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Breathless in Sydney: An OSCE Encounter

Emma, a nursing student, strode into the bustling hallways of Sydney General Hospital, her mind racing with the steps of patient assessment. It was the day of the OSCE (Objective Structured Clinical Examination), an exam that each nursing student must face, and her station was Patient Assessment. The scenario given was a patient who had been admitted with shortness of breath—a critical and often encountered situation in her future nursing career.

What is Emma preparing for?

  • A) A job interview.
  • B) Her graduation ceremony.
  • C) Her OSCE.
  • D) A routine check-up.
Introduction to Eager nursing student, mid-20s, fair skin with bright blue eyes, a nursing student at Sydney General Hospital.

Upon entering the exam station, Emma was greeted by a standardized patient—a trained actor simulating the real symptoms of distress. The patient was sitting on the edge of the bed, hands on knees, struggling for each breath. Without wasting a moment, Emma dove into her focused respiratory assessment. She began with inspection, noting the use of accessory muscles and the patient's posture.

What is the first part of Emma's assessment?

  • A) Inspection.
  • B) Palpation.
  • C) Percussion.
  • D) Auscultation.
Eager nursing student, mid-20s, fair skin with bright blue eyes starts respiratory assessment of simulated patient with distress.

Emma then proceeded with palpation, feeling for any abnormalities in chest expansion. She remembered to keep her hands firm yet gentle. After ensuring there was no discomfort, she moved to percussion, lightly tapping across the chest wall, listening for variations that might indicate areas of concern.

What does Emma check for through palpation?

  • A) Heart rate.
  • B) Abdominal pain.
  • C) Abnormalities in chest expansion.
  • D) Skin temperature.
Eager nursing student, mid-20s, fair skin with bright blue eyes continues assessment with palpation and percussion techniques.

With her stethoscope ready, Emma transitioned to auscultation. Her ears tuned to the sounds of the lungs, noting any wheezes, crackles, or silences that would help identify the issue at hand. The labored breathing of the patient made the situation feel all the more real, even though Emma knew this was only an exam.

What is Emma trying to identify with auscultation?

  • A) Heart murmurs.
  • B) Stomach gurgling.
  • C) Lung sounds.
  • D) Joint movement.
Eager nursing student, mid-20s, fair skin with bright blue eyes listens to lung sounds during the auscultation process.

Next, Emma requested the patient's permission to take vital signs. Carefully attaching the pulse oximeter, she recorded the oxygen saturation. She then measured the temperature, pulse, and respiration rate, concluding with the blood pressure cuff that would provide the final numeral to Emma's collection of critical signposts indicating the patient's state.

Which is not a vital sign that Emma took?

  • A) Oxygen saturation.
  • B) Pulse.
  • C) Blood sugar level.
  • D) Blood pressure.
Eager nursing student, mid-20s, fair skin with bright blue eyes is taking and recording the patient's vital signs.

After gathering physical evidence, Emma knew a thorough history was imperative. She asked about the onset of symptoms, the character of the patient's discomfort, and if certain positions alleviated or aggravated the shortness of breath. She inquired about past medical conditions, medications, and any family history of respiratory illnesses, noting everything on the patient chart with the precision of a detective assembling the pieces of a puzzling case.

What did Emma ask to understand the shortness of breath?

  • A) When the symptoms started.
  • B) Favorite color.
  • C) Last meal eaten.
  • D) Travel history.
Eager nursing student, mid-20s, fair skin with bright blue eyes questions the patient to get a detailed medical history.

The patient, though an actor, convincingly coughed and admitted to a smoking history—a fact that Emma knew could be pivotal to diagnosing the underlying cause of the symptoms. Pondering the evidence, Emma speculated about potential causes: could it be COPD, an acute infection, or perhaps asthma exacerbated by cigarette smoke?

What habit of the patient is relevant to the diagnosis?

  • A) Swimming.
  • B) Jogging.
  • C)
  • D) Reading.
Eager nursing student, mid-20s, fair skin with bright blue eyes considers the patient's smoking history in her diagnosis.

With all the information in hand, Emma began to document her findings meticulously. She wrote down each vital sign with the corresponding normal range nearby for comparison. She summarized the patient's history and her observations during the physical examination. Finally, she crafted a clear and concise report for the supervising nurse or doctor, outlining her assessment and potential causes for the symptoms.

What does Emma provide in her report?

  • A) A list of her favorite novels.
  • B)
  • C) A summary of the hospital's history.
  • D) An unrelated news article.
Eager nursing student, mid-20s, fair skin with bright blue eyes documents her findings and prepares a report for the supervisor.

Taking a deep breath herself, Emma handed over the report, her eyes meeting the supervising nurse's gaze. It was a look that conveyed understanding and the shared experience of countless past assessments, all meant to prepare her for the reality of patient care. The nurse gave a curt nod and a small, encouraging smile before moving off to review Emma's work.

What expression did the nurse give to Emma?

  • A) A disapproving glare.
  • B)
  • C) An encouraging smile.
  • D) A neutral gesture.
Eager nursing student, mid-20s, fair skin with bright blue eyes presents her findings to the supervising nurse in the exam.

The minutes ticked by, each one stretching longer than the last as Emma waited for feedback. When the nurse finally returned, she nodded with satisfaction. 'Well done, Emma. Your assessment was thorough, and your clinical reasoning is sound.' Hearing this, Emma felt a rush of relief flood through her. It was more than passing the station; it was affirmation that she was on her path to becoming a compassionate and capable nurse.

What feedback did the nurse provide about Emma's performance?

  • A) It lacked detail.
  • B) It was poorly documented.
  • C) It was thorough and reasoned.
  • D) It was incomplete.
The nurse gives positive feedback to Eager nursing student, mid-20s, fair skin with bright blue eyes's performance.

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