Reading a question
Find the decision you need to make
The stem is the scenario before the answer options. Use this routine to work out what it asks you to resolve.
- Read the instruction. Are you ranking appropriateness or selecting three actions together?
- Check your role. What are you responsible for, what can you safely do, and how are you involved?
- Identify the affected people. Include patients, relatives, colleagues and anyone left without care if you act.
- Separate facts from interpretations. “The nurse reports two missed tasks” is a fact about a report. “The doctor is lazy” is an inference.
- Find the risk and its timescale. What could happen if nothing changes? Is harm occurring, imminent, possible later, or not described?
- Identify the competing responsibilities. For example: supporting a colleague while protecting patients, or involving a family while respecting the patient’s wishes.
- Write a one-sentence task. “I need to find out what’s making the work difficult and arrange safe cover, while being open about the problem.”
Read the options only after you can describe the problem. Then let their exact wording refine your comparison.
Read actions literally
Break an option into verb + recipient + timing + condition.
“Suggest that the nurse speaks to the registrar tomorrow.”
This relies on someone else acting and delays contact until tomorrow. Judge that action as written. “I urgently inform the registrar myself” would be a different option.
Watch for distinctions such as:
| Wording | What to check |
|---|---|
| Ask / tell / insist | Does the level of direction fit the situation? |
| Discuss / report | Is the aim understanding, advice, immediate intervention or formal review? |
| Offer / arrange / confirm | Is help merely mentioned, or actually secured? |
| Privately / in front of the team | Does the setting protect dignity without delaying necessary action? |
| Now / later / if it recurs | Can the described risk safely wait? |
| Explain / reassure / promise | Is the statement true and supported by the facts? |
Work with the facts you’re given
Check that your reasoning uses facts from the question. A prior warning, malicious intent, a patient’s lack of capacity or an unavailable senior could all change the answer, but you need evidence for them. A reported concern also deserves attention even if you didn’t witness it.
Clarification is useful when it can change the response and is safe to obtain. It is weaker when it becomes an excuse to postpone action on a clear danger.
Example: A colleague says they cannot manage their remaining routine jobs. No immediate deterioration is described. The central question is how to understand the workload and arrange safe support. It is not automatically a disciplinary problem, nor proof that the colleague is medically unfit.
If the stem instead says an unreviewed patient is deteriorating, your task changes: obtain urgent clinical help and ensure the patient is attended to. The changed fact, rather than a different attitude to the colleague, explains the changed priority.
Finish with: “What fact would make my preferred action inappropriate?” If that fact is absent, keep it out of your reasoning.
Ready for the next chapter?
Keep track of what you’ve read on this device.