OSCE Clinical Procedures and Protocols 3 — Questions and Answers
Question 1: During IV cannula insertion, blood is seen in the flashback chamber. What does this confirm?
- The cannula is in the subcutaneous tissue
- The needle tip has entered a vein (Correct answer)
- The cannula is fully advanced into the vein
- IV fluid can now be administered safely
Correct answer: The needle tip has entered a vein
Flashback of blood into the chamber confirms the needle tip is within the vessel, but the cannula must still be advanced before the needle is withdrawn.
Question 2: What is the correct depth for chest compressions in adult cardiopulmonary resuscitation (CPR) according to current AHA guidelines?
- 1–2 cm
- 2–3 cm
- 5–6 cm (Correct answer)
- 7–8 cm
Correct answer: 5–6 cm
Current AHA guidelines recommend compressing the chest at least 5 cm (2 inches) but no more than 6 cm (2.4 inches) to maximize cardiac output.
Question 3: When collecting an arterial blood gas (ABG) from the radial artery, which test should be performed first to assess collateral circulation?
- Doppler ultrasound assessment
- Allen's test (Correct answer)
- Capillary refill check
- Pulse oximetry on the thumb
Correct answer: Allen's test
Allen's test assesses patency of the ulnar artery collateral circulation before radial artery puncture to prevent hand ischemia.
Question 4: A patient needs a central venous catheter (CVC) via the internal jugular vein. What complication is MOST specific to this site compared to the subclavian approach?
- Pneumothorax
- Air embolism
- Carotid artery puncture (Correct answer)
- Catheter-related bloodstream infection
Correct answer: Carotid artery puncture
Carotid artery puncture is the most site-specific complication of internal jugular CVC insertion due to the vessel's proximity.
Question 5: When applying a plaster of Paris backslab, which layer is applied FIRST directly against the skin?
- Plaster of Paris bandage
- Crepe bandage
- Stockinette and orthopaedic wool (padding) (Correct answer)
- Cohesive bandage
Correct answer: Stockinette and orthopaedic wool (padding)
Stockinette followed by orthopaedic wool provides padding that protects the skin from pressure, heat, and plaster contact.
Question 6: During an OSCE, you are asked to perform a digital nerve block for finger laceration repair. Which anesthetic is CONTRAINDICATED for this procedure?
- Plain lidocaine 1%
- Plain bupivacaine 0.25%
- Lidocaine with epinephrine (adrenaline) (Correct answer)
- Prilocaine 2%
Correct answer: Lidocaine with epinephrine (adrenaline)
Vasoconstrictors such as epinephrine are contraindicated in digital blocks due to risk of digital artery vasospasm and ischemia.
Question 7: What is the preferred position for a patient during a lumbar puncture to maximize the interspinous space?
- Prone with pillow under abdomen
- Lateral decubitus with knees drawn to chest and chin tucked (fetal position) (Correct answer)
- Sitting upright with arms hanging loosely
- Supine with one pillow under the head
Correct answer: Lateral decubitus with knees drawn to chest and chin tucked (fetal position)
The lateral fetal position opens the interspinous spaces maximally by flexing the lumbar spine, facilitating needle insertion.
OSCE Clinical Procedures and Protocols 3
During IV cannula insertion, blood is seen in the flashback chamber.
What does this confirm?