Community Medicine — Medical Ethics, NMC MBBS licence examination syllabus (Nepal Medical Council).
Medical ethics — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. They test ethical reasoning rather than legal thresholds, which must come from the NMC code of ethics and current Nepali law.
Level 1–2 — recall and understanding
Q1. For consent to be valid it must be:
A. Written and witnessed
B. INFORMED, VOLUNTARY, and given by someone with CAPACITY
C. Given at least 24 hours before the procedure
D. Countersigned by a relative
ANSWER: B.
Why: those three requirements define valid consent. A signed
form is evidence that a conversation happened — it is not
consent, and a signature without understanding is worthless.
LEARNING POINT: consent is a process and may be withdrawn at
any time.
Q2. Capacity requires that a patient can:
A. Agree with the doctor's recommendation
B. UNDERSTAND, RETAIN, WEIGH and COMMUNICATE a decision
C. Read and write
D. Score normally on a memory test
ANSWER: B.
Why: capacity concerns the PROCESS of decision-making, not
the content of the decision. It is presumed until shown
otherwise and is specific to the decision in question.
LEARNING POINT: capacity may fluctuate — reassess rather than
labelling a person.
Level 3–4 — application and reasoning
Q3. A man who fully understands the explanation refuses
life-saving surgery. The correct action is:
A. Declare him to lack capacity and operate
B. RESPECT THE REFUSAL, explore his reasons and document
C. Ask the family to consent instead
D. Sedate him and proceed
ANSWER: B.
Why: an unwise decision is not evidence of incapacity. He
understands, retains, weighs and communicates, so he has
capacity, and treating him against a capacitous refusal is an
assault on his autonomy.
LEARNING POINT: exploring his reasons often uncovers a fixable
fear or misunderstanding.
Q4. The adult son of a competent elderly patient asks for her
results, saying he manages her affairs. You should:
A. Disclose, since he is her carer
B. ASK THE PATIENT what she wishes to be shared, and with
whom
C. Disclose only the abnormal results
D. Refer him to the medical records department
ANSWER: B.
Why: the information belongs to the patient. A relative's
involvement does not confer a right of access while she has
capacity and can be asked directly.
LEARNING POINT: most patients readily agree to family
involvement once asked — record their wishes.
Q5. A consent form is signed, but the patient speaks a
different language, no interpreter was used, and a
relative translated briefly. The consent is:
A. Valid, because the form is signed
B. Probably INVALID, because it was not informed
C. Valid if the relative speaks both languages
D. Valid if the operation is straightforward
ANSWER: B.
Why: information given in a language the patient does not
understand does not inform. Using a relative as interpreter
also risks filtering and may compromise voluntariness.
LEARNING POINT: repeat the discussion with a proper
interpreter and document it.
Level 5 — exception-based
Q6. A family asks you not to tell a competent patient his
cancer diagnosis. You should:
A. Agree — the family knows him best
B. Tell him immediately regardless of his wishes
C. ASK THE PATIENT how much he wants to know
D. Tell only the nursing staff
ANSWER: C.
Why: the information belongs to the patient, so the family's
wish does not override him — but a patient who genuinely
prefers not to be told is also exercising autonomy. Asking
respects both possibilities, and the family's fear should be
explored too.
LEARNING POINT: both concealing the truth and forcing it can
breach autonomy.
Q7. A drug error caused temporary harm from which the patient
recovered completely. She is unaware. You should:
A. Say nothing, as no lasting harm occurred
B. TELL HER, apologise, explain, and report the incident
C. Record it in the notes only
D. Tell her only if she asks
ANSWER: B.
Why: patients are entitled to know what happened to them.
Recovery does not remove the duty of honesty, and concealment
turns a clinical error into a breach of trust that is far more
damaging if later discovered.
LEARNING POINT: reporting allows the underlying system problem
to be corrected.
Syllabus points
Recall and understanding questions
Application and reasoning questions
Exception-based questions
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