OSCE Procedural Skills 4 — Questions and Answers
Question 1: In an OSCE station for venepuncture, the most common complication is haematoma formation. What is the primary preventive measure?
- Using the smallest available needle gauge
- Applying firm pressure at the site for at least 1–2 minutes after needle removal (Correct answer)
- Asking the patient to pump their fist repeatedly after the draw
- Leaving the tourniquet on until after the needle is removed
Correct answer: Applying firm pressure at the site for at least 1–2 minutes after needle removal
Sustained direct pressure after needle withdrawal allows vessel sealing and prevents extravasation of blood into surrounding tissue.
Question 2: A patient presents with a dislocated shoulder. Before and after reduction, which nerve function should specifically be tested?
- Radial nerve (wrist extension)
- Ulnar nerve (finger abduction)
- Axillary nerve (sensation over regimental badge area) (Correct answer)
- Median nerve (thumb opposition)
Correct answer: Axillary nerve (sensation over regimental badge area)
The axillary nerve wraps around the surgical neck of the humerus and is the most commonly injured nerve in anterior shoulder dislocation.
Question 3: When performing a Gram stain, what color do Gram-positive organisms appear after the procedure?
- Pink/red
- Purple/blue (Correct answer)
- Yellow
- Colorless
Correct answer: Purple/blue
Gram-positive organisms retain crystal violet dye and appear purple-blue due to their thick peptidoglycan cell wall.
Question 4: During bag-valve-mask (BVM) ventilation, what is the correct technique for a two-person approach?
- One person holds the mask with one hand while squeezing the bag with the other
- One person maintains a two-hand mask seal using C-E clamp, while the second person squeezes the bag (Correct answer)
- Both persons squeeze the bag simultaneously
- One person tilts the head while the other compresses the chest
Correct answer: One person maintains a two-hand mask seal using C-E clamp, while the second person squeezes the bag
A two-person technique allows one provider to use both hands for an optimal mask seal while the other delivers consistent tidal volumes.
Question 5: A patient needs an incision and drainage (I&D) of a superficial abscess. After drainage, what is the appropriate wound management?
- Close the wound primarily with sutures
- Pack the cavity loosely with ribbon gauze and allow healing by secondary intention (Correct answer)
- Apply a pressure dressing and discharge immediately without follow-up
- Irrigate with hydrogen peroxide and seal with tissue glue
Correct answer: Pack the cavity loosely with ribbon gauze and allow healing by secondary intention
Abscesses should be packed to prevent premature skin closure and allow the cavity to fill in from the base to avoid re-accumulation.
Question 6: When using an otoscope during an ear examination OSCE, in which direction should the pinna be pulled to straighten the adult ear canal?
- Down and backward
- Up, back, and outward (Correct answer)
- Downward and forward
- Inward and upward
Correct answer: Up, back, and outward
In adults, pulling the pinna up, back, and outward straightens the S-shaped external auditory canal for optimal visualization.
Question 7: Which of the following indicates correct endotracheal tube (ETT) placement after intubation?
- Absence of breath sounds bilaterally
- Persistent waveform on end-tidal CO2 capnography (Correct answer)
- Gastric sounds heard over the epigastrium
- Oxygen saturation remaining at 95% for 10 seconds
Correct answer: Persistent waveform on end-tidal CO2 capnography
Continuous waveform capnography showing CO2 with each breath is the most reliable bedside confirmation of tracheal intubation.
OSCE Procedural Skills 4
In an OSCE station for venepuncture, the most common complication is haematoma formation.
What is the primary preventive measure?