OSCE Procedural Skills 2

Question 1

When performing a lumbar puncture, at which intervertebral space should the needle be inserted in an adult?

Accepted Answer

L3-L4

Answer

L3-L4 (or L4-L5) is preferred because the spinal cord ends at L1-L2, minimizing risk of cord injury.

Question 2

Which landmark is used to identify the correct level for lumbar puncture?

Accepted Answer

Posterior superior iliac spine (Tuffier's line)

Answer

Tuffier's line connects the posterior superior iliac spines and typically intersects at the L4 spinous process.

Question 3

During urinary catheterization of a male patient, resistance is felt at the external sphincter. What is the most appropriate next step?

Accepted Answer

Ask the patient to relax and take deep breaths, then gently advance

Answer

Having the patient relax the sphincter voluntarily by deep breathing allows gentle advancement without traumatizing the urethra.

Question 4

What is the correct sequence for donning sterile gloves using the open gloving technique?

Accepted Answer

Pick up dominant-hand glove by the cuff, don it, then use gloved hand to slide under the cuff of the second glove

Answer

The dominant hand glove is donned first by grasping only the folded cuff, then the sterile gloved hand slides under the second glove's cuff.

Question 5

A patient requires nasogastric tube insertion. After passing the tube, how do you confirm correct gastric placement at the bedside?

Accepted Answer

Listening for air sounds over the epigastrium while injecting 10–20 mL of air with a syringe

Answer

Auscultation of a 'whoosh' over the epigastrium after air injection is a standard bedside check, though radiographic confirmation is gold standard.

OSCE Practice Test