OSCE OSCE Pharmacology and Medication Administration

Question 1

What are the 'Five Rights' of medication administration?

Accepted Answer

Right patient, right drug, right dose, right route, right time

Answer

Right drug, right dose, right colour, right size, right nurse

Answer

Right patient, right drug, right floor, right doctor, right chart

Answer

Right time, right place, right team, right equipment, right policy

Question 2

A prescription reads 'paracetamol 1g PO QDS PRN.' What does 'QDS PRN' mean?

Accepted Answer

Four times daily as required (when needed)

Answer

Every day as prescribed

Answer

Twice daily at regular intervals

Answer

Once daily at bedtime

Question 3

When preparing to administer an intramuscular (IM) injection, which site is generally preferred in adults for volumes up to 3 mL?

Accepted Answer

Ventrogluteal (gluteus medius) — preferred for most IM injections in adults

Answer

Deltoid — suitable for volumes up to 1 mL only

Answer

Vastus lateralis — preferred in infants under 12 months

Answer

Dorsogluteal — preferred over all other sites

Question 4

Which vital sign change should trigger withholding digoxin and contacting the prescriber?

Accepted Answer

Heart rate below 60 beats per minute (bradycardia)

Answer

Blood pressure above 130/80 mmHg

Answer

Temperature above 37.5°C

Answer

Respiratory rate above 18 breaths per minute

Question 5

What is the purpose of a 'drug allergy alert' documentation in a patient's medication record?

Accepted Answer

To prevent the patient from receiving any drug in the same class as the allergen, preventing potentially life-threatening reactions

Answer

To note drugs the patient dislikes for personal preference

Answer

To document only anaphylaxis — mild reactions are recorded elsewhere

Answer

To indicate drugs that are too expensive for the formulary

Question 6

When administering IV medication, which step is essential to prevent air embolism?

Accepted Answer

Priming (flushing) the IV line to remove all air bubbles before connecting to the patient

Answer

Administering the medication as rapidly as possible

Answer

Using a large-bore cannula for all IV medications

Answer

Shaking the IV bag vigorously before use

Question 7

A patient is prescribed warfarin. Which blood test is routinely monitored to guide dose adjustment?

Accepted Answer

INR (International Normalised Ratio)

Answer

Full blood count (FBC)

Answer

Serum potassium

Answer

Creatinine kinase (CK)

Question 8

Which medication requires checking blood glucose before administration?

Accepted Answer

Insulin

Answer

Amoxicillin

Answer

Furosemide

Answer

Atorvastatin

Question 9

What does 'first-pass metabolism' mean, and which route of administration avoids it?

Accepted Answer

First-pass metabolism is the biotransformation of orally absorbed drugs by the liver before reaching systemic circulation; sublingual/intravenous routes bypass it

Answer

First-pass is the initial dose given to test a patient's response to a medication

Answer

It refers to the initial absorption of a drug through the skin

Answer

First-pass metabolism enhances the bioavailability of all oral drugs

Question 10

A patient develops a widespread urticarial rash and throat tightness 10 minutes after receiving IV amoxicillin. What is the immediate priority action?

Accepted Answer

Stop the amoxicillin infusion and administer IM adrenaline (epinephrine) 0.5 mg (1:1000) immediately — this is anaphylaxis

Answer

Continue the infusion and observe whether the rash resolves spontaneously

Answer

Give oral antihistamine and continue monitoring

Answer

Apply topical hydrocortisone to the rash