signed the form
  2. To speed up the theatre list scheduling
  3. To respect the patient's right to make an autonomous decision Correct answer.
  4. To protect the clinician from legal liability

Explanation

Informed consent exists to uphold the person's autonomy, ensuring they understand the proposed intervention and freely agree to it. Documentation and legal protection are consequences, not the ethical purpose.

Question 25Person-centred care and communication

A nurse wants to confirm a patient's understanding of discharge instructions. Which approach is best?

  1. Asking the patient to explain in their own words what they will do at home Correct answer.
  2. Asking 'Do you understand everything I've said?'
  3. Repeating the instructions more quickly to save time
  4. Giving the patient a printed sheet and asking them to read it later

Explanation

Teach-back asks the person to restate the plan in their own words, which reveals actual comprehension rather than polite agreement. Closed yes/no questions are unreliable because people often say yes to avoid embarrassment.

Question 26Person-centred care and communication

Which behaviour best demonstrates respect for a patient's dignity during personal care?

  1. Rushing the care to minimise the patient's embarrassment
  2. Exposing only the area being washed and covering the rest Correct answer.
  3. Chatting with colleagues about unrelated matters
  4. Keeping the curtain open so staff can monitor the patient

Explanation

Dignity in personal care is maintained by minimising exposure, preserving privacy, and treating the person with courtesy throughout. Keeping the patient covered except for the area being attended to protects modesty and control.

Question 27Person-centred care and communication

A patient declines a recommended treatment after a full discussion. What is the most appropriate nursing response?

  1. Respect the decision while ensuring the patient understands the consequences Correct answer.
  2. Proceed with the treatment because it is in the patient's best interest
  3. Escalate to the family to persuade the patient to agree
  4. Document refusal and cease all further contact about the treatment

Explanation

A competent person has the right to refuse treatment even when clinicians disagree, provided they understand the implications. The nurse's role is to ensure the decision is informed and to continue supporting the person.

Question 28Person-centred care and communication

Which statement best describes empathy in a therapeutic conversation?

  1. Feeling exactly the same emotions as the patient
  2. Avoiding any discussion of the patient's emotions
  3. Understanding the patient's perspective and communicating that understanding Correct answer.
  4. Telling the patient about a similar experience you had

Explanation

Empathy is the capacity to perceive and communicate understanding of another's experience without becoming overwhelmed by it. It is conveyed through acknowledgement and reflection rather than through shared personal stories or emotional fusion.

Question 29Person-centred care and communication

A patient becomes angry and raises their voice during a discussion. Which initial approach is most appropriate?

  1. Stay calm, acknowledge the anger, and explore the concern Correct answer.
  2. Leave the room without explanation
  3. Threaten to withdraw care if the behaviour continues
  4. Raise your voice to establish authority

Explanation

De-escalation begins with maintaining calm, acknowledging the person's emotion, and inviting them to explain the concern. This validates the feeling and reduces the sense of not being heard, which is often driving the anger.

Question 30Person-centred care and communication

Which factor is most likely to undermine a patient's ability to give valid consent?

  1. Being given written information to take away
  2. Having a family member present for support
  3. Being asked to repeat the explanation
  4. Being in severe pain and receiving sedation Correct answer.

Explanation

Valid consent requires capacity, which can be temporarily impaired by severe pain, sedation, or acute illness. Offering information, support persons, and teach-back all support rather than undermine the consent process.

Question 31Person-centred care and communication

What is the most appropriate way to address an older patient when first meeting them?

  1. Address them as 'dear' to show warmth
  2. Ask how they prefer to be addressed Correct answer.
  3. Use their first name to appear friendly
  4. Use their bed number to avoid mispronouncing their name

Explanation

Asking how a person prefers to be addressed respects their identity and autonomy, and avoids assumptions based on age or familiarity. Terms of endearment and bed numbers can feel impersonal or demeaning.

Question 32Person-centred care and communication

A patient says they want their daughter to make all healthcare decisions for them. What should the nurse do first?

  1. Refuse the request because patients must decide alone
  2. Assume the daughter has legal authority and proceed
  3. Discuss the patient's wishes and clarify the legal decision-making arrangements Correct answer.
  4. Ask the daughter to sign the consent forms

Explanation

The nurse should explore the patient's wishes and establish whether a legally recognised substitute decision-maker arrangement exists. Assuming authority or bypassing the patient's own capacity can disempower the person and create legal problems.

Question 33Person-centred care and communication

Which communication technique best supports a patient with early dementia to participate in care planning?

  1. Directing all conversation to the family instead of the patient
  2. Using complex medical terminology to be precise
  3. Speaking rapidly to cover all points before memory fades
  4. Using short sentences, one idea at a time, with visual cues Correct answer.

Explanation

People with cognitive impairment benefit from simplified language, one idea at a time, and visual or written cues to support comprehension and recall. This preserves their involvement and respects their personhood.

Question 34Person-centred care and communication

What does the term 'shared decision-making' mean in practice?

  1. The patient decides alone without clinical input
  2. Clinician and patient exchange information and agree a plan together Correct answer.
  3. The clinician decides and informs the patient afterwards
  4. The family decides on behalf of the patient in all cases

Explanation

Shared decision-making is a collaborative process in which the clinician offers evidence-based options and the patient contributes their values and preferences to reach an agreed plan. Neither party decides in isolation.

Question 35Person-centred care and communication

A patient discloses that they have been experiencing domestic abuse. What is the most appropriate immediate response?

  1. Advise the patient to leave the relationship straight away
  2. Tell the patient you must inform the police immediately
  3. Record the disclosure and continue with the physical assessment
  4. Listen without judgement, acknowledge the disclosure, and explore safety Correct answer.

Explanation

A supportive, non-judgemental response that acknowledges the disclosure and explores immediate safety is the priority. The nurse should follow local safeguarding policy while respecting the person's choices and control over next steps.

Question 36Person-centred care and communication

Which action best demonstrates respect for a patient's cultural needs?

  1. Avoiding any discussion of culture to prevent offence
  2. Assuming all patients from one country have identical beliefs
  3. Applying your own cultural norms as the standard
  4. Asking the patient about their preferences and any cultural needs Correct answer.

Explanation

Cultural safety is achieved by asking the individual about their own needs and preferences rather than making assumptions based on ethnicity. This recognises diversity within groups and supports personalised care.

Question 37Person-centred care and communication

A patient is hard of hearing and does not use sign language. Which adjustment best supports communication?

  1. Shouting from the doorway
  2. Speaking clearly face-to-face in a quiet area with good lighting Correct answer.
  3. Asking a colleague to explain later
  4. Writing everything in small print on a single sheet

Explanation

Face-to-face communication in a well-lit, quiet environment allows lip-reading and reduces background interference, which supports people with hearing loss. Shouting distorts sound and can appear aggressive.

Question 38Person-centred care and communication

What is the main purpose of a nursing handover structured around the patient's own goals?

  1. To replace the need for documentation
  2. To ensure continuity of person-centred care across shifts Correct answer.
  3. To allow staff to complain about difficult patients
  4. To reduce the time spent talking about the patient

Explanation

Handover that includes the person's goals and preferences promotes continuity of individualised care and reduces the risk that the patient's priorities are lost between shifts. It supplements, rather than replaces, formal documentation.

Question 39Person-centred care and communication

A patient refuses a bed bath and asks to wash themselves. How should the nurse respond?

  1. Document non-compliance and inform the team of difficult behaviour
  2. Allow the patient to wash independently while remaining nearby if needed Correct answer.
  3. Insist on providing the bath because it is on the care plan
  4. Skip hygiene altogether for the rest of the shift

Explanation

Supporting independence and choice is central to person-centred care; the nurse should enable self-care and offer assistance if required. Labelling refusal as non-compliance misrepresents a legitimate exercise of autonomy.

Question 40Person-centred care and communication

Which question is most likely to elicit a meaningful account of a patient's concerns?

  1. Why didn't you tell us sooner?
  2. What is the most important thing you would like us to know today? Correct answer.
  3. You're not worried, are you?
  4. Do you have any pain or not?

Explanation

Open, person-centred questions invite the patient to identify their own priorities and encourage fuller disclosure. Leading, closed, or blaming questions restrict or discourage honest responses.

Question 41Person-centred care and communication

A patient's family asks for information about the patient's diagnosis without the patient's permission. What is the correct response?

  1. Give vague hints so the family can work it out
  2. Explain that information cannot be shared without the patient's consent Correct answer.
  3. Ask the family to read the notes on the desk
  4. Provide full details because family are usually involved

Explanation

Confidentiality means information may only be shared with the patient's agreement or where a lawful exception applies. The nurse should explain this politely and offer to discuss with the patient what they wish to share.

Question 42Person-centred care and communication

Which statement about the therapeutic use of touch is most accurate?

  1. Touch should be used with sensitivity to the individual's preferences and context Correct answer.
  2. Touch is always welcome and should be used freely
  3. Touch should never be used in nursing
  4. Touch is only appropriate during physical procedures

Explanation

Touch can convey reassurance but its acceptability varies with culture, personal history, and situation, so consent and context must guide its use. Nurses should be attentive to verbal and non-verbal cues of discomfort.

Question 43Person-centred care and communication

A patient is nearing the end of life and wants to discuss their fears. Which approach is most appropriate?

  1. Tell them to speak to the doctor instead
  2. Sit at eye level, invite them to talk, and listen without rushing Correct answer.
  3. Reassure them that everything will be fine and change the subject
  4. Avoid the topic to protect them from distress

Explanation

People approaching the end of life often need permission and time to express fears; being present, at eye level, and listening without rushing provides that space. Deflection or false reassurance can leave the person feeling isolated.

Question 44Person-centred care and communication

What is the best way for a nurse to support a patient's privacy on a shared ward during a sensitive conversation?

  1. Move to a private space and confirm the patient is comfortable to talk Correct answer.
  2. Ask other patients to cover their ears
  3. Conduct the conversation quietly at the bedside
  4. Discuss the matter later in the corridor

Explanation

Sensitive discussions should take place in a private setting where the person feels able to speak freely. Moving to a suitable space protects confidentiality and dignity better than relying on quiet voices.

Question 45Person-centred care and communication

A patient repeatedly asks the same question about their medication. Which response best reflects person-centred communication?

  1. Tell them they have already been told the answer
  2. Ask a colleague to deal with the patient
  3. Answer patiently and check what is worrying them about the medication Correct answer.
  4. Ignore the question to discourage repetition

Explanation

Repeated questions often signal anxiety or unmet understanding, so a patient, respectful response that explores the underlying worry is appropriate. Dismissing the question can increase distress and erode trust.

Question 46Person-centred care and communication

Which action best demonstrates person-centred care when a patient is admitted to a hospital ward?

  1. Completing the admission form before speaking with the patient to save time
  2. Asking the patient what matters most to them and what they would like to be called Correct answer.
  3. Telling the patient about the ward routine and when meals are served
  4. Assigning the patient a bed near the nurses' station for close observation

Explanation

Person-centred care begins with understanding the person's own priorities, preferences, and identity, including how they wish to be addressed. Seeking this information at admission respects autonomy and builds a therapeutic relationship. Completing tasks before engaging the patient or imposing routines without discussion is task-centred rather than person-centred.

Question 47Person-centred care and communication

Which behaviour by a nurse best supports a patient's autonomy during a care planning meeting?

  1. Making the decision on the patient's behalf to avoid confusion
  2. Asking the patient's family to decide so the patient is not burdened
  3. Presenting the nurse's preferred plan and asking the patient to agree with it
  4. Offering the patient choices within the safe limits of their care and respecting their decisions Correct answer.

Explanation

Autonomy is supported when patients are given meaningful choices and their decisions are respected within safe and lawful limits. This requires the nurse to share information, explore options, and accept the patient's informed preferences. Deciding for the patient or deferring to family without the patient's involvement undermines their right to self-determination.

Question 48Person-centred care and communication

A patient with a new stoma says, 'I feel disgusting and I don't want anyone to see me.' Which response best reflects person-centred communication?

  1. Explain the stoma's anatomy and care in detail so the patient understands it better
  2. Acknowledge the patient's distress and ask what would help them feel more comfortable right now Correct answer.
  3. Tell the patient that focusing on the stoma will only make things worse and suggest distraction
  4. Reassure the patient that many people feel this way at first and that it will pass

Explanation

Person-centred communication validates the patient's emotional experience and explores their immediate needs and preferences rather than imposing reassurance or information. Acknowledging distress and asking what would help demonstrates respect for the patient's feelings and supports their control. This approach also opens the door to further discussion when the patient is ready.

Question 49Person-centred care and communication

During a conversation about goals of care, a patient says, 'I don't know what I want anymore.' What is the nurse's most appropriate response?

  1. Explore what has changed for the patient and what matters most to them now Correct answer.
  2. Suggest the patient discuss it with family and then report back
  3. Recommend the option that most patients in similar situations choose
  4. Change the subject to give the patient time to think

Explanation

When a patient expresses uncertainty, person-centred communication explores the reasons for that uncertainty and revisits what matters to the patient. This helps the patient clarify their own values and goals without the nurse imposing a direction. It also maintains trust and supports shared decision-making.

Question 50Person-centred care and communication

A patient with a life-limiting illness says, 'I'm scared my family won't cope when I'm gone.' Which response best demonstrates advanced person-centred communication?

  1. Reassure the patient that families usually cope well after a loss
  2. Advise the patient to focus on their own health rather than worrying about others
  3. Tell the patient that these feelings are normal and will lessen over time
  4. Explore the patient's specific worries and ask what support they would like to arrange for their family Correct answer.

Explanation

Advanced person-centred communication involves exploring the patient's specific concerns and collaborating on practical and emotional support that aligns with their values. This respects the patient's relational identity and need to care for their family. It also enables the nurse to mobilise appropriate resources.