OSCE Pharmacology and Medication Administration 2 — Questions and Answers
Question 1: A patient is prescribed warfarin 5mg daily. Which food should the nurse instruct the patient to keep consistent in their diet?
- Grapefruit juice
- Vitamin K-rich foods like spinach (Correct answer)
- Calcium-rich dairy products
- High-fiber foods
Correct answer: Vitamin K-rich foods like spinach
Vitamin K directly antagonizes warfarin's anticoagulant effect, so consistent intake (not elimination) prevents INR fluctuations.
Question 2: When administering a Z-track injection, the nurse should release the skin how many seconds after injecting the medication?
- Immediately after withdrawing the needle
- After 5 seconds
- After 10 seconds (Correct answer)
- After 30 seconds
Correct answer: After 10 seconds
Waiting 10 seconds allows the medication to disperse into the tissue before releasing the skin, preventing leakage.
Question 3: A patient taking metformin is scheduled for a contrast CT scan. What is the priority nursing action?
- Administer metformin with extra fluids on the day of the scan
- Hold metformin 48 hours before and after the procedure (Correct answer)
- Switch to insulin the day before the scan only
- Continue metformin unless renal function is abnormal
Correct answer: Hold metformin 48 hours before and after the procedure
Metformin must be held 48 hours before and after contrast dye to prevent lactic acidosis risk from contrast-induced nephropathy.
Question 4: Which ophthalmic medication administration technique is correct?
- Drop medication directly onto the cornea for best absorption
- Pull down the lower eyelid and instill drops into the conjunctival sac (Correct answer)
- Instill drops into the inner canthus while the eye is open
- Squeeze the inner canthus after instillation to enhance absorption
Correct answer: Pull down the lower eyelid and instill drops into the conjunctival sac
The conjunctival sac (lower eyelid pocket) is the correct site for eye drop instillation to avoid corneal trauma.
Question 5: A nurse is preparing to administer digoxin 0.125mg. Before giving this medication, which assessment is most critical?
- Blood pressure
- Apical pulse for one full minute (Correct answer)
- Respiratory rate
- Serum potassium level
Correct answer: Apical pulse for one full minute
Digoxin is held if the apical pulse is below 60 bpm, as it slows conduction and can cause life-threatening bradycardia.
Question 6: A patient develops redness, swelling, and pain at an IV site. The nurse suspects phlebitis. What is the priority action?
- Slow the IV infusion rate and apply a warm compress
- Discontinue the IV and restart at a new site (Correct answer)
- Elevate the extremity and continue the current infusion
- Apply a cold compress and notify the physician
Correct answer: Discontinue the IV and restart at a new site
Phlebitis requires immediate discontinuation of the IV line and restarting at a new site to prevent further vascular damage.
Question 7: A nurse is administering medications through a nasogastric tube. Which action is correct?
- Crush all medications together and mix into one syringe
- Verify tube placement, flush with 30mL water, and give each medication separately (Correct answer)
- Administer medications without flushing to conserve fluid intake
- Aspirate gastric contents and discard before giving medications
Correct answer: Verify tube placement, flush with 30mL water, and give each medication separately
Each medication must be given separately with water flushes between to prevent interactions and verify correct tube placement before administration.
OSCE Pharmacology and Medication Administration 2
A patient is prescribed warfarin 5mg daily.
Which food should the nurse instruct the patient to keep consistent in their diet?