MOH Clinical Medicine & Patient Safety 2 — Questions and Answers
Question 1: What does the Glasgow Coma Scale (GCS) assess?
- Pain threshold
- Level of consciousness via eye, verbal, and motor responses (Correct answer)
- Depth of anesthesia only
- Psychiatric status
Correct answer: Level of consciousness via eye, verbal, and motor responses
The GCS assesses level of consciousness by evaluating three domains: eye opening (4), verbal response (5), and motor response (6), with a maximum score of 15 indicating full consciousness.
Question 2: Normal oxygen saturation (SpO2) in a healthy adult is:
- 85–90%
- 90–94%
- 95–100% (Correct answer)
- 80–85%
Correct answer: 95–100%
Normal SpO2 in a healthy adult breathing room air is 95–100%; values below 94% indicate hypoxemia requiring clinical assessment and possible oxygen supplementation.
Question 3: A patient in respiratory distress is using accessory muscles. This indicates:
- Normal breathing effort
- Increased work of breathing (Correct answer)
- Patient anxiety only
- Imminent cardiac arrest always
Correct answer: Increased work of breathing
Use of accessory muscles (sternocleidomastoid, scalenes, intercostals) during breathing indicates increased respiratory effort due to airway obstruction, reduced lung compliance, or respiratory fatigue.
Question 4: Pain assessment in non-verbal or cognitively impaired patients should use:
- Self-report scales only
- Behavioral pain observation scales (e.g., PAINAD, FLACC) (Correct answer)
- No formal assessment — clinical judgment only
- Patient family estimates only
Correct answer: Behavioral pain observation scales (e.g., PAINAD, FLACC)
Behavioral pain assessment tools such as PAINAD (for dementia) or FLACC (for children) evaluate observable indicators of pain (facial expression, body movement, crying) in patients unable to self-report.
Question 5: The WHO Surgical Safety Checklist includes a 'Sign In' phase that must be completed:
- After induction of anesthesia
- Before induction of anesthesia (Correct answer)
- After skin incision
- Before the patient leaves the operating room
Correct answer: Before induction of anesthesia
The 'Sign In' phase of the WHO Surgical Safety Checklist is completed before induction of anesthesia to confirm patient identity, site, consent, and anesthesia safety checks.
Question 6: Pressure ulcers most commonly develop over which anatomical area in bedridden patients?
- Lumbar spine
- Sacrum and heels (Correct answer)
- Shoulder blades
- Back of the head
Correct answer: Sacrum and heels
The sacrum and heels are the most common sites for pressure ulcers in bedridden patients due to high-pressure bony prominences with limited soft tissue padding in supine positions.
MOH Clinical Medicine & Patient Safety 2
What does the Glasgow Coma Scale (GCS) assess?