UK Law, Consent and Mental Capacity MCQs

Question 1

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 2

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 3

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 4

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 5

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 6

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 7

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 8

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 9

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 10

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

Question 11

In England, a patient is asked to sign consent for a lumbar puncture. The patient says the clinician explained the purpose but did not discuss important possible complications or alternatives. What should the nurse do?

Accepted Answer

Ask the patient to discuss the missing information with the clinician

Answer

Witness the signature because the patient accepts the procedure

Answer

Explain every possible complication before obtaining the signature

Answer

Proceed because the procedure has already been recommended

Question 12

In England, an adult with capacity agrees to surgery while a relative repeatedly says, “You must do this.” What should the nurse do before accepting the consent?

Accepted Answer

Speak with the patient privately to check the choice is voluntary

Answer

Accept the consent because the patient has said yes

Answer

Ask the relative to sign as an additional witness

Answer

Ask the surgeon to proceed because the treatment is beneficial

Question 13

In England, a 14-year-old who is assessed as Gillick competent asks for confidential sexual health advice. The young person understands the advice and there is no indication of abuse or serious harm. What should the nurse do?

Accepted Answer

Provide confidential advice and explain its limits

Answer

Refuse confidentiality because the patient is under 16

Answer

Tell the parents before discussing the health concern

Answer

Ask the school to decide whether advice can be given

Question 14

In England, an 8-year-old does not understand a proposed routine operation. A parent with parental responsibility gives consent after receiving appropriate information. Which principle applies?

Accepted Answer

The parent may consent when treatment is in the child’s best interests

Answer

The child must give written consent before treatment

Answer

The nurse may consent because the child lacks understanding

Answer

The operation is unlawful unless a court gives permission

Question 15

In England, a 16-year-old understands the purpose, risks and alternatives of a proposed operation and wishes to proceed. What is the most appropriate action?

Accepted Answer

Obtain the young person’s own consent after checking understanding

Answer

Obtain consent only from a parent with parental responsibility

Answer

Treat the young person as unable to consent until age 18

Answer

Delay treatment until a court confirms the young person’s choice

Question 16

In England, a 17-year-old with capacity refuses a non-emergency operation after receiving clear information. The parents demand that staff proceed. What should the nurse do?

Accepted Answer

Stop the preparation and urgently seek senior and legal advice

Answer

Proceed because parental consent overrides the refusal

Answer

Ignore the refusal because the operation is clinically advisable

Answer

Ask the parents to hold the patient during the operation

Question 17

In England, which feature is required for an advance decision to refuse life-sustaining treatment to be legally binding?

Accepted Answer

It is written, signed and witnessed, and states it applies even if life is at risk

Answer

It is spoken to a relative during a hospital admission

Answer

It is recorded by a nurse without the patient’s signature

Answer

It is mentioned casually in a previous outpatient appointment

Question 18

In England, a patient who speaks very little English needs to consent to an invasive procedure. The patient’s adult child offers to interpret. What should the nurse arrange?

Accepted Answer

Use a professional interpreter and check the patient’s understanding

Answer

Use the child because the family knows the patient best

Answer

Ask the patient to sign because the procedure is necessary

Answer

Cancel the procedure permanently because communication is difficult

Question 19

In England, a patient gives verbal consent for a procedure after discussion with the clinician. Which record best demonstrates the consent process?

Accepted Answer

A note of the information given, questions asked and decision made

Answer

The patient’s signature alone on a standard form

Answer

A statement that the treatment is routine and therefore needs no record

Answer

A relative’s confirmation that the patient usually accepts treatment

Question 20

In England and Wales, a patient has a diagnosis of dementia but answers questions accurately and makes a clear decision about accepting antibiotics. What should the nurse conclude?

Accepted Answer

The patient has capacity for this decision unless evidence shows otherwise

Answer

The diagnosis automatically means the patient lacks capacity

Answer

A relative must give consent before treatment can proceed

Answer

The patient must undergo a formal court assessment first

Free UK Law, Consent and Mental Capacity MCQs with Answers