Important OMSB_OEN Exam Questions

Answer: D

Explanation:

Patient History: The patient has angina pectoris, which means they have episodes of chest pain due to reduced blood flow to the heart muscle. Nitroglycerin is a common medication used to relieve this pain by dilating blood vessels.

Nitroglycerin Mechanism: Nitroglycerin works by relaxing and widening blood vessels, which decreases the workload on the heart and increases blood flow to the heart muscle. This process typically lowers blood pressure.

Assessment Concerns:

Heart rate of 90 bpm: This is within the normal range and does not typically contraindicate the use of nitroglycerin.

Blood sugar of 12 mmol/L: Elevated blood sugar is concerning but not directly affected by nitroglycerin administration.

Blood pressure of 190/110 mmHg: This is high and nitroglycerin can help reduce it. High blood pressure is often treated with nitroglycerin.

Blood pressure of 80/60 mmHg: This is hypotension (low blood pressure). Since nitroglycerin lowers blood pressure further, administering it to a patient with already low blood pressure can lead to severe hypotension, which is life-threatening.

Conclusion: The most concerning finding is the low blood pressure (80/60 mmHg) because administering nitroglycerin in this situation can further lower the blood pressure to dangerous levels. Reference: NCLEX-RN review guides, pharmacology textbooks, clinical guidelines on the management of angina pectoris and nitroglycerin use.

Answer: A

Explanation:

When assessing the health of a family, considering their genetic predispositions to certain conditions falls under the category of bio-cultural factors. These factors include genetic traits, physical characteristics, and biological variations that can influence health. In this case, the nurse's awareness of the genetic predisposition of Asian individuals to cardiovascular diseases helps in understanding the family's health risks.

Spector, R. E. (2017). Cultural Diversity in Health and Illness. Pearson.

Answer: C

Explanation:

Safety in Bedridden Patient Care:

Ensuring patient safety is paramount before beginning any care activities.

Priority Actions:

Bed Locked: Prevents bed movement which could cause patient falls.

Pillows and Bed Sheets: Secondary actions related to patient comfort and hygiene.

Client Position: Important but ensuring bed stability is the first step for safety.

Joint Commission guidelines on patient safety

Fundamentals of Nursing textbooks

Answer: B

Explanation:

A perforated appendix is a medical emergency requiring immediate surgical intervention to prevent complications such as peritonitis and sepsis. Therefore, an appendectomy in this context is classified as an emergent procedure. Emergent surgeries are those that need to be performed without delay to preserve the patient's life or health.

Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing. Lippincott Williams & Wilkins.

Answer: D

Explanation:

Screening Programs and Fasting Requirements:

Certain screening tests, like fasting blood glucose or lipid profiles, require fasting for accurate results.

Nurse's Response:

Not Eligible: Incorrect as the patient can still participate in parts of the screening.

Come Tomorrow: Not the most efficient use of the patient's time.

No Worries: Incorrect as fasting is important for some tests.

Take History Now, Blood Test Later: The best response as it makes efficient use of the current visit for history taking and schedules the blood test for another time when fasting can be ensured.

American Diabetes Association (ADA) guidelines