OSCE OSCE Pharmacology and Medication Administration 4

Question 1

A patient is prescribed a statin for hyperlipidemia and develops muscle pain with a CK level 10 times the upper limit of normal. What is the priority action?

Accepted Answer

Discontinue the statin immediately

Answer

Markedly elevated CK with muscle symptoms indicates statin-induced myopathy or rhabdomyolysis, requiring immediate discontinuation to prevent renal failure.

Question 2

Which 'five rights' of medication administration is being verified when the nurse checks the patient's armband?

Accepted Answer

Right patient

Answer

Checking the patient's armband and using two identifiers verifies the right patient, a core component of safe medication administration.

Question 3

A patient receives 1,000 mg of acetaminophen (paracetamol) every 6 hours. What is the total daily dose, and is it within safe limits for a healthy adult?

Accepted Answer

4,000 mg/day — at the maximum safe limit

Answer

Four doses of 1,000 mg equals 4,000 mg/day, which is the maximum recommended daily dose for healthy adults per current guidelines.

Question 4

Which class of medications requires dose reduction in hepatic impairment due to extensive first-pass metabolism?

Accepted Answer

Oral beta-blockers like propranolol

Answer

Propranolol undergoes extensive hepatic first-pass metabolism; liver impairment reduces clearance, leading to significantly elevated plasma levels.

Question 5

A patient on warfarin is started on ciprofloxacin. What monitoring change is required?

Accepted Answer

Monitor INR more frequently as it may rise

Answer

Ciprofloxacin inhibits CYP1A2 and CYP3A4, reducing warfarin metabolism and increasing anticoagulant effect, requiring more frequent INR monitoring.

OSCE Practice Test

OSCE Practice Test

OSCE OSCE Pharmacology and Medication Administration 4