NMC OSCE Emergency Nursing Scenarios

Question 1

You find a patient unresponsive in bed.
After calling for help and confirming they are not breathing normally, what is the correct sequence of actions according to the Resuscitation Council UK guidelines?

Accepted Answer

Call the resuscitation team (2222), start chest compressions at a rate of 100-120 per minute with a depth of 5-6 cm, apply defibrillator pads as soon as available

Answer

Place in the recovery position and wait for the resuscitation team

Answer

Attempt to give oral medications to revive the patient

Answer

Perform mouth-to-mouth ventilation only until help arrives

Question 2

A patient develops anaphylaxis after receiving IV antibiotics. They have widespread urticaria, facial swelling, wheeze, and a blood pressure of 70/40 mmHg. What is the first-line drug treatment?

Accepted Answer

Intramuscular adrenaline 500 micrograms (0.5 mL of 1:1000) into the anterolateral thigh

Answer

Intravenous hydrocortisone 200 mg

Answer

Oral chlorphenamine 4 mg

Answer

Nebulised salbutamol 5 mg

Question 3

A patient with type 1 diabetes is found unconscious with a capillary blood glucose of 1.8 mmol/L. They have no IV access. What is the most appropriate immediate treatment?

Accepted Answer

Intramuscular glucagon 1 mg

Answer

Oral glucose gel rubbed inside the cheek

Answer

Wait for IV access to administer dextrose

Answer

Administer insulin as the glucose reading may be inaccurate

Question 4

A patient develops a major haematemesis (vomiting blood) and becomes haemodynamically unstable. What are the immediate nursing priorities?

Accepted Answer

Call for emergency help, secure two large-bore IV cannulae, commence rapid IV fluid resuscitation, monitor vital signs, position patient on their side, prepare for blood transfusion

Answer

Give oral fluids and reassess in 30 minutes

Answer

Administer oral omeprazole and wait for the doctor

Answer

Perform a PR examination to check for melaena

Question 5

A patient on the ward develops acute chest pain, becomes breathless, and has oxygen saturations of 85%. They have recently undergone hip replacement surgery. What is the most likely diagnosis and what immediate nursing actions are required?

Accepted Answer

Pulmonary embolism — sit upright, high-flow oxygen 15L via non-rebreather, IV access, call medical emergency team, prepare for CTPA and anticoagulation

Answer

Pneumonia — administer oral antibiotics

Answer

Anxiety attack — reassure the patient

Answer

Musculoskeletal chest wall pain — give analgesia

Question 6

A patient with epilepsy has a generalised tonic-clonic seizure that has lasted 5 minutes. What is the first-line medication and how should it be administered?

Accepted Answer

Buccal midazolam 10 mg or rectal diazepam 10 mg; if IV access is available, IV lorazepam 4 mg

Answer

Oral phenytoin 300 mg

Answer

Intramuscular morphine 10 mg

Answer

Inhaled salbutamol 5 mg via nebuliser