OSCE OSCE Pharmacology and Medication Administration 2

Question 1

A patient is prescribed warfarin. Which INR range is typically targeted for atrial fibrillation?

Accepted Answer

2.0–3.0

Answer

For atrial fibrillation, the therapeutic INR range for warfarin is 2.0–3.0 to balance stroke prevention with bleeding risk.

Question 2

Which medication requires a tuberculin skin test (PPD) before initiation due to risk of reactivating latent TB?

Accepted Answer

Adalimumab (Humira)

Answer

TNF-alpha inhibitors like adalimumab can reactivate latent tuberculosis, so a PPD or IGRA test is required before starting therapy.

Question 3

A nurse is about to give IV potassium chloride. What is the maximum safe rate of peripheral IV KCl infusion?

Accepted Answer

10 mEq/hr

Answer

Peripheral IV potassium chloride should not exceed 10 mEq/hr to prevent phlebitis and cardiac arrhythmias.

Question 4

Which opioid analgesic is considered safest for patients with renal failure?

Accepted Answer

Fentanyl

Answer

Fentanyl has no active renally-cleared metabolites, making it the preferred opioid in renal failure patients.

Question 5

A patient taking lithium develops tremor, polyuria, and confusion. Serum lithium is 2.1 mEq/L. What is the next step?

Accepted Answer

Hold lithium and provide IV fluids

Answer

A lithium level above 1.5 mEq/L with toxicity symptoms requires stopping lithium and providing supportive care with IV hydration.

OSCE Practice Test