OSCE Treatment Protocols & Interventions 5

Question 1

A patient is in ventricular fibrillation. After two defibrillation attempts and CPR, which medication should be given?

Accepted Answer

Epinephrine 1mg IV every 3-5 minutes

Answer

Epinephrine 1mg IV every 3–5 minutes is the standard vasopressor for all shockable and non-shockable cardiac arrest rhythms.

Question 2

You are asked to perform a digital nerve block for a finger laceration repair. Which technique is most appropriate?

Accepted Answer

Inject 1–2 mL of plain lidocaine at each side of the finger base (web space block)

Answer

A web space digital block using plain lidocaine (no epinephrine) at the base of the finger effectively anesthetizes a digit for laceration repair.

Question 3

A post-operative patient develops a DVT confirmed by ultrasound. Which anticoagulant is preferred for initial outpatient treatment?

Accepted Answer

Rivaroxaban 15mg twice daily for 21 days, then 20mg daily

Answer

Direct oral anticoagulants (DOACs) like rivaroxaban are now preferred over heparin/warfarin for DVT treatment in most outpatient settings.

Question 4

A patient with COPD exacerbation presents with PaO2 of 50 mmHg and PaCO2 of 65 mmHg. What oxygen target is appropriate?

Accepted Answer

Titrate oxygen to SpO2 88–92% to avoid hypercapnic drive suppression

Answer

Titrating oxygen to SpO2 88–92% in COPD exacerbation prevents Haldane effect-driven hypercapnia while treating hypoxia.

Question 5

During a joint aspiration (arthrocentesis) of the knee, the aspirated fluid appears purulent and cloudy. What is the immediate next step?

Accepted Answer

Send fluid for culture, Gram stain, cell count, and glucose; start empiric antibiotics

Answer

Purulent joint fluid is septic arthritis until proven otherwise — send fluid for analysis and start empiric antibiotics immediately.

OSCE Practice Test