All International Nursing Practice MCQs

Question 1

In England and Wales, a patient is confused after receiving a sedating medicine and cannot explain the decision about a non-urgent procedure. The confusion is expected to improve later. What should the nurse do?

Accepted Answer

Delay the decision if it is safe to do so

Answer

Ask the family to consent immediately

Answer

Assume the patient lacks capacity permanently

Answer

Proceed because the procedure is recommended

Question 2

In England and Wales, a patient lacks capacity to decide about discharge. The patient’s daughter says, “I know exactly what my parent would want,” but there is no health and welfare attorney. What should the nurse do?

Accepted Answer

Use the Mental Capacity Act best interests process

Answer

Accept the daughter’s decision without further assessment

Answer

Ask the daughter to make the legal decision

Answer

Discharge the patient because capacity is absent

Question 3

In England and Wales, a patient with capacity agrees to an operation but then says, “Stop,” while preparations are being made. What should the nurse do?

Accepted Answer

Stop and inform the responsible clinical team

Answer

Continue because consent was already documented

Answer

Ask the family whether treatment should continue

Answer

Continue unless the patient submits a written refusal

Question 4

In England and Wales, a patient lacks capacity to choose a treatment. The patient’s record shows a previous clear objection to that treatment, although the objection is not a formal advance decision. What should the nurse do?

Accepted Answer

Include the previous objection in the best interests assessment

Answer

Ignore the previous objection because capacity is absent

Answer

Treat the objection as an automatic legal refusal

Answer

Ask the nearest relative to cancel the treatment

Question 5

In England and Wales, a patient lacks capacity and needs help with personal care. Two safe approaches are available, but one involves less restriction of the patient’s movement. Which approach best follows the Mental Capacity Act?

Accepted Answer

Choose the approach that limits freedom least

Answer

Use the most restrictive approach for consistency

Answer

Ask staff to decide without consulting the patient

Answer

Avoid all care because capacity is impaired

Question 6

In England and Wales, a patient’s capacity to consent varies during the day because of a fluctuating mental health condition. The patient is alert and can weigh the information this morning. What should the nurse do?

Accepted Answer

Assess capacity for the decision at this time

Answer

Treat the patient as lacking capacity at all times

Answer

Assess capacity only from the medical diagnosis

Answer

Ask a relative to consent instead

Question 7

In England and Wales, an adult with capacity asks the nurse not to involve a relative in a discussion about treatment. The relative offers useful information about the patient’s usual communication. What should the nurse do?

Accepted Answer

Respect the patient’s choice and seek permission for relevant involvement

Answer

Exclude the relative from every aspect of care

Answer

Allow the relative to consent on the patient’s behalf

Answer

Share the full record because the relative is supportive

Question 8

In England and Wales, an unconscious patient arrives with a life-threatening injury and requires immediate treatment. There is no time to establish the patient’s wishes or contact relatives. What should the nurse support the team to do?

Accepted Answer

Provide necessary treatment in the patient’s best interests

Answer

Wait for written family permission before treatment

Answer

Refuse treatment because consent is unavailable

Answer

Ask any available visitor to make the decision

Question 9

In England and Wales, a health and welfare attorney asks staff to refuse a treatment for a patient who lacks capacity. What should the nurse check first?

Accepted Answer

Whether the attorney has relevant valid authority

Answer

Whether the attorney is the patient’s oldest relative

Answer

Whether the attorney has visited recently

Answer

Whether the patient has a financial deputy

Question 10

In England and Wales, a patient who lacks capacity is kept in hospital under continuous supervision and is not free to leave. The arrangement is expected to continue. What should the nurse do?

Accepted Answer

Inform the responsible team that lawful authorisation may be required

Answer

Treat the arrangement as ordinary nursing supervision

Answer

Ask the patient to sign a consent form after admission

Answer

Use family agreement as the only legal safeguard

Question 11

In England and Wales, an adult with expressive aphasia needs to consent to a dressing change. The patient appears to understand the explanation but cannot speak clearly. What should the nurse do?

Accepted Answer

Use communication aids and allow time for a response

Answer

Ask the relative to provide consent for the patient

Answer

Record that the patient lacks capacity to consent

Answer

Proceed because the dressing change is clinically necessary

Question 12

In England and Wales, an adult with capacity refuses a recommended operation because the person considers the possible complications unacceptable. The person understands the information and communicates a clear choice. What should the nurse recognise?

Accepted Answer

The decision is valid even if others consider it unwise

Answer

The decision is invalid because the risks are significant

Answer

The decision requires approval from the next of kin

Answer

The decision proves that the patient lacks capacity

Question 13

In England and Wales, a patient can decide what to wear but cannot understand or weigh information about a proposed operation. Which approach is correct?

Accepted Answer

Assess capacity for the operation as a separate decision

Answer

Record that the patient lacks capacity for every decision

Answer

Ask the family to make all decisions from now on

Answer

Assume capacity because the patient chooses clothing independently

Question 14

In England and Wales, a patient lacks capacity to decide about a feeding procedure. The patient’s sister offers information about the patient’s past wishes, while the clinical team explains the treatment benefits. What should the nurse support?

Accepted Answer

A best-interests decision using the relevant information

Answer

The sister’s personal preference as the final decision

Answer

The treatment that gives the greatest clinical benefit only

Answer

A decision based on the patient’s diagnosis alone

Question 15

In England and Wales, an adult who lacks capacity needs serious medical treatment. There is no health and welfare attorney and no family member or friend who can be consulted appropriately. What should the nurse expect?

Accepted Answer

An Independent Mental Capacity Advocate is appointed

Answer

The nearest relative gives legally binding consent

Answer

The nurse signs consent on behalf of the patient

Answer

The treatment is automatically postponed indefinitely

Question 16

In England and Wales, a patient who now lacks capacity previously wrote a clear statement expressing a preference for care in a particular setting. The statement does not refuse a specific treatment. What should the team do?

Accepted Answer

Consider the statement when deciding the patient’s best interests

Answer

Treat the statement as an automatically binding advance decision

Answer

Ignore the statement because it was written before admission

Answer

Ask the family to replace the statement with their preference

Question 17

In England and Wales, a patient understands and agrees to a wound assessment but cannot sign because of severe hand tremor. What is the most appropriate action?

Accepted Answer

Obtain and document verbal consent before proceeding

Answer

Ask a relative to sign instead of the patient

Answer

Treat the lack of a signature as refusal

Answer

Proceed without consent because assessment is routine

Question 18

In England and Wales, a patient consents to an examination by the registered nurse but does not want a student present. What should the nurse do?

Accepted Answer

Carry out the examination without the student present

Answer

Tell the patient that student involvement cannot be refused

Answer

Ask the student to observe without informing the patient

Answer

Ask a relative to decide whether the student may attend

Question 19

In England and Wales, an adult with schizophrenia needs to decide whether to accept a prescribed treatment. The patient understands, retains and weighs the relevant information and communicates a choice. What should the nurse conclude?

Accepted Answer

The diagnosis alone does not establish lack of capacity

Answer

The diagnosis means the patient cannot give valid consent

Answer

The treatment must be authorised by the patient’s family

Answer

The patient must be assessed as lacking capacity automatically

Question 20

In England and Wales, a patient lacks capacity for a specific treatment decision. The nurse is completing the capacity assessment record. Which documentation is most appropriate?

Accepted Answer

Record the impairment and how it prevents this decision

Answer

Record only the patient’s diagnosis and current location

Answer

Record that the patient is difficult and needs supervision

Answer

Record that the family disagrees with the treatment plan

All Free International Nursing Practice MCQs with Answers