OSCE Patient Assessment and Evaluation 2 — Questions and Answers
Question 1: During an OSCE station, a patient presents with asymmetric facial drooping, arm drift, and slurred speech. What is the most appropriate immediate action?
- Administer aspirin and monitor
- Activate stroke protocol and note time of symptom onset (Correct answer)
- Order a CT scan and wait for results
- Perform a lumbar puncture to rule out hemorrhage
Correct answer: Activate stroke protocol and note time of symptom onset
Activating the stroke protocol and documenting symptom onset time is critical because thrombolytics have a narrow treatment window.
Question 2: When assessing a patient's jugular venous pressure (JVP), at what angle is the patient typically positioned?
- Flat (0 degrees)
- 45 degrees (Correct answer)
- 60 degrees
- 90 degrees (sitting upright)
Correct answer: 45 degrees
JVP is best assessed with the patient at 45 degrees, where the meniscus of the internal jugular vein is most visible in the neck.
Question 3: A 68-year-old patient reports exertional chest pain that radiates to the left arm and resolves with rest. Which OPQRST component does 'resolves with rest' best represent?
- Onset
- Provocation/Palliation (Correct answer)
- Quality
- Radiation
Correct answer: Provocation/Palliation
Palliation refers to what makes the symptom better or worse, and rest relieving chest pain is a classic palliating factor for angina.
Question 4: On abdominal examination, dullness that shifts when the patient rolls to one side is called:
- Murphy's sign
- Shifting dullness (Correct answer)
- Rebound tenderness
- Rovsing's sign
Correct answer: Shifting dullness
Shifting dullness indicates ascites, as free fluid redistributes with position changes.
Question 5: In a cardiovascular OSCE station, which finding on auscultation is most consistent with aortic stenosis?
- High-pitched, blowing diastolic murmur at the left sternal border
- Harsh systolic ejection murmur at the right upper sternal border radiating to the carotids (Correct answer)
- Mid-diastolic rumble at the apex
- Pansystolic murmur at the apex radiating to the axilla
Correct answer: Harsh systolic ejection murmur at the right upper sternal border radiating to the carotids
Aortic stenosis produces a harsh crescendo-decrescendo systolic ejection murmur heard best at the right upper sternal border with radiation to the carotids.
Question 6: During a psychiatric assessment, a patient states, 'My thoughts are being broadcast on national television.' This is an example of:
- Thought insertion
- Thought withdrawal
- Thought broadcasting (Correct answer)
- Ideas of reference
Correct answer: Thought broadcasting
Thought broadcasting is the delusion that one's thoughts are transmitted outward and can be heard by others.
Question 7: A patient's Glasgow Coma Scale score is calculated as E3V4M5. What is the total GCS score?
- 10
- 11
- 12 (Correct answer)
- 13
Correct answer: 12
The GCS is calculated by summing the Eye (3), Verbal (4), and Motor (5) scores: 3 + 4 + 5 = 12.
OSCE Patient Assessment and Evaluation 2
During an OSCE station, a patient presents with asymmetric facial drooping, arm drift, and slurred speech.
What is the most appropriate immediate action?