Registered Nurse Objective Structured Clinical Examination (NMC OSCE) Assessment and Care Planning (APIE) Syllabus

Assessment and Care Planning (APIE) syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Assessment and Care Planning (APIE) in Registered Nurse Objective Structured Clinical Examination (NMC OSCE), not a summary of it.

1. 1

   Holistic Patient Assessment

   4 topics

   • Structured assessment frameworks
     • Activities of Living (Roper-Logan-Tierney) model
     • ABCDE systematic approach
   • History taking and information gathering
     • Using SBAR for handover and escalation
     • Reviewing the care record and observations chart
   • Baseline observations and vital signs
     • Temperature, pulse, respiration, blood pressure, oxygen saturation
     • National Early Warning Score 2 (NEWS2) calculation
   • Risk screening at assessment
     • Falls, pressure ulcer (e.g. Waterlow), VTE and nutrition (MUST) screening
     • Pain assessment tools
2. 2

   Nursing Diagnosis and Problem Identification

   3 topics

   • Distinguishing actual and potential problems
   • Prioritising care needs
     • Linking findings to escalation triggers
   • Identifying patient-centred goals
3. 3

   Planning Individualised Care

   4 topics

   • Writing SMART goals and care plans
     • Short-term and long-term outcomes
   • Person-centred and shared decision making
     • Involving the patient, family and carers
   • Evidence-based interventions in the plan
   • Discharge and ongoing care considerations
4. 4

   Implementation and Evaluation

   4 topics

   • Delivering planned interventions safely
   • Reassessment and monitoring response to care
     • Adjusting the plan based on findings
   • Evaluating whether goals were met
   • Documentation of evaluation and revised plans

Assessment and Care Planning (APIE) flashcards for Registered Nurse Objective Structured Clinical Examination (NMC OSCE)

23 of 52 cards from the Assessment and Care Planning (APIE) deck — real questions with worked answers.

1. What does the nursing process acronym APIE stand for?

   Assessment, Planning, Implementation and Evaluation — the four cyclical stages of person-centred nursing care.

2. In the NMC OSCE, why is the nursing process described as cyclical rather than linear?

   Because Evaluation feeds back into reassessment: findings continually inform new assessment, updated plans and revised interventions, so the cycle repeats rather than ending.

3. What does the ADPIE expansion of the nursing process add to APIE?

   It inserts 'Diagnosis' (Nursing Diagnosis) between Assessment and Planning, giving Assessment, Diagnosis, Planning, Implementation, Evaluation.

4. Name the four phases of the structured ABCDE assessment framework used in initial/acute patient assessment.

   Airway, Breathing, Circulation, Disability, and Exposure — assessed in that priority order, treating life-threatening problems before moving on.

5. What is the purpose of a structured assessment framework (e.g. ABCDE, Roper-Logan-Tierney)?

   To ensure a systematic, comprehensive and consistent assessment so no key information or deterioration is missed, supporting safe prioritisation.

6. What are the 12 Activities of Living in the Roper-Logan-Tierney (RLT) model often used in UK nursing assessment?

   Maintaining a safe environment; communication; breathing; eating and drinking; eliminating; personal cleansing/dressing; controlling body temperature; mobilising; working and playing; expressing sexuality; sleeping; and dying.

7. In the ABCDE approach, why must you treat each problem before moving to the next letter?

   Because each step addresses an immediately life-threatening problem; correcting Airway before Breathing, etc., follows a 'treat as you find' priority that prevents preventable deterioration or death.

8. What does the mnemonic SBAR stand for in clinical handover and information gathering?

   Situation, Background, Assessment, Recommendation — a structured tool for concise, accurate communication of patient information.

9. What is the difference between subjective and objective data in history taking?

   Subjective data is what the patient reports (symptoms, feelings, history they describe); objective data is what the nurse measures or observes (vital signs, examination findings, test results).

10. What does the SOCRATES mnemonic assess when taking a pain or symptom history?

    Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/relieving factors, and Severity.

11. What is the difference between an open and a closed question in history taking, and why use open questions first?

    Open questions invite a free narrative answer (e.g. 'Tell me about your breathing'); closed questions elicit a yes/no or short answer. Open questions first gather richer information and avoid leading the patient.

12. List the standard set of baseline observations (vital signs) recorded on admission.

    Respiratory rate, oxygen saturation (SpO2), heart/pulse rate, blood pressure, temperature, and level of consciousness (e.g. ACVPU), often with capillary blood glucose and pain score.

13. What is the normal adult respiratory rate range at rest?

    $12$–$20$ breaths per minute.

14. What is the normal adult resting heart rate range?

    $60$–$100$ beats per minute.

15. What is the typical normal adult oral/tympanic body temperature range?

    Approximately $36.1\,^{\circ}\mathrm{C}$ to $37.2\,^{\circ}\mathrm{C}$ (commonly cited as around $37\,^{\circ}\mathrm{C}$).

16. What target oxygen saturation range is generally recommended for adults without risk of hypercapnic respiratory failure?

    $94\%$–$98\%$ SpO2.

17. What is the recommended target SpO2 range for patients at risk of hypercapnic (type 2) respiratory failure, e.g. some COPD patients?

    $88\%$–$92\%$ SpO2.

18. What does the ACVPU scale assess and what do its letters stand for?

    It rapidly assesses level of consciousness: Alert, new Confusion, responds to Voice, responds to Pain, Unresponsive.

19. What is the National Early Warning Score 2 (NEWS2) and what does it measure?

    A standardised UK tool that aggregates six physiological parameters (respiratory rate, SpO2, air/oxygen, systolic BP, pulse, consciousness/ACVPU, temperature) into a single score to detect and escalate acute deterioration.

20. In NEWS2, what aggregate score typically triggers an urgent clinical/critical care response?

    A total score of $\geq 7$ (or any single parameter scoring 3) prompts urgent review; a score of $5$–$6$ is a key threshold for urgent escalation.

21. How is Mean Arterial Pressure (MAP) estimated from systolic (SBP) and diastolic (DBP) blood pressure?

    $$MAP \approx DBP + \frac{1}{3}(SBP - DBP)$$

22. Name three common risk-screening assessment tools used at admission in UK adult nursing.

    Waterlow or Braden (pressure ulcer risk), MUST (malnutrition risk), and a falls risk assessment; VTE risk assessment is also routinely completed.

23. What does the MUST tool screen for and what are its three components?

    MUST (Malnutrition Universal Screening Tool) screens nutrition risk using BMI score, unplanned weight loss score, and an acute disease effect score, summed to a 0–6+ risk category.

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