NAC OSCE History Taking & Communication 2 — Questions and Answers
Question 1: During a paediatric NAC OSCE station, a mother reports her 8-month-old has had decreased oral intake and fever for 2 days. Which developmental milestone question is most relevant to include in this history?
- Whether the infant is sitting with support and babbling (Correct answer)
- Whether the child can read simple words
- Whether the infant can walk independently
- Whether the child has started solid foods at 12 months
Correct answer: Whether the infant is sitting with support and babbling
At 8 months, Canadian Paediatric Society (CPS) milestones include sitting with support and babbling; regression or delay can indicate a serious underlying condition.
Question 2: A 55-year-old male presents with a 2-week history of productive cough and night sweats. Which epidemiological history question is MOST critical in a Canadian context?
- Country of birth and travel history to TB-endemic regions (Correct answer)
- Exposure to asbestos in the workplace
- History of recent influenza vaccination
- Family history of lung cancer
Correct answer: Country of birth and travel history to TB-endemic regions
Canada has a disproportionate TB burden in immigrants from high-prevalence countries; Canadian Tuberculosis Standards require country of birth and travel history as first-line screening questions.
Question 3: In a NAC OSCE psychiatric history station, which Canadian screening tool is recommended for identifying major depressive disorder in primary care?
- PHQ-9 (Patient Health Questionnaire-9) (Correct answer)
- CAGE questionnaire
- GAD-7
- MMSE
Correct answer: PHQ-9 (Patient Health Questionnaire-9)
The PHQ-9 is endorsed by the Canadian Network for Mood and Anxiety Treatments (CANMAT) and widely used in Canadian primary care to screen and monitor depression severity.
Question 4: When taking a medication history in a NAC OSCE station, which additional information is MOST important to elicit beyond drug name and dose?
- Adherence, allergies with reaction type, and over-the-counter or herbal use (Correct answer)
- The dispensing pharmacy name
- The prescribing physician's specialty
- The date the prescription was written
Correct answer: Adherence, allergies with reaction type, and over-the-counter or herbal use
Comprehensive medication reconciliation includes adherence, true allergies versus intolerances (with reaction type), and non-prescription or herbal products, which is a patient safety priority in Canadian hospital and outpatient settings.
Question 5: A 28-year-old Indigenous woman presents for antenatal care. Which culturally safe practice is MOST important to incorporate at this first visit according to Canadian guidelines?
- Ask about traditional practices and preferences without assumptions, and involve family or community supports if desired (Correct answer)
- Assume she is high-risk due to Indigenous background
- Order additional screening tests not ordered for other patients
- Avoid discussing social determinants of health
Correct answer: Ask about traditional practices and preferences without assumptions, and involve family or community supports if desired
SOGC and the National Aboriginal Council of Midwives emphasise culturally safe care that avoids stereotyping, respects traditional practices, and incorporates patient-defined supports for Indigenous women.
Question 6: A patient discloses intimate partner violence (IPV) during a routine history. According to Canadian guidelines, what is the MOST appropriate immediate response?
- Believe and validate the disclosure, assess immediate safety, and provide information on local resources (Correct answer)
- Immediately contact police on the patient's behalf
- Document the disclosure and defer further discussion to a social worker
- Ask the partner to leave and then confront them directly
Correct answer: Believe and validate the disclosure, assess immediate safety, and provide information on local resources
Canadian guidelines from the SOGC and provincial health authorities recommend believing the patient, conducting a safety assessment, and offering community resources while respecting patient autonomy — mandatory reporting for IPV does not apply to competent adults in most Canadian provinces.
NAC OSCE History Taking & Communication 2
During a paediatric NAC OSCE station, a mother reports her 8-month-old has had decreased oral intake and fever for 2 days.
Which developmental milestone question is most relevant to include in this history?