The 12 Known OSCE APIE Scenarios

The 12 scenarios listed here are not official NMC publications. They circulate widely among international nurses preparing for the OSCE and are based on candidate accounts of the scenarios they encountered in their sittings.

Treat them as preparation themes: focus areas to study, frameworks to practice, conditions to know. The actual scenarios at your sitting may match these directly or use variants.

The 12 scenarios

1. Alzheimer’s / dementia care

Scenario type: an elderly patient with dementia presenting with a clinical issue (often confusion progression, agitation, fall risk, or co-morbidity).

Key knowledge:

• Mental capacity assessment for the specific decision.
• Communication adaptations for dementia (clear language, time, calm environment).
• Risk assessment for falls, wandering, nutrition.
• Family/carer involvement.
• Safeguarding awareness.

Key NICE guidance: NG97 (Dementia: assessment, management and support for people living with dementia and their carers).

2. Anxiety / depression

Scenario type: an adult presenting with anxiety or low mood, often in primary care or general ward context.

Key knowledge:

• Mental health risk assessment (suicide/self-harm screening).
• Communication techniques (active listening, validation).
• Onward referral pathways.
• Recognition of physical symptoms of anxiety.

Key NICE guidance: CG113 (Generalised anxiety disorder) and CG90 (Depression in adults).

3. Asthma

Scenario type: an adult with asthma, often presenting with an acute exacerbation.

Key knowledge:

• Acute asthma severity assessment.
• Peak flow measurement and interpretation.
• Oxygen therapy and inhaler/nebuliser technique.
• Escalation triggers.

Key NICE guidance: NG244 (Asthma).

4. Chronic heart failure

Scenario type: an adult with established heart failure, often presenting with worsening symptoms.

Key knowledge:

• Fluid balance and oedema assessment.
• NYHA functional classification awareness.
• Medication adherence and education.
• Daily weighing and symptom diary education.

Key NICE guidance: NG106 (Chronic heart failure).

5. Community diabetes

Scenario type: a patient with type 2 diabetes in a community or outpatient context.

Key knowledge:

• Blood glucose monitoring technique.
• HbA1c interpretation.
• Foot assessment.
• Diet and lifestyle education.
• Insulin administration if relevant.

Key NICE guidance: NG28 (Type 2 diabetes in adults).

6. Ectopic pregnancy

Scenario type: a woman of reproductive age presenting with abdominal pain or bleeding.

Key knowledge:

• Recognition of red flags.
• ABCDE assessment.
• Sensitivity in communication.
• Urgent escalation.

Key NICE guidance: NG126 (Ectopic pregnancy and miscarriage).

7. End-of-life care

Scenario type: a patient in the last days or hours of life, focus on comfort care.

Key knowledge:

• Recognition of dying.
• Pain and symptom management.
• Family support.
• Documentation of preferences (ReSPECT, advance care plans).
• Care after death.

Key NICE guidance: NG31 (Care of dying adults in the last days of life).

8. Fall / fracture

Scenario type: an elderly patient with a fall, often with a suspected or confirmed fracture.

Key knowledge:

• Pain assessment.
• Falls risk assessment and prevention.
• NEWS2 and ABCDE.
• Communication and dignity during examination.
• Medication review for falls risk.

Key NICE guidance: CG161 (Falls in older people) and NG124 (Hip fracture).

9. Hernia

Scenario type: a patient with a hernia, often pre- or post-surgical.

Key knowledge:

• Pre-operative assessment and patient preparation.
• Post-operative wound care.
• Pain management.
• Discharge planning.

Key NICE guidance: various surgical pathways.

10. Homelessness

Scenario type: a patient who is homeless, presenting with a health issue that’s complicated by their housing situation.

Key knowledge:

• Holistic assessment including social circumstances.
• Recognition of common health issues in homeless populations.
• Onward referral pathways (social services, housing teams).
• Safeguarding considerations.
• Communication without judgement.

Key NICE guidance: NG214 (Integrated health and social care for people experiencing homelessness).

11. Pneumonia

Scenario type: an adult presenting with community-acquired or hospital-acquired pneumonia.

Key knowledge:

• CURB-65 score awareness.
• Sepsis screening (Sepsis Six).
• Oxygen therapy.
• Antibiotic administration.
• NEWS2 deterioration recognition.

Key NICE guidance: NG138 (Pneumonia in adults).

12. Subdural haematoma

Scenario type: an adult (often elderly) with a head injury developing neurological symptoms.

Key knowledge:

• Neurological assessment (GCS, pupil response).
• Recognition of delayed presentation.
• Urgent escalation.
• ABCDE assessment.

Key NICE guidance: NG232 (Head injury).

How to use the list for preparation

For each of the 12:

• Read the relevant NICE guideline (or its summary).
• Know the typical presentation.
• Practice an ABCDE assessment on the scenario.
• Draft a SMART care plan.
• Identify the priorities and the escalation triggers.

You don’t have to memorise care plans. Memorise the framework that produces a care plan for any of these scenarios.

What if your scenario isn’t on the list

The 12 are reported scenarios, not exhaustive. Your sitting may include a scenario from outside this list. The framework still applies:

• ABCDE for acutely unwell.
• Holistic assessment for stable patients.
• NEWS2 where vital signs warrant.
• SMART care plan structure.
• Patient-centred communication throughout.

A candidate prepared for these 12 scenarios is generally prepared for most plausible variants.

This is the end of Part 6. The next part (chapters 85-94) covers clinical reference content: NEWS2, ABCDE, SBAR, drug calculations, hand hygiene, PPE, ANTT, sepsis red flags, and the top 20 UK nursing drugs.