NMC OSCE Medicine Administration 2

Question 1

You are preparing to administer IV medication through a peripheral cannula. What checks must you perform on the cannula site before administration?

Accepted Answer

Check for signs of phlebitis (redness, swelling, pain, palpable venous cord), infiltration, patency by flushing with 0.9% saline, and check the dressing is intact and dated

Answer

Before IV administration, assess the cannula site using the Visual Infusion Phlebitis (VIP) score: check for pain, redness, swelling, palpable venous cord, and pyrexia. Flush with 0.9% sodium chloride to confirm patency (no resistance, swelling, or pain). Ensure the dressing is clean, dry, intact, and dated. Replace the cannula if any signs of phlebitis.

Question 2

A patient refuses to take their prescribed medication. According to NMC standards, what is the correct nursing action?

Accepted Answer

Respect the patient's right to refuse, explain the consequences, document the refusal and reasons, and inform the prescriber

Answer

Competent adults have the right to refuse any treatment, including medication. The nurse must respect this decision, ensure the patient understands the potential consequences of not taking the medication, document the refusal (including the reason if given), and inform the prescriber. Covert administration without consent is only permissible in specific circumstances under the Mental Capacity Act 2005.

Question 3

When reconstituting a powdered antibiotic for intravenous administration, which document should you consult for specific dilution instructions?

Accepted Answer

The Summary of Product Characteristics (SmPC) or local injectable medicines guide

Answer

The Summary of Product Characteristics (SmPC) provides authoritative information on reconstitution diluent, volume, concentration, rate of administration, and compatibility. Many hospitals also have local injectable medicines guides (e.g., Medusa) accessible via the intranet. Using incorrect diluent or concentration can cause drug precipitation, phlebitis, or adverse reactions.

Question 4

A medication error occurs: a patient receives double the prescribed dose of an antihypertensive. What is the correct sequence of actions?

Accepted Answer

Assess the patient for adverse effects, take immediate clinical action if needed, inform the prescriber and nurse in charge, complete a Datix/incident report, and inform the patient using duty of candour

Answer

Patient safety is the immediate priority: assess for adverse effects (hypotension, bradycardia) and take clinical action. Then inform the prescriber and nurse in charge immediately. Complete an incident report (Datix or equivalent). Under duty of candour (NMC Code), inform the patient honestly about what has happened. Reflect on the error to prevent recurrence.

Question 5

What is the maximum volume that should be administered via intramuscular injection at a single site in an adult?

Accepted Answer

5 mL (for large muscles such as ventrogluteal); 2 mL for the deltoid

Answer

The maximum volume for a single IM injection site varies by muscle: ventrogluteal and vastus lateralis can accommodate up to 5 mL, while the deltoid muscle should receive no more than 1-2 mL. Exceeding these volumes causes pain, poor absorption, and tissue damage. Larger volumes should be divided between two sites.

NMC OSCE Practice Test

NMC OSCE Practice Test

NMC OSCE Medicine Administration 2