OMSB-OEN Sample Questions & Answers

According to the hierarchy of evidence, systematic reviews and meta-analyses of multiple randomized controlled trials (RCTs) provide the highest level of evidence because they synthesize findings from multiple high-quality studies, increasing the strength and generalizability of the results. A single RCT is strong evidence but is subordinate to a systematic review. A case-control study is lower on the hierarchy than an RCT, and an expert opinion is considered the lowest level of evidence.

By 6 months, an infant should be able to roll from back to front and sit without support. Building a tower of three blocks is a milestone for an 18-month-old. Walking while holding onto furniture (cruising) typically occurs around 9-12 months. Speaking in three-word sentences is a milestone for a toddler, around 2-3 years of age.

By 6 months, an infant should be able to roll from back to front and sit without support. Building a tower of three blocks is a milestone for an 18-month-old. Walking while holding onto furniture (cruising) typically occurs around 9-12 months. Speaking in three-word sentences is a milestone for a toddler, around 2-3 years of age.

The patient is exhibiting classic signs of acute delirium, which is common in elderly post-operative patients. Delirium is often caused by an underlying medical condition. The priority nursing action is to assess for and identify treatable causes like hypoxia (check oxygen saturation), infection (check for fever, wound status, urinary symptoms), electrolyte imbalances, pain, or medication side effects. Restraints and sedative medications (especially benzodiazepines like lorazepam) can worsen delirium and should be avoided as first-line interventions. Documenting is important but is not the priority action.

Furosemide is a potent loop diuretic that causes significant fluid and electrolyte loss, particularly potassium. The primary therapeutic effect is increased urine output (diuresis), which must be monitored to evaluate effectiveness. The most critical adverse effect to monitor for is hypokalemia (low potassium), which can cause cardiac arrhythmias. While blood pressure and glucose can be affected, monitoring urine output for efficacy and potassium for safety are the highest priorities.

In a wet suction system, continuous gentle bubbling in the suction control chamber indicates that the suction is active and set correctly. This is a normal and expected finding. Vigorous bubbling might indicate the wall suction is set too high, but the bubbling itself is normal. Bubbling in the water-seal chamber would indicate an air leak. Clamping the tube is contraindicated unless specifically ordered or when changing the system. Therefore, the appropriate action is to document this normal finding.

The priority assessments for magnesium sulfate toxicity include respiratory rate (risk of respiratory depression/arrest), urine output (magnesium is excreted by the kidneys), and deep tendon reflexes (loss of reflexes is an early sign of toxicity). Calcium gluconate is the antidote. Fetal heart rate is a standard assessment but not a direct indicator of maternal toxicity. Blood glucose is not directly related to magnesium toxicity.

The priority assessments for magnesium sulfate toxicity include respiratory rate (risk of respiratory depression/arrest), urine output (magnesium is excreted by the kidneys), and deep tendon reflexes (loss of reflexes is an early sign of toxicity). Calcium gluconate is the antidote. Fetal heart rate is a standard assessment but not a direct indicator of maternal toxicity. Blood glucose is not directly related to magnesium toxicity.

The priority assessments for magnesium sulfate toxicity include respiratory rate (risk of respiratory depression/arrest), urine output (magnesium is excreted by the kidneys), and deep tendon reflexes (loss of reflexes is an early sign of toxicity). Calcium gluconate is the antidote. Fetal heart rate is a standard assessment but not a direct indicator of maternal toxicity. Blood glucose is not directly related to magnesium toxicity.

The only IV fluid compatible with blood products is 0.9% Sodium Chloride (Normal Saline). Dextrose solutions (like D5W) can cause hemolysis (rupture) of the red blood cells. Lactated Ringer's contains calcium, which can cause the blood to clot in the IV tubing. 0.45% NaCl is hypotonic and can also cause hemolysis.

During a panic attack, the most therapeutic approach is to provide a sense of safety and control. Acknowledging the patient's fear ('I can see you're very frightened'), offering presence ('I will stay with you'), and providing simple, concrete directions ('Try to take slow, deep breaths with me') is calming and helps the patient regain control. Telling someone to 'calm down' is dismissive. Asking 'why' can increase anxiety as the patient may not know the cause. Leaving the patient alone can escalate their fear.

Aspirin should never be given to a child with a viral illness like varicella due to the risk of developing Reye's syndrome, a rare but serious condition that causes swelling in the liver and brain. This statement indicates a critical need for further education. Keeping fingernails short prevents scratching and secondary bacterial infections. Calamine lotion can soothe itching. The child is contagious until all lesions have crusted over.

An INR of 4.5 is supratherapeutic (above the typical target range of 2.0-3.0), placing the patient at high risk for bleeding. The antidote for warfarin is Vitamin K (phytonadione), which helps restore the synthesis of clotting factors. Protamine sulfate is the antidote for heparin. Heparin would further increase the risk of bleeding. Fresh frozen plasma is used for active, severe bleeding.