OSCE Emergency Response Procedures 3 — Questions and Answers
Question 1: A patient presents with altered mental status, hypotension (BP 80/50), and a heart rate of 140 bpm after a suspected GI bleed. Which resuscitation product should be administered FIRST?
- Crystalloid IV fluid bolus (normal saline or lactated Ringer's) (Correct answer)
- Packed red blood cells
- Fresh frozen plasma
- Platelets
Correct answer: Crystalloid IV fluid bolus (normal saline or lactated Ringer's)
Initial resuscitation begins with isotonic crystalloid to restore perfusion while blood products are being prepared and cross-matched.
Question 2: You respond to a patient with suspected opioid overdose who is apneic but has a faint pulse. After calling for help, the NEXT priority is:
- Provide rescue breathing with a bag-valve mask (Correct answer)
- Administer naloxone 0.4 mg IV immediately
- Start chest compressions
- Place a nasopharyngeal airway and monitor
Correct answer: Provide rescue breathing with a bag-valve mask
The patient has a pulse but is apneic, so rescue breathing (BVM ventilation) to correct hypoxia takes priority over naloxone administration.
Question 3: In the JUMP-START pediatric triage system (used in MCIs), a child is apneic but begins breathing after repositioning the airway. This patient should be tagged:
- Red (Immediate) (Correct answer)
- Black (Expectant)
- Yellow (Delayed)
- Green (Minor)
Correct answer: Red (Immediate)
In JumpSTART, a child who is apneic but breathes after airway repositioning is tagged Red because they require immediate airway intervention to survive.
Question 4: A patient develops ventricular fibrillation (VF) during a monitored cardiac procedure. The FIRST action after confirming no pulse is:
- Defibrillate immediately with the highest energy setting available (Correct answer)
- Begin CPR for 2 minutes before defibrillation
- Administer epinephrine 1 mg IV push
- Intubate the patient to secure the airway
Correct answer: Defibrillate immediately with the highest energy setting available
Witnessed VF in a monitored setting warrants immediate defibrillation; survival rates are highest when defibrillation occurs within seconds.
Question 5: A nurse finds a patient on the floor, unresponsive. After confirming unresponsiveness and calling for help, the nurse should next:
- Check for normal breathing and a carotid pulse simultaneously for no more than 10 seconds (Correct answer)
- Begin chest compressions immediately without checking for a pulse
- Perform a head-tilt chin-lift and give 2 rescue breaths
- Apply the AED pads before assessing pulse or breathing
Correct answer: Check for normal breathing and a carotid pulse simultaneously for no more than 10 seconds
AHA BLS guidelines direct providers to simultaneously check for breathing and pulse for up to 10 seconds before initiating CPR.
Question 6: An unconscious trauma patient arrives by EMS. Cervical spine injury is suspected. Which airway technique is preferred?
- Jaw thrust maneuver without head tilt (Correct answer)
- Head-tilt chin-lift maneuver
- Jaw thrust with aggressive neck extension
- Blind nasotracheal intubation without cervical stabilization
Correct answer: Jaw thrust maneuver without head tilt
The jaw thrust without head extension opens the airway while maintaining cervical spine alignment in a patient with suspected c-spine injury.
Question 7: During a hospital fire drill, which evacuation priority order (RACE) is correct?
- Rescue, Alarm, Confine, Extinguish/Evacuate (Correct answer)
- Run, Alert, Contain, Escape
- Remove, Alert, Call 911, Evacuate
- Rescue, Alert, Call, Exit
Correct answer: Rescue, Alarm, Confine, Extinguish/Evacuate
The RACE mnemonic (Rescue, Alarm, Confine, Extinguish/Evacuate) is the standardized hospital fire response protocol used across US healthcare facilities.
OSCE Emergency Response Procedures 3
A patient presents with altered mental status, hypotension (BP 80/50), and a heart rate of 140 bpm after a suspected GI bleed.
Which resuscitation product should be administered FIRST?