OSCA PREP QUESTIONS Stage 3 2024 (1) (AutoRecovered)
OSCA PREP QUESTIONS Stage 3 2024 (1) (AutoRecovered)
OSCA PREP QUESTIONS Stage 3 2024 (1) (AutoRecovered)
S: Situation
B: Background
A: Assessment
R: Recommendation
This structured format helps ensure that critical information is effectively communicated during
handovers, particularly in healthcare settings. Each component prompts the communicator to provide
essential details about the patient's condition, background, current assessment, and
recommendations for further care or actions
6 Rights of Medication
Administration:
1. Right Patient: Verify the
patient's identity using at
least two unique identifiers
(e.g., name, date of birth) to
ensure the medication is
given to the correct
individual.
2. Right Medication: Confirm
that the medication
matches the prescribed
drug therapy for the
patient, including the name,
dosage, form, and route.
3. Right Dose: Administer the
medication at the
prescribed dose. Pay
attention to the
concentration of the
medication and calculate
the correct dosage based
on the patient's weight,
age, and other factors as
applicable.
4. Right Route: Ensure that
the medication is
administered by the correct
route (e.g., oral,
intravenous, intramuscular)
as prescribed by the
healthcare provider.
5. Right Time: Administer the
medication at the
scheduled time specified in
the prescription to maintain
therapeutic effectiveness
and avoid potential
complications.
6. Right Documentation:
Record the medication
administration promptly
and accurately in the
patient's medical record,
including the name of the
medication, dosage, route,
time, and any relevant
patient response.
3 Checks of Medication
Administration:
1. First Check (Preparation):
Verify the
medication order
against the
medication
administration
record (MAR).
Check the
medication label for
accuracy, including
the name, strength,
dosage, and
expiration date.
Assess the patient's
allergies and
contraindications to
ensure safety.
2. Second Check (Before
Administration):
Recheck the
medication against
the MAR and verify
the patient's identity.
Confirm any special
considerations (e.g.,
dosage adjustments,
specific
administration
instructions).
3. Third Check (After
Administration):
Evaluate the
patient's response to
the medication,
including any
expected therapeutic
effects or potential
adverse reactions.
Document the
medication
administration and
patient response
accurately.
1. STAT:
Meaning:
Immediately or at
once; indicating that
a medication or
procedure should be
done urgently or
without delay.
Example: "Give the
medication STAT"
means to administer
the medication
immediately.
2. XR:
Meaning: Extended
Release.
Example: "Take one
XR tablet daily"
indicates a
medication
formulation
designed for
prolonged release
over time.
3. NEB:
Meaning: Nebulizer
or Nebulized.
Example:
"Administer
albuterol via NEB
every 4 hours as
needed" refers to
using a nebulizer to
deliver albuterol for
respiratory
treatment.
4. W:
Meaning: With.
Example: "Take this
medication with
food" means to
consume the
medication while
eating or after
eating.
5. S/C:
Meaning:
Subcutaneous.
Example: "Inject
insulin S/C into the
abdomen" refers to
administering insulin
into the fatty tissue
beneath the skin.
6. N:
Meaning: Normal.
Example: "Patient's
vital signs are within
N limits" suggests
that the patient's
vital signs are within
normal range.
b) Angle:
Insert the needle at a 90-degree angle (perpendicular) to the skin surface. This allows the
medication to be injected directly into the muscle tissue.
c) Site:
b) Angle:
Insert the needle at a 45-degree angle to the skin surface for most adults. For patients with a
very thin layer of subcutaneous fat, a 90-degree angle may be used.
c) Site:
Additional Considerations:
Aspiration: For IM injections, aspirate (pull back) on the syringe plunger slightly after inserting
the needle to check for blood return, which helps ensure that the needle is not in a blood vessel
before injecting the medication.
Injection Technique: Always follow proper aseptic technique, including site preparation and
needle disposal, to minimize the risk of infection and ensure patient safety.
These guidelines are general recommendations and may vary based on specific patient characteristics,
the type of medication being administered, and healthcare provider preferences. It's important for
healthcare professionals to receive training and follow institutional protocols when performing
injections.
1. Observe Behavior: Watch for facial expressions, body movements, and vocalizations that may
indicate pain.
2. Use Pain Assessment Tools: Employ specialized scales like PAINAD or CPOT designed for non-
verbal patients.
3. Clinical Examination: Check for physical signs of pain such as localized tenderness or guarding.
4. Consult Caregivers: Gather insights from those familiar with the patient's behavior.
5. Trial Pain Relief: Consider a trial of pain medication to evaluate response.
6. Document and Reassess: Record findings and monitor pain status regularly.
4. Where would you find medications if they are not in the patient’s drawer?
1. Ward Imprest: In some healthcare settings, medications are stocked in a designated area called the ward
imprest. This is a supply of commonly used medications that are readily available for patients on the
ward. If a specific medication is not in the patient’s drawer, you can check the ward imprest to see if it’s
stocked there1.
2. Pharmacy: If a medication is not available in the ward imprest or the patient’s drawer, you can contact
the ward pharmacist. They can arrange for the medication to be dispensed for the individual
patient. Alternatively, the original order on the NIMC (National Inpatient Medication Chart) or other
approved medication chart can be sent to the pharmacy for dispensing1.
1. Describe two signs and symptoms this client might suffering from chest pain.show if she is
Pain or Discomfort in the Chest:
a. Sensation of pressure, tightness, heaviness, or discomfort in the chest.
b. Pain may be sharp, stabbing, burning, or squeezing.
c. Often felt behind the breastbone or in the left side of the chest, and may radiate to the
neck, jaw, shoulders, arms, back, or abdomen.
Shortness of Breath (Dyspnea):
d. Difficulty breathing or sensation of breathlessness.
e. Feeling like you cannot get enough air, especially with exertion or lying flat.
Oxygen should be administered to a client with chest pain if their oxygen saturation levels fall below 94%. This is
to ensure that the heart muscle receives enough oxygen to function properly.
The strength of Glyceryl Trinitrate (GTN) varies by formulation: sublingual tablets range from 300 to 800
micrograms (mcg) per tablet, sublingual spray delivers around 400 mcg per spray, and transdermal patches come
in strengths of 5 to 20 milligrams (mg) for controlled release over time.
5. How is it given
Sublingual: Tablets are placed under the tongue to dissolve or spray is administered
under the tongue for rapid absorption.
Transdermal: Patches are applied to clean, non-hairy skin on the chest or upper arm.
Intravenous (IV): Given directly into a vein in hospital settings for immediate effect.
The specific administration method depends on the medical condition and patient's needs. Always
follow healthcare provider instructions for safe and effective use of GTN.
Always assess the patient's medical history and current condition before giving GTN to ensure safety
and avoid potential complications.
1. Describe two signs and symptoms this client may experience if he were suffering from acute respiratory distress
Two key signs of acute respiratory distress include:
1. Difficulty Breathing (Dyspnea): Rapid, shallow breathing with visible effort or feeling of
suffocation.
2. Cyanosis: Bluish discoloration of the skin, especially around lips and fingertips, due to oxygen
deprivation.
3. Identify three oxygen delivery devices and the appropriate flow rate for each.( Page 45 )
4. What history might a patient have that would limit the amount of oxygen they can have and what is the maximum
they can receive?
Answer; Patients with conditions like COPD, interstitial lung disease, hypercapnia, respiratory failure, or
pulmonary hypertension may have limitations on the amount of oxygen they can safely receive. The
maximum oxygen they can receive is typically adjusted to maintain oxygen saturation (SpO2) levels
between 88-92% to avoid complications such as worsening respiratory drive, CO2 retention, or oxygen
toxicity. Oxygen therapy should be carefully monitored and individualized based on the patient's specific
medical history and condition. Always seek guidance from a healthcare professional for appropriate
oxygen therapy management.
Allergic Reaction:
Anaphylaxis:
Monitor vital signs frequently (blood pressure, pulse, and respiratory rate).
Adjust patient positioning (e.g., elevate legs if not contraindicated).
Administer intravenous fluids or vasopressors per provider's orders.
Notify the healthcare provider promptly for further interventions.
Respiratory Depression:
1. Identify 3 areas of preoperative education that will benefit your patients post op recovery.
Preoperative education plays a crucial role in preparing patients for their postoperative recovery. Here
are three areas of preoperative education that can significantly benefit patients during their post-op
recovery:
2. Your pt has received their premed for their operation and you identify that they have not signed their consent.
Why is this significant?
In short, it is significant if a patient has not signed their consent for an operation after receiving
premedication because:
Legal and Ethical Implications: Without signed consent, the procedure may be considered
unauthorized and pose legal and ethical issues regarding patient autonomy and decision-
making.
Patient Safety: Consent ensures that the patient is fully informed about the procedure, risks,
and alternatives, contributing to patient safety and informed decision-making.
Risk of Complications: Proceeding without proper consent may lead to complications, disputes,
and potential legal repercussions for the healthcare provider.
1. List three things you would check for when observing an IVC site?
2. Your Pt’s IV infusion pump alarms saying occlusion downstream, identify the possible causes?
3. Your patient’s IV antibiotics were commenced 10 minutes ago and she has developed a rash. What are your
actions?
4. Identify two signs and symptoms of a fluid overload and what medication would you administer.
1. What is the rate for compressions during CPR
The recommended rate for chest compressions during CPR is 100-120 compressions per minute. This
rate is crucial for effective blood circulation and maximizing the chances of survival during cardiac arrest.
2. What does PQRST stand for?
3. Name 3 components of Neurological assessment?
4. Name 3 components of Neurovascular assessment?
5. What does PEARL stand for?
6. Describe two signs and symptoms of a narcotised patient.
1. Normal BGL range and terminology for above and below normal range?
2. What would you do if pt 3.5mmol?
1. Assess the patient for symptoms of low blood sugar and their level of consciousness.
2. Give the patient a rapid-acting source of sugar like glucose tablets, juice, or sugar-containing
drinks if they can swallow safely.
3. Recheck their blood glucose after 15 minutes.
4. Monitor the patient closely and seek medical help if needed.
5. Identify and address the cause of hypoglycemia to prevent recurrence.
It appears you are asking about a scenario involving a patient with a blood glucose level of 3.5 mmol/L.
A blood glucose level of 3.5 mmol/L indicates hypoglycemia (low blood sugar). Here are steps that can
be taken in response to this situation:
1. Assess the Patient: Evaluate the patient's symptoms and level of consciousness. Symptoms of
hypoglycemia can include sweating, trembling, confusion, irritability, weakness, and palpitations.
Severe hypoglycemia can lead to loss of consciousness.
2. Administer Rapid-Acting Carbohydrates: If the patient is conscious and able to swallow safely,
provide them with a fast-acting source of sugar to raise their blood glucose levels quickly.
Examples include glucose tablets or gel, sugar cubes, fruit juice, or non-diet soda.
3. Recheck Blood Glucose: After administering the sugar, recheck the patient's blood glucose level
after 15 minutes to ensure it has risen to a safe level (above 4 mmol/L).
4. Monitor the Patient: Stay with the patient and monitor their condition closely. If symptoms
persist or worsen, seek medical assistance immediately.
5. Identify and Address Underlying Cause: Determine why the patient's blood glucose dropped.
Common causes include delayed or missed meals, excessive insulin or diabetic medication dose,
increased physical activity, or alcohol consumption.
6. Prevent Recurrence: Educate the patient and their caregivers about hypoglycemia prevention
strategies, such as regular meal timing, appropriate insulin or medication dosing, and carrying a
source of fast-acting sugar.
7. Seek Medical Attention if Necessary: If the patient's condition does not improve with initial
treatment, if they become unconscious, or if they are unable to swallow safely, call emergency
services for immediate medical attention.
It's important to respond promptly to hypoglycemia to prevent complications and ensure the patient's
safety. If you are a healthcare provider managing a patient with hypoglycemia, always follow
institutional protocols and guidelines for treatment and management
4. Identify nursing actions once the Patient’s BGL is above 4mmol (for both oral and NBM)
7.Outline the signs and symptoms of ketoacidosis High blood sugar levels (typically >250 mg/dL or 13.9
mmol/L)
Fruity breath odor
Deep, rapid breathing (Kussmaul breathing)
Excessive thirst (polydipsia) and frequent urination (polyuria)
Nausea, vomiting, or abdominal pain
Weakness or fatigue
Confusion or altered mental status
Flushed, dry skin
Difficulty breathing
Decreased consciousness or coma
8.What tests would you use to establish if your patient was developing ketoacidosis To establish if a patient
is developing ketoacidosis, several tests can be used to assess blood glucose levels, acid-base balance,
and ketone levels. These tests include:
7. What is a primary and secondary survey Detailed medical history taking (if possible).
Comprehensive physical examination of all body systems.
Additional diagnostic tests (e.g., imaging studies, laboratory tests) as needed based on findings
from the primary survey.
Monitoring of vital signs and reassessment of interventions initiated during the primary survey.
8. What ketone level would you expect of a pt at risk of DKA (above 1.5 mmols)
Follow up care post insulin administration Monitor blood glucose levels regularly.
Watch for signs of hypoglycemia (low blood sugar) and treat promptly if needed.
Educate the patient on insulin use, hypo- and hyperglycemia symptoms, and appropriate actions.
Provide dietary guidance and encourage meal planning.
Recommend regular physical activity tailored to the patient's needs.
Reinforce medication adherence and schedule follow-up appointments.
Educate on recognizing and managing diabetic emergencies.
Address psychosocial factors impacting diabetes management.
Collaborate with the healthcare team for comprehensive care and support.
9.
1. Your patient has agreed to Palliation, how often would you perform their observations.
2. Formulate your nursing interventions and priorities of care of your palliative patient.
1. How would you identify increasing confusion in a pt with Alzheimers.
2. What method or tools could you use to assess her pain
3. Your patient become aggressive and threatening, what de-escalation tactics can you use?
PT EDUCATION
1. Identify the impact on wound healing/BGL/post-op recovery of:
- chronic hyperglycaemia
- smoking
- decreased mobility
- excessive alcohol intake
2. Provide health education regarding (including support services available and potential nursing interventions)
- Stopping smoking
- Alzheimer’s disease
- Palliative care
- Diabetes (acute and chronic) What information can you discuss with the patient to determine his
understanding of his condition, medications and management strategies
Terminology: please provide a definition and explain what it is. Fluid overload
CVA (Cerebrovascular accident) NBM
CAD (coronary artery disease) Osteoarthritis
Angina Major depression as per DSM-5 and management
Angioplasty
Bowel Resection
Bowel Obstruction 1. Fluid Overload:
COPD (and SpO2 range) Definition: Fluid overload, also
Epilepsy known as hypervolemia, occurs
Hemiplegia when there is an excessive
Dysphagia accumulation of fluid in the body.
Hypercholesterolemia
Explanation: This condition can
HT or HTN - Hypertension
result from various causes, such as
T1DM or T2DM
heart failure, kidney disease, liver
#NOF
disease, or excessive fluid intake.
Symptoms may include swelling
(edema), shortness of breath, and
increased blood pressure.
1. CVA (Cerebrovascular Accident): Treatment involves addressing the
underlying cause and may include
Definition: CVA, commonly known as a
diuretic medications to help
stroke, occurs when blood flow to a
remove excess fluid.
part of the brain is interrupted or
reduced, leading to damage or death 2. NBM (Nil by Mouth):
Definition: NBM is a medical
of brain cells.
Explanation: Strokes can be caused by
abbreviation that means a patient
a blocked artery (ischemic stroke) or should not be given any food or
the leaking or bursting of a blood liquids by mouth.
vessel (hemorrhagic stroke). Symptoms Explanation: Nil by Mouth status is
may include sudden numbness or often implemented before surgery,
weakness, confusion, trouble speaking certain medical procedures, or if
or understanding speech, and difficulty there's a risk of aspiration (where
walking. food or liquids enter the airway
2. CAD (Coronary Artery Disease): instead of the stomach). Patients
Definition: CAD is a condition where may receive necessary fluids and
the blood vessels that supply blood to nutrition through intravenous (IV)
the heart become narrowed or blocked lines.
due to a buildup of plaque (cholesterol 3. Osteoarthritis:
deposits) in the coronary arteries. Definition: Osteoarthritis is the
Explanation: CAD can lead to chest most common form of arthritis,
pain or discomfort known as angina, characterized by the breakdown of
and it increases the risk of heart cartilage in joints and subsequent
attacks and other heart-related damage to underlying bone.
problems. Explanation: It commonly affects
3. Angina: weight-bearing joints such as the
Definition: Angina is chest pain or knees, hips, spine, and hands.
discomfort that occurs when the heart Symptoms include joint pain,
muscle doesn't get enough oxygen- stiffness, and reduced range of
rich blood. motion. Treatment focuses on pain
Explanation: Angina is 9often a management, maintaining joint
symptom of CAD. It can feel like function, and lifestyle
pressure, squeezing, heaviness, or modifications such as exercise and
tightness in the chest. It can also occur weight management.
in the shoulders, arms, neck, jaw, or 4. Major Depression as per DSM-5 and
back. Management:
4. Angioplasty: Definition: Major Depression,
Definition: Angioplasty is a procedure according to the Diagnostic and
to widen narrowed or blocked arteries, Statistical Manual of Mental
usually performed in the coronary Disorders, Fifth Edition (DSM-5), is
arteries of the heart. a mood disorder characterized by
Explanation: During angioplasty, a persistent feelings of sadness,
balloon-tipped catheter is inserted into hopelessness, and loss of interest
the blocked artery and inflated to or pleasure in activities.
compress the plaque against the artery Explanation: To diagnose major
walls, restoring blood flow. Sometimes depression, specific criteria must
a stent (a small mesh tube) is placed to be met, including the presence of
keep the artery open. depressive symptoms lasting at
5. Bowel Resection: least two weeks. Treatment
Definition: Bowel resection is a surgical typically involves a combination of
procedure to remove a damaged or psychotherapy (such as cognitive-
diseased part of the intestine (bowel). behavioral therapy) and
Explanation: It is often performed to antidepressant medications (such
treat conditions such as bowel as selective serotonin reuptake
obstruction, tumors, or inflammatory inhibitors or SSRIs). Lifestyle
bowel disease. changes and support from family
6. Bowel Obstruction: and friends are also essential
Definition: Bowel obstruction is a components of managing major
blockage in the intestines that depression.
prevents the normal movement of
food, fluids, and gas through the
digestive tract.
Explanation: Symptoms of bowel
obstruction include severe abdominal
pain, bloating, constipation, vomiting,
and inability to pass gas.
7. COPD (Chronic Obstructive Pulmonary
Disease): Abbreviations:
Definition: COPD is a chronic N/S
inflammatory lung disease that causes IVC
obstructed airflow from the lungs. BGL’s
Explanation: Common forms of COPD HR
include emphysema and chronic #NOF
bronchitis. SpO2 (pulse oximetry) NP
range for COPD patients is typically SOB
88-92% or higher. HTN
CAD
8. Epilepsy:
PCA
Definition: Epilepsy is a neurological
DKA
disorder characterized by recurrent,
unprovoked seizures. N/S - Normal saline (a common
Explanation: Seizures can vary widely in intravenous fluid)
severity and type, ranging from brief IVC - Intravenous cannula (a small tube
lapses of attention to severe and placed into a vein to administer fluids or
prolonged convulsions. medications)
9. Hemiplegia: BGL’s - Blood glucose levels
Definition: Hemiplegia is a condition (measurement of the amount of glucose
characterized by paralysis (weakness or in the blood)
inability to move) on one side of the HR - Heart rate (number of heartbeats
body. per minute)
Explanation: Hemiplegia is often #NOF - Fractured neck of femur (a
caused by a stroke or brain injury common type of hip fracture)
affecting one side of the brain, leading NP - Nurse practitioner (a registered
to paralysis on the opposite side of the nurse with advanced training)
body. SOB - Shortness of breath (difficulty
10. Dysphagia: breathing)
Definition: Dysphagia is difficulty or HTN - Hypertension (high blood
discomfort in swallowing. pressure)
Explanation: Dysphagia can be caused CAD - Coronary artery disease (narrowing
by neurological disorders, muscular or blockage of the coronary arteries)
disorders, or structural problems in the PCA - Patient-controlled analgesia (a
throat or esophagus. method of pain control where patients
11. Hypercholesterolemia: self-administer small doses of pain
Definition: Hypercholesterolemia is a medication)
condition characterized by high levels DKA - Diabetic ketoacidosis (a serious
of cholesterol in the blood. complication of diabetes where the body
Explanation: Elevated cholesterol levels produces excess blood acids called
can increase the risk of developing ketones)
CAD and other cardiovascular diseases.
12. HT or HTN (Hypertension):
Definition: Hypertension, or high blood
pressure, is a common condition in
which the long-term force of the blood
against the artery walls is consistently
too high.
Explanation: Hypertension can lead to
serious health problems such as heart
disease, stroke, and kidney failure if left
untreated.
13. T1DM or T2DM:
Definition:
T1DM: Type 1 Diabetes Mellitus
is a chronic condition where the
pancreas produces little or no
insulin.
T2DM: Type 2 Diabetes Mellitus
is a chronic condition where the
body becomes resistant to
insulin or doesn't produce
enough insulin.
Explanation: Both types of diabetes
result in high blood sugar levels, which
can lead to various complications if not
managed properly.
14. #NOF:
Definition: #NOF refers to a fractured
neck of femur, which is a common type
of hip fracture.
Explanation: This injury often requires
surgical intervention to repair and
rehabilitative care to restore mobility
and function
Resources
Diabetes
User Guide to National Insulin Subcutaneous Order and Blood Glucose Record: Adult (pg 23, section
10.2)
Type 1 diabetes | Diabetes Australia
Depression
COPD
Angiogram
Bowel resection
Osteoarthritis
#NOF
Hip Fracture Clinical Care Standard | Australian Commission on Safety and Quality in Health Care