Find your course
Menu

Station 11 of 24 · Free

Subcutaneous insulin before breakfast.

  • Medication administration
  • Care delivery
  • Medical ward, 07:30
  • Simulated patient

Station timer

Station timer: two minutes of reading, then eight to perform [S1], with a bell when two minutes are left [S1].

Candidate instructions

Setting: Medical ward, 07:30. Patient: Simulated patient.

Mrs Priya Sharma, 63, has type 2 diabetes treated with insulin. She was admitted yesterday with an infected foot ulcer.

Her chart has insulin aspart (a rapid-acting insulin) 8 units subcutaneously with breakfast, using her own labelled insulin pen. Her breakfast tray is on its way.

In eight minutes:

  1. Check her blood glucose.
  2. Give the insulin safely.
  3. Tell the examiner what you checked and what you taught her.

In the room: Blood glucose meter, strips, lancets, her labelled insulin aspart pen, safety pen needles, gloves, sharps container at the bedside, medication chart, blood glucose chart.

END OF CANDIDATE INSTRUCTIONS

Findings: what the patient or examiner tells you

Open these as you assess, one at a time, the way an examiner or patient would give them.

  • Blood glucose 9.2 mmol/L.
  • Pen label: her name, insulin aspart, opened 10 days ago, in date.
  • A firm, lumpy area on the left of her abdomen where she says she always injects.
  • Her breakfast arrives; she says she is hungry and will eat all of it.

The checklist

Tick what you really did. 10 points, 3 safety-critical, each mapped to the NMBA standards [S4]. Our own practice checklist, not the NMBA marking scheme.

Did you do these?
  • Why it matters

    A patient's own pen must only ever be used for that patient.

  • Why it matters

    Insulin names look alike and doses vary. Each part is checked every time.

  • Why it matters

    The reading decides whether the dose is safe and whether to call the doctor.

  • Why it matters

    Rapid-acting insulin without food can cause severe hypoglycaemia within the hour.

  • Why it matters

    Insulin used past its in-use period may not work properly.

  • Why it matters

    Priming removes air and confirms the needle works, so the full dose is given.

  • Why it matters

    Insulin absorbs unpredictably from lumpy tissue, causing highs and lows.

  • Why it matters

    Removing the needle too early lets some of the dose leak out.

  • Why it matters

    Needlestick injuries happen when used needles are recapped or carried around.

  • Why it matters

    Evaluation closes the loop: did the dose do what it should, safely?

Model walkthrough

Show it, minute by minute (try the station first)
  1. Reading

    Rapid-acting insulin with breakfast, and breakfast is only on its way. Plan: identity and pen label, glucose, meal in front of her, pen checks, prime, healthy site, 10 seconds, sharps at the bedside.

  2. 0:00

    Hand rub, introduce yourself, two identifiers, allergies. Match the pen label to her ID band.

    Say: Priya, I'm (your name). Can you tell me your full name and date of birth? This is your own pen, with your name on it.

  3. 0:45

    Order check: insulin aspart, 8 units, subcutaneous, with breakfast, signed, not yet given.

  4. 1:15

    Blood glucose: 9.2. Record it.

  5. 2:00

    Breakfast arrives. Confirm she will eat it now.

    Say: This insulin works quickly, so I'll give it now that your breakfast is here. Are you happy to eat all of it?

  6. 2:30

    Pen check: insulin aspart, in date, opened 10 days ago (within its in-use period). New pen needle. Prime 1 to 2 units, needle up, until a drop appears. Dial 8.

  7. 3:30

    Site: look and feel. Avoid the lumpy area.

    Say: This firm area can stop insulin working properly. Let's use the other side today, and move the spot around each time.

  8. 4:30

    Inject at 90 degrees, press fully, count 10 seconds, remove. Pen needle straight into the bedside sharps container, no hand recapping.

  9. 5:30

    Sign the chart. Teach: signs of a low, and to call straight away.

  10. 6:00

    Bell. Tell the examiner: next glucose before lunch, watching for a low, and a referral to the diabetes educator about the lumpy site.

Common mistakes

  • Giving rapid-acting insulin before the meal is there.

    No meal, no rapid-acting insulin: wait, or ask the doctor.

  • Injecting into the lumpy area she always uses.

    Choose healthy tissue and teach rotation.

  • Skipping the prime.

    Prime until you see a drop, then dial the dose.

  • Pulling the needle out as soon as the button is pressed.

    Hold for 10 seconds, or as the pen's instructions say.

  • Carrying the used needle to the treatment room.

    Sharps container at the bedside, every time.

From the official handbook

  • Skills that may be tested include (the list is not exhaustive): observations and vital signs, calculating drug dosages, subcutaneous and intramuscular injection, aseptic non-touch technique (ANTT), in-hospital resuscitation, safe disposal of sharps, medication administration, wound care, hand hygiene, communication and consent, infection control, patient identification, intravenous therapy and risk management. [S1]
  • You are required to demonstrate the skills, not just talk about what you would do. [S1]
  • The candidate instructions end with the line END OF CANDIDATE INSTRUCTIONS, and you must stay seated for the whole two minutes of reading time, even if you have finished reading. [S1]
  • When reading time ends, the candidate instructions are taken away: at one exam centre they disappear from the screen, at the other you return the instruction card before you enter the room. [S1]
  • It is a regulatory exam, not an educational one. Examiners do not coach, prompt or give feedback, and when station time is up you move on even if you have not finished. [S1]
  • Try to complete every task in the candidate instructions, including writing the documentation. You get a new piece of notepaper at each station, and you hand all your notes to the examiner when time is up. [S1]

Open my report · Study plan · All stations

Independent practice. Not affiliated with or endorsed by the NMBA, Ahpra, Prometric or any exam body. Every station is original practice material, not real exam content. Our checklists are our own, not the NMBA marking scheme. No guarantee of a pass. Written with AI from the official RN OSCE handbook and NMBA standards, with every fact linked to its source and checked word for word against it. Not advice for real patient care: follow your workplace policy and the NMBA standards.