Exam MCCQE Topic 1 Question 129 Discussion

Actual exam question for Medical Council of Canada's MCCQE exam
Question #: 129
Topic #: 1

A 10-day-old boy is brought to the Emergency Department with a fever. The newborn looks well. Other than a rectal temperature of 38.6 °C, findings of the physical examination are unremarkable. When you list all the recommended testing their baby will have to undergo, the parents become upset at all the testing their baby will have to undergo. Which one of the following is the best approach?

A. Inform the parents that child protection services may be contacted if they refuse care. B. Advise the parents that their child will not remember painful procedures. C. Reassure the parents that their child will be given an appropriate analgesic. D. Proceed with testing and address the parents ' concerns afterwards. E. Encourage the parents not to be present during the procedures.

Suggested Answer: C Vote an answer

A febrile neonate (#28 days old) requires a full sepsis evaluation (e.g., blood cultures, urine testing, lumbar puncture) because of the high risk of serious bacterial infection despite a well appearance. MCCQE objectives emphasize both appropriate medical management and effective communication with parents. When caregivers are distressed about painful procedures, the best approach is empathetic communication and reassurance that adequate analgesia and comfort measures (e.g., topical anesthetic, oral sucrose, swaddling) will be provided.
Threatening child protection involvement is inappropriate unless there is clear refusal of life-saving care after thorough discussion. Saying the infant "will not remember" dismisses parental concerns and undermines trust.
Proceeding without addressing concerns violates principles of shared decision-making. Excluding parents from procedures may increase anxiety and is not routinely recommended.
The physician should acknowledge concerns, explain the rationale for testing (risk of occult sepsis), outline pain-control strategies, and invite questions. This maintains trust while ensuring timely, evidence-based care.

by Devin at Jul 24, 2026, 08:12 PM

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