Patient Assessment & NEWS2 Flashcards
6 cards from real NMC OSCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Patient Assessment & NEWS2 flashcards as text
A nurse is assessing a patient for sepsis. According to UK Sepsis Trust criteria, which finding most strongly suggests sepsis requiring urgent treatment?
Answer: Systolic BP of 85 mmHg with suspected infection
A systolic BP below 90 mmHg in the context of suspected infection is a red flag for sepsis with haemodynamic compromise (septic shock). This requires immediate escalation, blood cultures, and the Sepsis 6 bundle to be initiated within one hour.
When assessing pain using the numeric rating scale (NRS), what score range indicates severe pain requiring immediate intervention?
Answer: 7–10
On a 0–10 NRS, scores of 7–10 indicate severe pain requiring prompt intervention. Scores of 4–6 are moderate and 1–3 are mild. The NRS is a validated, simple tool for pain assessment in adults who can communicate verbally.
What does a raised jugular venous pressure (JVP) indicate in a patient assessment?
Answer: Increased right atrial pressure, suggesting fluid overload or right heart failure
Raised JVP (above 3–4 cm above the sternal angle at 45°) indicates elevated right atrial pressure, which is seen in right heart failure, cardiac tamponade, tension pneumothorax, and fluid overload. It is an important clinical sign in cardiovascular assessment.
A patient with diabetes is found unresponsive. A blood glucose reading shows 1.8 mmol/L. What is the priority intervention?
Answer: Administer IV 10% glucose or glucagon if IV access is unavailable
Severe hypoglycaemia causing unconsciousness requires IV glucose (e.g., 75–80 mL of 20% glucose or 150–160 mL of 10% glucose) or IM glucagon if IV access cannot be obtained. Oral glucose is contraindicated in an unconscious patient due to aspiration risk.
During a respiratory assessment, a nurse auscultates and hears coarse crackles bilaterally at the lung bases. What is the most likely cause?
Answer: Pulmonary oedema or consolidation
Coarse crackles at the lung bases are typically associated with pulmonary oedema (from fluid in the alveoli) or pulmonary consolidation (e.g., pneumonia). Fine crackles are more associated with fibrosis. Pleural effusion typically causes reduced or absent breath sounds.
A patient is assessed post-operatively and has a urine output of 15 mL/hour for the past three hours. What is the significance of this finding?
Answer: Oliguria — requires urgent review as it may indicate acute kidney injury or inadequate perfusion
Normal adult urine output is 0.5 mL/kg/hour, approximately 30–50 mL/hour. Output below 30 mL/hour (oliguria) for more than two hours warrants urgent review. Post-operative oliguria may signal hypovolaemia, acute kidney injury, or inadequate resuscitation.