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Communicating Information · PSA section guide

Communicating Information in the PSA: what it tests, how it is marked, and a real question

Pick the single most important thing this patient must know about their medicine. Several options may be true; one is the one that prevents harm.

Practise Communicating Information →20 questions free across all sections, no card
6items in the exam
2marks each
12 / 200of the paper
91questions in the bank

At a glance

Items in the exam6
Marks per item2
Share of the paper12 of 200
Question styleSingle best answer from five
Primary skillPrioritising the safety-critical advice
BNF usePatient and carer advice, important safety information, warnings
PassthePSA bank91 questions, rated easy to hard
On PassthePSASingle best answer in the exam's layout
Time at exam pace1 min 12 s

What this section is really testing

  • Distinguishing information that prevents serious harm from information that is merely useful.
  • Knowing the specific warnings attached to specific drugs: the ones the BNF flags under important safety information and patient advice.
  • Reading the patient: pregnancy, driving, occupation, other medicines and the reason they were given the drug all change what matters most.
  • Resisting the clinic reflex of saying everything. The exam wants a ranking, not a list.

A repeatable approach

  1. Name the worst realistic harmFor this drug in this patient, what is the most serious thing that could go wrong?
  2. Ask what the patient must do or avoid to prevent itThat action is the candidate answer.
  3. Check the drug's specific warningsPatient and carer advice, and any important safety information box.
  4. Rank the remaining optionsSerious and specific beats general and practical.
  5. Choose oneThe option that, if unsaid, is most likely to end in harm.

Practise communicating information questions →

BNF strategy for this section

The exam is open book, and the time is short. Know which heading answers which question before you open the monograph.

Drug→Important safety information→Patient and carer advice→Pregnancy / driving / other flags→The one thing to say
What must every patient on this drug be told?
Patient and carer advice
Is there a regulator warning?
Important safety information
Can they drive, drink, get pregnant?
The monograph's cautions and pregnancy sections; driving under patient advice
What symptom means stop and seek help?
Side-effects, and the advice attached to them

The general technique, with drills, is in the BNF speed guide.

A hierarchy for ranking advice

When several options are true, rank them. The top of the hierarchy wins.

  1. 1Immediate serious harm: the warning that prevents a hospital admission or worse.
  2. 2An action the patient must take: report this symptom, do not stop suddenly, take it weekly not daily.
  3. 3A specific warning for this drug: sun, alcohol, driving, pregnancy.
  4. 4Routine practical advice: with food, at night, swallow whole.
An original example

A woman of 26 starts sodium valproate. Take it with food is true. Do not stop it suddenly is true and important. That it must not be used in pregnancy without specialist review and highly effective contraception is the mark, because it sits at the top of the hierarchy for this patient.

Common traps

The useful over the vitalTake with food is true; report unexplained bruising is the mark.
Generic adviceOptions that apply to any drug rarely beat the warning specific to this one.
Forgetting the patientA warning about pregnancy matters more for a 24-year-old than a 74-year-old.
Reassurance as adviceTelling someone a side effect is common is not the same as telling them what to do about it.
The most frequent effectCommon is not the same as dangerous. Rank by harm, not by frequency.

Areas worth being comfortable with

Not predictions. These are the broad clinical areas this section draws on, taken from the shape of the exam and the BNF; being fluent in them makes the lookup fast.

  • Anticoagulants: bleeding, interactions and what to report
  • Antiepileptics and valproate in women of childbearing potential
  • Steroids: not stopping abruptly, sick-day rules, steroid cards
  • Methotrexate: weekly dosing and infection warnings
  • Opioids: sedation, driving, constipation and dependence
  • Antibiotics with alcohol or sun warnings
  • Inhaler technique and preventer versus reliever
  • Insulin and hypoglycaemia awareness
  • Lithium, digoxin and other narrow-margin drugs
  • Drugs that affect driving

A real communicating information question from the bank

This is one of the 20 items every visitor can try free, in the interface the exam uses. Work it before you open the answer.

ID : COM-03Communicating Information2 marksmedium
Case presentation

A 60-year-old woman is started on an oral bisphosphonate for osteoporosis.

PMH: osteoporosis (T-score −2.6), gastro-oesophageal reflux disease.

DH: alendronic acid 70 mg PO once weekly (newly started), colecalciferol.

On examination: no dysphagia.

Investigations: corrected calcium 2.35 mmol/L (2.20–2.60), vitamin D replete.

QuestionSelect the most important instruction for taking this medicine.
(mark it with a tick)
INFORMATION OPTIONS
  • crush the tablet into a hot drink if it is hard to swallow whole
  • take it in the middle of breakfast each week to avoid feeling sick
  • take it last thing at night and stay lying down afterwards
  • take it on an empty stomach with water, upright for 30 minutes
  • take it with a large glass of milk to protect the stomach
Answer and marking
Correct answer

take it on an empty stomach with water, upright for 30 minutes

Marks

2

Explanation

Oral bisphosphonates must be taken on an empty stomach with plenty of water, while sitting or standing upright for at least 30 minutes, to aid absorption and reduce the risk of oesophageal irritation. Two further points belong to this counselling and are commonly missed: calcium and vitamin D supplements, antacids and iron all bind the bisphosphonate in the gut, so they are taken at a different time of day, not with it; and new thigh, hip or groin pain should be reported, because it can rarely be the first sign of an atypical femoral fracture (MHRA Drug Safety Update, atypical femoral fractures with bisphosphonates).

Try another communicating information question →

More free communicating information questions, each with its full explanation

COM-19 · HardA 24-year-old with epilepsy offered a change to sodium valproate2 marks →

Before you submit

  • Have I ranked by harm rather than by how often I would say it?
  • Is my choice specific to this drug?
  • Does it fit this patient's age, pregnancy status and job?
  • Is there a regulator warning I have not considered?
  • Would the patient know what to do after hearing it?

Practice questions

91 Communicating Information questions, easy to hard, marked like the exam

Every answer comes with the explanation and the BNF reference behind it. Twenty questions across all eight sections are free. Pass guarantee: fail after 400+ questions and your access is extended free for 3 months.

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Continue revising

Adverse Drug ReactionsAttributing a presentation to a medicine2 marks per item →Planning ManagementChoosing the correct next treatment step2 marks per item →Drug MonitoringKnowing what to measure, when, and what to do with it2 marks per item →

View all 8 sections and the exam overview →

Section weightings follow the published PSA blueprint. The BNF headings named here are the current online BNF's. Check any dose or threshold against the BNF before you rely on it; this page teaches the method, the BNF holds the numbers.

Practise Communicating Information →