OSCE OSCE Pharmacology and Medication Administration 3 — Questions and Answers
Question 1: What is the antidote for benzodiazepine overdose?
- Naloxone
- Flumazenil (Correct answer)
- N-acetylcysteine
- Physostigmine
Correct answer: Flumazenil
Flumazenil is a competitive benzodiazepine receptor antagonist used to reverse benzodiazepine-induced sedation.
Question 2: A patient receiving heparin infusion develops a platelet count drop from 280,000 to 60,000 over 5 days. What condition should be suspected?
- Disseminated intravascular coagulation
- Heparin-induced thrombocytopenia (HIT) (Correct answer)
- Immune thrombocytopenic purpura
- Aplastic anemia
Correct answer: Heparin-induced thrombocytopenia (HIT)
A 50% or greater platelet drop occurring 5–10 days after heparin initiation is classic for HIT, an immune-mediated prothrombotic condition.
Question 3: Which route of administration provides the fastest onset of drug action in emergency situations?
- Oral
- Subcutaneous
- Intravenous (Correct answer)
- Intramuscular
Correct answer: Intravenous
Intravenous administration delivers the drug directly into the bloodstream, providing the fastest onset of action.
Question 4: A patient is prescribed metformin for type 2 diabetes. Which condition is an absolute contraindication?
- Mild obesity
- eGFR of 35 mL/min/1.73m² (Correct answer)
- Controlled hypertension
- Age over 65
Correct answer: eGFR of 35 mL/min/1.73m²
Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to risk of lactic acidosis; caution is advised at eGFR 30–45.
Question 5: When administering an IM injection in the deltoid muscle, what is the maximum volume that should be injected?
- 0.5 mL
- 1 mL
- 2 mL (Correct answer)
- 5 mL
Correct answer: 2 mL
The deltoid can safely accommodate up to 2 mL of medication; larger volumes should be given in the vastus lateralis or ventrogluteal site.
Question 6: A patient on digoxin develops nausea, yellow-green vision changes, and bradycardia. What electrolyte disturbance potentiates digoxin toxicity?
- Hyperkalemia
- Hyponatremia
- Hypokalemia (Correct answer)
- Hypermagnesemia
Correct answer: Hypokalemia
Hypokalemia increases digoxin binding to the Na+/K+-ATPase pump, potentiating toxicity even at normal serum digoxin levels.
Question 7: Which medication used for anaphylaxis should be administered in the anterolateral thigh for fastest absorption?
- Diphenhydramine
- Methylprednisolone
- Epinephrine 1:1000 (Correct answer)
- Albuterol
Correct answer: Epinephrine 1:1000
Epinephrine 1:1000 given IM into the anterolateral thigh (vastus lateralis) achieves the fastest peak serum levels in anaphylaxis treatment.
OSCE OSCE Pharmacology and Medication Administration 3
What is the antidote for benzodiazepine overdose?