Free OMSB-OEN sample questions

Correct answer: Prepare for a digital vaginal examination to assess cervical dilation.

In a patient with known or suspected placenta previa, digital vaginal examinations are absolutely contraindicated. Such an examination can disrupt the placenta and cause catastrophic hemorrhage. All other orders are appropriate: betamethasone is given to promote fetal lung maturity, continuous fetal monitoring assesses fetal well-being, and maintaining IV access is crucial in case of sudden decompensation and the need for fluid resuscitation or blood transfusion.

Correct answer: Metabolic Acidosis with respiratory compensation

The pH of 7.25 indicates acidosis (normal is 7.35-7.45). The HCO3 of 14 mEq/L is low (normal is 22-26 mEq/L), which points to a metabolic cause. The PaCO2 of 30 mmHg is also low (normal is 35-45 mmHg), indicating that the respiratory system is attempting to compensate by blowing off CO2 (an acid) to raise the pH. This pattern is characteristic of metabolic acidosis with respiratory compensation, which is the classic acid-base imbalance seen in DKA.

Correct answer: False

The initial assessment, analysis of data, and creation of the nursing care plan are components of the nursing process that fall within the scope of practice of a Registered Nurse (RN). While an LPN/PN can contribute to the care plan and implement interventions, the responsibility for the initial comprehensive assessment and plan formulation cannot be delegated to them, especially for a complex patient.

Correct answer: A systematic review of multiple randomized controlled trials.

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.

Correct answers: Sits without support for short periods.; Rolls from back to front.

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.

Correct answer: Assess for potential underlying causes such as hypoxia, infection, or electrolyte imbalance.

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.

Correct answer: Urine output and serum potassium levels.

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.

Correct answer: Document the finding as it is an expected occurrence.

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.

Correct answers: Respiratory rate; Urine output; Deep tendon reflexes

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.

Correct answer: 0.9% Sodium Chloride (Normal Saline)

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.