Nursing Practice & Decision-making

A 16-year-old who fully understands a proposed treatment wishes to consent to it. Under UK law, how should the nurse regard this?

• AA 16-year-old is presumed able to consent to their own treatment✓
• BConsent must always be deferred to a court before treatment can begin
• COnly a parent can give valid consent
• DThe young person cannot give valid consent until they reach the age of 18

Answer: In the UK, people aged 16 and 17 are presumed to have the capacity to consent to their own medical treatment. Younger children may also consent if assessed as Gillick competent.

A patient's NEWS2 score has risen sharply with a new score of 7. What does this indicate the nurse should do?

• AReduce the frequency of observations to avoid disturbing the patient
• BTrigger an urgent clinical review and escalate as per protocol✓
• CWait for the next scheduled medication round
• DContinue routine 12-hourly observations

Answer: A NEWS2 score of 7 or more is a high score that triggers an emergency response, including urgent clinical review and continuous monitoring. Prompt escalation reduces the risk of deterioration and cardiac arrest.

An unconscious patient is brought to hospital after an accident and needs immediate life-saving treatment. There is no advance decision. What is the legal basis for treating them?

• ATreatment may be given in the patient's best interests under the doctrine of necessity✓
• BA court order is required before any treatment
• CNo treatment can be given without written consent
• DTreatment must wait until a relative arrives to consent

Answer: When a patient lacks capacity and there is no valid advance decision, urgent life-saving treatment may lawfully be given in their best interests under the principle of necessity. Waiting for consent would risk serious harm.

A nurse suspects an older patient is being financially abused by a family member. What is the correct action?

• ARaise a safeguarding concern following local policy✓
• BIgnore it as it is a private family matter
• CWait until the patient complains formally
• DConfront the family member directly without evidence

Answer: Nurses have a duty to safeguard adults at risk and must raise a safeguarding concern through local procedures when abuse is suspected. Acting promptly protects the patient from further harm.

Before administering a medicine, which of the following must the nurse check as one of the 'rights' of medicines administration?

• AThe right patient, drug, dose, route and time✓
• BThe right ward stock level
• CThe right colour of the packaging and the right size of box
• DThe right pharmacy supplier

Answer: Safe medicines administration requires confirming the right patient, drug, dose, route and time, along with documentation. These checks reduce the risk of medication errors and patient harm.