Intramuscular vitamin B12 with needle anxiety
RN OSCE practice station

The task

You are the RN in a general practice clinic. David Ellis, aged 63, is attending for prescribed maintenance hydroxocobalamin 1000 micrograms intramuscularly today for vitamin B12 deficiency. Check the prescription, calculate the volume and demonstrate a consent-based injection sequence. Complete the supplied practice record. You and the patient are in the room; assistance can be called. You have eight minutes; describe and select physical actions in this online exercise.

What this station tests

• David’s dose is 1000 micrograms, giving one mL of the supplied ampoule.
• Agree lying positioning and a stop signal before exposing injection equipment.
• Landmark the IM site and choose equipment for his assessed build.
• Light-headedness on sitting means support recovery before standing.
• Hydroxocobalamin can discolour urine; concerning associated symptoms still need assessment.

Sources for the clinical content

• ACSQHC medicine information: hydroxocobalamin (VITA-B12 Injection)
• NHMRC: Australian Guidelines for the Prevention and Control of Infection in Healthcare
• ACSQHC: Making informed choices (informed consent)
• ACSQHC: Communicating for Safety Standard

An original practice scenario with invented patients. Not an exam question.

Practise next

• Oral paracetamol with an uncertain dose history
• Mealtime subcutaneous insulin safety check
• Subcutaneous heparin with a safety pause
• Checking an oral dose on a child medication record
• An S8 tablet and the controlled medicine register