OSCE Pharmacology and Medication Administration 5 — Questions and Answers
Question 1: A patient with a penicillin allergy is prescribed a cephalosporin. What is the nurse's priority action?
- Administer the medication since there is no cross-reactivity
- Notify the prescriber and clarify the order before administration (Correct answer)
- Administer with diphenhydramine as premedication
- Substitute amoxicillin, which is safer for penicillin-allergic patients
Correct answer: Notify the prescriber and clarify the order before administration
Cross-reactivity between penicillins and cephalosporins exists in 1-10% of patients, requiring prescriber notification before administration.
Question 2: A nurse is calculating a drug dose: the prescriber orders amoxicillin 500mg, and the medication is available as 250mg/5mL. How many mL should the nurse administer?
- 5 mL
- 10 mL (Correct answer)
- 2.5 mL
- 15 mL
Correct answer: 10 mL
Using ratio-proportion: 250mg/5mL = 500mg/x; x = 10mL is the correct dose.
Question 3: Which action by a nursing student during medication administration requires immediate correction by the supervising nurse?
- Checking the MAR against the medication label three times
- Drawing up two different insulin types in the same syringe without checking compatibility (Correct answer)
- Performing hand hygiene before preparing medications
- Asking the patient to state their name and date of birth
Correct answer: Drawing up two different insulin types in the same syringe without checking compatibility
Not all insulins are compatible in the same syringe; mixing incompatible insulins can alter their pharmacokinetics and cause harm.
Question 4: A nurse administers a medication to the wrong patient. After ensuring patient safety, what is the priority next step?
- Inform the charge nurse only and complete a shift report
- Complete an incident report and notify the physician immediately (Correct answer)
- Document that the medication was given and monitor the patient
- Ask the patient not to mention the error to family members
Correct answer: Complete an incident report and notify the physician immediately
A medication error requires immediate physician notification for potential intervention and incident report completion per institutional safety protocols.
Question 5: A patient on long-term corticosteroid therapy asks why they cannot stop the medication abruptly. The nurse explains that sudden discontinuation can cause:
- Hypertensive crisis
- Adrenal insufficiency and hemodynamic collapse (Correct answer)
- Rebound hyperglycemia only
- Severe withdrawal causing seizures
Correct answer: Adrenal insufficiency and hemodynamic collapse
Long-term corticosteroids suppress the HPA axis, so abrupt discontinuation can cause adrenal crisis with hypotension, hypoglycemia, and cardiovascular collapse.
Question 6: When preparing to administer an intradermal injection for a tuberculin skin test, the nurse should use which needle gauge and length?
- 18-gauge, 1.5-inch needle
- 22-gauge, 1-inch needle
- 25-28 gauge, 3/8-5/8 inch needle (Correct answer)
- 20-gauge, 1-inch needle
Correct answer: 25-28 gauge, 3/8-5/8 inch needle
Intradermal injections require a fine-gauge (25-28G), short (3/8-5/8 inch) needle to deposit medication just below the epidermis into the dermis.
Question 7: A nurse is preparing to give a medication labeled 'otic' to a patient with an ear infection. What does 'otic' indicate?
- The medication is for the eyes
- The medication is for the ears (Correct answer)
- The medication is for the nasal passages
- The medication is for oral use only
Correct answer: The medication is for the ears
Otic medications are formulated specifically for the ear canal; confusing otic with optic (eye) is a common and dangerous medication error.
OSCE Pharmacology and Medication Administration 5
A patient with a penicillin allergy is prescribed a cephalosporin.
What is the nurse's priority action?