Unit quiz: Formulation, escalation and the ethics of influence

Check understanding, separately from reading

5 questions · 80% to pass · no timer. This quiz checks the lessons in this unit. These authored questions assess recognition and application of the taught distinctions, not professional qualification. You may review the lessons and retry. Repeat attempts reuse the question bank; a remembered answer is not proof of transfer to a new situation.

Saving a lesson records reading only. Previous lesson completions have not been converted into passing scores. You can continue reading without a pass; the assessment remains unpassed.

Question 1

A trainee writes a discharge summary that lists the timeline, the mental state findings, the social circumstances and the diagnosis, all accurately. A supervisor says the document contains no formulation. What is the supervisor asking for?An argued account of why these difficulties arose in this person now, with the load-bearing factors identified, their evidence status marked, and a stated implication for the plan.A more detailed social history, since a formulation is a summary written in the person's own words rather than the clinician's.

Question 2

A fictional patient is judged to need more support. One colleague proposes admission because the person is the most unwell on the caseload; another proposes an intensive home-based crisis service plus a housing worker. Which reasoning decides between them?Choosing the setting with the highest staffing level, because the amount of clinical contact is the best available proxy for unmet need.Naming the specific unmet needs, checking which setting can meet each one, and identifying the least restrictive option, with a plan containing crisis contact, relapse signs and a review date.

Question 3

A fictional man detained under mental health legislation tells the team he will not accept a proposed change in his accommodation. A colleague writes in the notes that he lacks capacity to decide about accommodation. What is wrong with that entry?Capacity was concluded from a refusal and from his legal status rather than assessed against the four abilities for that specific decision, and the entry records a conclusion rather than what he said and did.Nothing, because a person subject to compulsion cannot exercise capacity while the compulsion continues.

Question 4

A fictional 82-year-old with known memory problems becomes agitated and disoriented on the second evening of a hospital admission for a chest infection. A junior clinician suggests a referral to psychiatry for behavioural assessment. What should happen first?An urgent psychiatric referral, because new agitation in a person with cognitive impairment is by definition a behavioural and psychological symptom of dementia.The change should be documented and assessed along the delirium route, since older age and cognitive impairment are recognised risk factors, and the guideline states that where delirium and dementia cannot be distinguished the delirium is managed first.

Question 5

A fictional patient reports months of spinal pain, unrefreshing sleep and fatigue that is worse for a day after any sustained activity. A colleague proposes a graduated programme of fixed weekly increases in exercise. What is the problem with the proposal?The pattern of symptom worsening after exertion is the one the ME/CFS guideline identifies as post-exertional malaise, and programmes built on fixed incremental increases in activity should not be offered, with the framework instead being staying within an energy limit.There is no problem, because graded increases in activity are the standard approach for chronic pain regardless of the pattern of symptom response.

Continuing does not mark this assessment passed.

Progress stays in this browser, on this device—not an account or cloud backup. Clearing browser data removes it. Visits never count as study. Previous untimed legacy completions are not invented as study days.