NMC OSCE Medicine Administration — Questions and Answers
Question 1: According to NMC standards, what are the five rights of medication administration that must be verified before giving any medicine?
- Right patient, right drug, right dose, right route, right time (Correct answer)
- Right patient, right drug, right dose, right nurse, right documentation
- Right patient, right drug, right ward, right consultant, right time
- Right patient, right drug, right dose, right cost, right pharmacy
Correct answer: Right patient, right drug, right dose, right route, right time
The five rights of medication administration are: right patient (check identity using at least two identifiers), right drug (check against prescription), right dose (verify calculation), right route (oral, IV, IM, etc.), and right time (correct frequency and timing). Some frameworks now include additional rights such as right documentation and right to refuse.
Question 2: A patient is prescribed insulin via subcutaneous injection. Which sites are appropriate for subcutaneous insulin injection and what technique should be used?
- Abdomen (avoiding 5cm around the umbilicus), outer thigh, upper arm, or buttock; inject at 90 degrees into a skin fold using a short needle (Correct answer)
- Only the deltoid muscle at 90 degrees
- The antecubital fossa at 45 degrees
- Any site on the torso at 15 degrees
Correct answer: Abdomen (avoiding 5cm around the umbilicus), outer thigh, upper arm, or buttock; inject at 90 degrees into a skin fold using a short needle
Subcutaneous insulin injection sites include the abdomen (fastest absorption, avoiding 5cm around the umbilicus), outer thigh, upper outer arm, and buttock. A 90-degree angle with a short needle (4-8mm) into a gentle skin fold is recommended. Sites should be rotated systematically within the same body region to prevent lipohypertrophy.
Question 3: You need to administer an intramuscular injection to an adult patient. Using the ventrogluteal site, what is the correct landmark technique?
- Place the palm over the greater trochanter, the index finger on the anterior superior iliac spine, and the middle finger towards the iliac crest — inject into the V formed between the fingers (Correct answer)
- Divide the buttock into four quadrants and inject into the upper outer quadrant
- Inject into the middle of the lateral thigh
- Inject 2 inches below the acromion process
Correct answer: Place the palm over the greater trochanter, the index finger on the anterior superior iliac spine, and the middle finger towards the iliac crest — inject into the V formed between the fingers
The ventrogluteal site is the preferred IM injection site for adults as it has no major nerves or blood vessels nearby. The landmarks are: palm on the greater trochanter, index finger on the ASIS, middle finger stretched towards the iliac crest, forming a V-shaped area. Inject into the centre of this V at 90 degrees using a Z-track technique.
Question 4: A patient has a known penicillin allergy documented as anaphylaxis. The doctor prescribes co-amoxiclav (Augmentin). What should the nurse do?
- Withhold the medication and immediately contact the prescriber, as co-amoxiclav contains amoxicillin which is a penicillin (Correct answer)
- Administer the medication as prescribed since co-amoxiclav is different from penicillin
- Give a test dose and observe for 30 minutes
- Administer with antihistamine cover
Correct answer: Withhold the medication and immediately contact the prescriber, as co-amoxiclav contains amoxicillin which is a penicillin
Co-amoxiclav (Augmentin) contains amoxicillin, which is a penicillin antibiotic. It must NOT be given to a patient with a documented penicillin allergy, especially one with a history of anaphylaxis. The nurse must withhold the drug, document the reason, and contact the prescriber immediately for an alternative antibiotic.
Question 5: When administering a controlled drug (Schedule 2) in a hospital setting, what specific procedure must be followed according to NMC and UK regulations?
- Two registered practitioners must check, prepare, and witness administration; the entry must be recorded in the controlled drug register with both signatures (Correct answer)
- A single nurse can administer after checking with the pharmacist by phone
- Only doctors can administer controlled drugs
- No special procedures are needed beyond standard drug administration
Correct answer: Two registered practitioners must check, prepare, and witness administration; the entry must be recorded in the controlled drug register with both signatures
Schedule 2 controlled drugs (e.g., morphine, fentanyl, oxycodone) require a second registered practitioner to independently check the prescription, prepare the dose, witness administration, and sign the controlled drug register. The stock balance must be checked and recorded. Any discrepancy must be reported immediately.
Question 6: A prescription states: 'Amoxicillin 500mg TDS PO for 7 days.' How many doses should the patient receive in total?
- 21 doses (3 times daily for 7 days) (Correct answer)
- 7 doses
- 14 doses
- 28 doses
Correct answer: 21 doses (3 times daily for 7 days)
TDS (ter die sumendum) means three times daily. PO means per os (by mouth). Therefore, 3 doses per day x 7 days = 21 doses. The total amount of amoxicillin is 21 x 500mg = 10,500mg (10.5g). Understanding prescription abbreviations is essential for safe medication administration.
NMC OSCE Medicine Administration
According to NMC standards, what are the five rights of medication administration that must be verified before giving any medicine?