Preoperative assessment: refusal of blood products: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Preoperative assessment: refusal of blood products

Sample item

A competent 45-year-old woman who is a Jehovah's Witness has signed an informed refusal of blood transfusion and is booked for elective hysterectomy. What is the best approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Respect her documented refusal, optimise haemoglobin beforehand, and use blood-conservation techniques

A competent adult may refuse treatment, including life-saving transfusion, and the refusal is respected once informed and documented. The team plans to avoid blood loss by correcting anaemia beforehand, using meticulous surgical technique, tranexamic acid and cell salvage if she accepts it.

Option by option

  • A. Obtain consent from a relative to allow transfusion if it becomes necessary

    A relative cannot consent on behalf of a competent adult who has refused.

  • B. Respect her documented refusal, optimise haemoglobin beforehand, and use blood-conservation techniques (correct)

    Correct. Autonomy is respected and the plan focuses on minimising blood loss.

  • C. Proceed and transfuse if bleeding is life-threatening, because saving life takes priority

    Overriding an informed, documented refusal by a competent adult is not acceptable ethically or legally.

  • D. Cancel all surgery, since care cannot be given without a transfusion option

    Surgery can often be done safely with blood-conservation measures, so cancelling is not required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Respect her documented refusal, optimise haemoglobin beforehand, and use blood-conservation techniques. A competent adult may refuse treatment, including life-saving transfusion, and the refusal is respected once informed and documented.

Why is "Obtain consent from a relative to allow transfusion if it becomes nec…" not the answer?

A relative cannot consent on behalf of a competent adult who has refused.

Why is "Proceed and transfuse if bleeding is life-threatening, because saving…" not the answer?

Overriding an informed, documented refusal by a competent adult is not acceptable ethically or legally.

Why is "Cancel all surgery, since care cannot be given without a transfusion…" not the answer?

Surgery can often be done safely with blood-conservation measures, so cancelling is not required.

What concept does this question test?

It tests Preoperative assessment: refusal of blood products in Anaesthesia. The team plans to avoid blood loss by correcting anaemia beforehand, using meticulous surgical technique, tranexamic acid and cell salvage if she accepts it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Preoperative assessment: refusal of blood products?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.