ADC Practice Question — BBFE First Aid & Risk Assessment

What are the legal and ethical implications, and how…

Infection control in the ADC exam tests decision-making around exposure incidents, instrument classification, and decontamination protocols. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

After a needlestick injury, the source patient refuses to consent to blood-borne virus testing. What are the legal and ethical implications, and how does this affect the injured worker's management?

A. If the source refuses testing, no follow-up is needed
B. The source patient has the legal right to refuse testing
C. Force the source patient to be tested
D. The employer can compel the patient to be tested

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: B

The source patient has the legal right to refuse testing — informed consent is required and cannot be overridden, even by court order in most jurisdictions. This means the injured worker must be managed as if the source were potentially positive for HIV, HBV, and HCV: (1) start HIV PEP if the exposure was high-risk (deep hollow-bore needlestick), (2) assess HBV immunity and give HBIG if non-immune, (3) commence HCV surveillance testing. The injured worker should receive counselling about transmission risk, safe sex practices during the surveillance period, and psychological support for the anxiety of not knowing the source status. Document the refusal and the clinical reasoning for the management decisions taken

Source: Odell 4th Ed, Case 31: A Sharps Injury

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Exam preparation FAQ

How are BBFE First Aid & Risk Assessment questions structured in the ADC written exam?

ADC BBFE First Aid & Risk Assessment questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Should I memorise guidelines word-for-word for BBFE First Aid & Risk Assessment?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

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