NMC OSCE Patient Assessment & NEWS2 2

Question 1

When performing a head-to-toe patient assessment, which system should be assessed first if the patient appears acutely unwell?

Accepted Answer

Airway, Breathing, Circulation using the ABCDE approach

Answer

In any acutely unwell patient, the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach is used. This systematic method prioritises life-threatening problems by assessing and treating in order of urgency.

Question 2

A patient's blood pressure is recorded as 88/56 mmHg and they have a respiratory rate of 26 breaths per minute. What is the most appropriate immediate action?

Accepted Answer

Escalate immediately to the medical team and apply ABCDE approach

Answer

Hypotension (systolic <90 mmHg) combined with tachypnoea (>20 breaths/min) are red flag signs suggesting haemodynamic instability or sepsis. Immediate escalation using a structured communication tool (e.g., SBAR) and the ABCDE approach is essential.

Question 3

What does SBAR stand for in the context of clinical communication?

Accepted Answer

Situation, Background, Assessment, Recommendation

Answer

SBAR stands for Situation, Background, Assessment, Recommendation. It is a structured communication tool widely used in the NHS to ensure safe, efficient handover of clinical information, particularly during escalation of deteriorating patients.

Question 4

During patient assessment, a nurse notes that a patient is using accessory muscles to breathe. What does this indicate?

Accepted Answer

Increased work of breathing suggesting respiratory distress

Answer

Use of accessory muscles (sternocleidomastoid, scalenes, intercostals) during breathing indicates increased work of breathing, a sign of respiratory distress. It suggests the diaphragm and primary respiratory muscles are not meeting ventilatory demands.

Question 5

A patient's capillary refill time is measured at 4 seconds. What does this indicate?

Accepted Answer

Possible peripheral vasoconstriction or poor perfusion

Answer

Normal capillary refill time is less than 2 seconds. A CRT of 4 seconds suggests peripheral vasoconstriction or poor perfusion, which may indicate shock, hypothermia, or peripheral vascular disease. It should be interpreted alongside other perfusion markers.

NMC OSCE Practice Test

NMC OSCE Practice Test

NMC OSCE Patient Assessment & NEWS2 2