Unit quiz: Difficult questions, contested concepts and the written record

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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.

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Question 1

A fictional crisis service introduces a short self-report questionnaire scored by total, with the total sorted into low, medium and high bands, and the band attached to the person's record and used to decide who is seen first. The service's rationale is that staff are overloaded and the bands are objective. Using this level's material, what is the strongest criticism?The band replaces a written formulation of needs, triggers and planned actions with a number, which the guideline on self-harm specifically warns against for prediction and stratification, and which also removes the material a clinician actually needs in order to act.The criticism is that total scores from self-report questionnaires are always invalid, because only clinician-rated instruments may be used in an urgent assessment.

Question 2

A fictional clinician asks a person in distress whether they are going to 'do anything silly', receives a no, and records 'no suicidal ideation, low risk'. Two weeks later the person discloses that they had been thinking about ending their life throughout that appointment. What went wrong, in this level's terms?Nothing procedural went wrong: a person who does not disclose thoughts of suicide at a direct appointment cannot be assessed for them, since risk interviewing depends on voluntary disclosure.The question was euphemistic and indirect, so the answer it produced does not establish what the record claims; the plain question about suicide was not asked, the record converted the person's response into a risk verdict, and neither the person's words nor the limits of the inquiry were documented.

Question 3

A fictional team is discussing a man who says he will not take the medication offered because he believes it caused his previous admission. One member of the team says this proves he lacks insight and that the team should proceed on the basis of what is best for him. Using this level's material, what is wrong with that move?It converts a dispute about explanation and a disagreement about treatment into a global rating of insight and then treats that rating as if it settled the separate legal question of whether he can decide for himself.It is wrong because a person who refuses a treatment offered by a team cannot be judged to lack insight, since insight is defined as agreement with the clinical team's view.

Question 4

A fictional note about a 31-year-old woman reads: 'Known drug user, chaotic lifestyle, denies problem use, poor compliance with appointments, unlikely to engage. Habitual use of multiple substances.' Using this level's material, what is the main problem?The note is too detailed about matters that are not clinically relevant, and the correct approach is to record only whether the person is using substances and whether they wish to stop.The note records verdicts about the person rather than an assessment of the use: the substances, pattern, timing, function, context, consequences and the person's own goal are all missing, and the language used carries the judgements the published guidance recommends avoiding.

Question 5

Read this fictional handover paragraph: 'Ms C has a long history of emotional instability and recurrent crises. She was admitted last night after an argument with her partner. She is well known to the team and always difficult to engage. Current plan: continue current management, review as needed.' Which single criticism best captures what is missing, in this level's terms?It is descriptive rather than analytical and contains nothing checkable: no reported or observed findings distinguish the admission, no load-bearing factor is named, no trigger for earlier review is stated, and a decision to take no action beyond routine review is not recorded as a decision.It is too brief, and the remedy is a longer narrative account of Ms C's previous admissions so that the next team has more background.

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