NMC OSCE Clinical Assessment Skills

Question 1

You are performing a systematic patient assessment using the ABCDE approach. A patient has noisy, gurgling respirations. What is your immediate priority?

Accepted Answer

Open the airway using head tilt, chin lift and suction if necessary

Answer

In the ABCDE approach, Airway always comes first. Gurgling indicates fluid in the airway which must be cleared immediately using suction and appropriate airway manoeuvres. You cannot move to Breathing, Circulation, Disability, or Exposure until the airway is secured.

Question 2

A patient's NEWS2 (National Early Warning Score) is calculated as 7. According to the Royal College of Physicians guidance, what escalation response is required?

Accepted Answer

Emergency response — urgent clinical review by a team with critical care competencies, including a practitioner with advanced airway management skills

Answer

A NEWS2 score of 7 or above triggers an emergency response, requiring urgent assessment by a team with critical care competencies. This may include the critical care outreach team or medical emergency team. The patient should be considered for transfer to a higher level of care.

Question 3

When measuring blood pressure manually, where should the lower edge of the cuff be positioned?

Accepted Answer

Approximately 2-3 cm above the antecubital fossa

Answer

The blood pressure cuff should be placed with the lower edge approximately 2-3 cm above the antecubital fossa (the crease of the elbow). The bladder centre should be over the brachial artery. The cuff should be snug but allow two fingers to be placed underneath. The arm should be supported at heart level.

Question 4

You are assessing a patient's neurological status using the Glasgow Coma Scale (GCS). The patient opens their eyes to pain, makes incomprehensible sounds, and withdraws from pain. What is their GCS score?

Accepted Answer

8 (E2 + V2 + M4)

Answer

GCS is scored across three components: Eye opening to pain = 2, Verbal response (incomprehensible sounds) = 2, Motor response (withdrawal from pain) = 4. Total = 8. A GCS of 8 or below generally indicates the need for airway protection and is a critical threshold in clinical practice.

Question 5

When performing capillary blood glucose monitoring, which finger should ideally be used and where on the finger should the lancet be applied?

Accepted Answer

The side of any finger except the thumb and index finger, avoiding the fingertip centre

Answer

Capillary blood glucose samples should be taken from the side of the finger (the third or fourth finger is preferred) as this area has fewer nerve endings and causes less pain. The thumb and index finger should be avoided as they are used for fine motor tasks. The centre of the fingertip has more nerve endings and should be avoided.

NMC OSCE Practice Test

NMC OSCE Practice Test

NMC OSCE Clinical Assessment Skills