OSCE Emergency Assessment 3

Question 1

A patient presents with sudden onset of unilateral pleuritic chest pain and dyspnea. Breath sounds are absent on the right. The trachea is midline. The MOST likely diagnosis is:

Accepted Answer

Simple pneumothorax

Answer

Absent breath sounds unilaterally with pleuritic pain and dyspnea, but midline trachea, indicates a simple (not tension) pneumothorax.

Question 2

When performing the SAMPLE history in an emergency, what does the 'E' stand for?

Accepted Answer

Events leading to the complaint

Answer

In the SAMPLE mnemonic, E stands for Events leading to the current illness or injury, providing context for the chief complaint.

Question 3

A patient with DKA has a serum potassium of 5.8 mEq/L on admission. When should potassium replacement begin?

Accepted Answer

When potassium falls below 5.0 mEq/L

Answer

Potassium replacement in DKA should begin when the level falls below 5.0 mEq/L, as insulin therapy will drive potassium intracellularly and cause hypokalemia.

Question 4

Which finding in a trauma patient most urgently indicates a needle decompression?

Accepted Answer

Tracheal deviation, absent breath sounds, and hypotension

Answer

Tension pneumothorax presents with tracheal deviation away from the affected side, absent breath sounds, and hemodynamic compromise requiring immediate needle decompression.

Question 5

A 30-year-old presents with altered mental status, fever 39.8°C, neck stiffness, and photophobia. The FIRST intervention should be:

Accepted Answer

Administer antibiotics and dexamethasone, then perform LP

Answer

In suspected bacterial meningitis, antibiotics and dexamethasone should be given immediately before LP if there will be any delay, as treatment must not be deferred.

OSCE Practice Test

OSCE Practice Test

OSCE Emergency Assessment 3