OMSB_OEN Omani Examination for Nurses Questions and Answers

Chlorpromazine is an antipsychotic medication that can cause extrapyramidal symptoms (EPS), such as muscle spasms and tremors. Benztropine is an anticholinergic medication often prescribed to manage these side effects.

If a client on chlorpromazine develops muscle spasms and tremors, it indicates EPS, and administering Benztropine would help alleviate these symptoms. The other options, such as severe agitation, sore throat, or suicidal thoughts, are not directly related to the need for Benztropine.

For a patient with HIV who is experiencing chronic diarrhea, anorexia, and weight loss, a high-protein, high-carbohydrate diet is recommended. This type of diet helps maintain muscle mass, provides energy, and supports overall nutritional status, which is critical for patients with HIV. Eating three large meals per day may not be practical due to anorexia and gastrointestinal symptoms; smaller, more frequent meals are often better tolerated. A low-protein, high-carbohydrate diet would not meet the nutritional needs, and unpasteurized dairy products pose a risk of foodborne infections.

Herzberg's two-factor theory of motivation distinguishes between hygiene factors and motivators. Hygiene factors (like pay, working conditions, and benefits) can prevent dissatisfaction but do not create long-term motivation. Motivators, on the other hand, are related to the nature of the work itself and include factors such as achievement, recognition, responsibility, and opportunities for growth. Offering opportunities for achievement and recognition is a motivator according to Herzberg's theory and would likely improve job performance by enhancing job satisfaction and intrinsic motivation.

When teaching nursing students about the recommended diet for a patient with a myocardial infarction, it's crucial to emphasize a diet low in fat and cholesterol. This helps in reducing the risk of further cardiovascular complications.

Low Fat and Cholesterol: Foods low in saturated fat and cholesterol are recommended to prevent the build-up of plaque in the arteries and reduce the risk of another heart attack.

Avoiding Red Meat: High intake of red meat is discouraged because it is often high in saturated fat and cholesterol.

Dark Chocolate Intake: While some dark chocolate in moderation can have health benefits due to its antioxidant properties, the emphasis should be on a balanced diet.

Protein and Carbohydrates: Protein is essential for recovery, but the focus should be on lean sources. Carbohydrates should come from whole grains and other healthy sources rather than simple sugars.

References:

American Heart Association (AHA): Dietary Recommendations for Cardiovascular Health

National Institutes of Health (NIH): Heart-Healthy Eating

Randomized controlled trials (RCTs) are considered the highest level of evidence in research because they reduce bias and provide the most reliable results. When conducting a systematic review to identify best practice evidence for hemodialysis in patients with anemia, RCTs should be prioritized. These studies provide strong evidence on the efficacy of interventions. Case-control studies, non-experimentalstudies, and quasi-experimental studies provide valuable information but are considered lower levels of evidence compared to RCTs.

Post Renal Transplant Care:

Patients who undergo renal transplants are prescribed immunosuppressive medications like Cyclosporine (Sandimmune) to prevent organ rejection.

Risk Factors for Septic Shock:

Age:Older adults have a higher risk of infections, but age alone is not the primary factor for septic shock in this context.

Multiple Surgeries:Increase the risk of infection but not as significant as immunosuppression.

Immunosuppression:The primary risk factor as it weakens the immune system, making the patient highly susceptible to infections leading to septic shock.

History of Medication Sensitivity:Important but less relevant to septic shock risk.

References:

National Institutes of Health (NIH) on post-transplant care

Mayo Clinic on Septic Shock

Audiometry is the most important diagnostic test for assessing hearing loss. This test measures a person's ability to hear sounds, varying in pitch and loudness. It is a comprehensive evaluation that helps determine the degree and type of hearing loss, whether it is conductive, sensorineural, or mixed. Tympanogram, middle ear endoscopy, and auditory brain stem response are also valuable diagnostic tools, but audiometry provides the primary assessment necessary for diagnosing hearing loss and guiding subsequent treatment.

Disaster Triage Principles:

In disaster scenarios, triage prioritizes patients based on the severity of their injuries and the likelihood of survival.

The goal is to provide the greatest good for the greatest number of people.

Triage Categories:

Immediate (Red):Life-threatening injuries requiring immediate intervention.

Delayed (Yellow):Serious injuries needing treatment but not immediately life-threatening.

Minor (Green):Minor injuries that can wait for treatment.

Expectant (Black):Injuries are so severe that survival is unlikely, even with treatment.

Case Analysis:

Conscious with Femur Fracture:Delayed category, serious but not immediately life-threatening.

Conscious with Superficial Cuts:Minor category, least priority but still above expectant.

Unconscious with Internal Bleeding:Immediate category, needs urgent intervention.

Unconscious with Open Skull Fracture and Brain Matter Showing:Expectant category, very low chance of survival, thus least priority.

References:

American College of Emergency Physicians (ACEP)

World Health Organization (WHO) on Mass Casualty Management Systems

Outcome research in nursing focuses on understanding the results of health care practices and interventions. It aims to evaluate how effective these practices are in improving patient outcomes. This type of research is crucial for ensuring that the care provided is evidence-based and leads to the best possible health results for patients.

For example, if a new wound care protocol is introduced, outcome research would measure whether patients heal faster or have fewer infections compared to the previous method. This helps in determining the effectiveness of the new protocol.

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.

References:

Joint Commission guidelines on patient safety

Fundamentals of Nursing textbooks

The most appropriate way to assess pain is by asking the client to rate their pain. Pain is a subjective experience, meaning only the person experiencing it can accurately describe its intensity and quality. This is often done using a numerical scale (0-10) where the patient rates their pain, with 0 being no pain and 10 being the worst pain imaginable.

Nonverbal cues and the nurse's impression can provide additional information, but they are not as reliable as the patient's self-report. Pain relief after interventions helps evaluate the effectiveness of the pain management but does not assess the initial pain level.

The staff nurse is facing an ethical dilemma in this situation. An ethical dilemma occurs when a nurse encounters a situation with conflicting moral principles and there is no clear right or wrong answer. Here, the nurse feels powerless due to the patient's suffering and the family's refusal to agree to a Do Not Resuscitate (DNR) order. This creates a conflict between the nurse's desire to alleviate suffering and respect for the family's wishes and autonomy. Moral outrage, moral conflict, and ethical indifference do not fully capture the complexity of the situation as ethical dilemmas do.

Post-Tonsillectomy Care:

After a tonsillectomy, the focus is on minimizing discomfort, preventing bleeding, and promoting healing.

Food and Drink Recommendations:

Citrus Juice and Carbonated Beverages:These can irritate the throat and should be avoided.

Fruits Cut into Pieces:Solid foods can be difficult to swallow and may cause discomfort.

Crushed Ice:Helps to soothe the throat, reduce swelling, and provide hydration without causing irritation.

References:

American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)

Mayo Clinic guidelines on tonsillectomy aftercare

When a child with autism is hospitalized, it is essential to maintain consistency and continuity in their care. Reviewing the child's therapy plan from the rehabilitation center ensures that the hospital staff can continue to address the child's speech and social needs in a manner that aligns with his established routines and therapy goals. Modifying daily routines or developing a new care plan without prior review may cause unnecessary stress or disruption. Referring the child to in-hospital therapy departments can be beneficial, but it should be done in conjunction with the existing plan to ensure continuity and effectiveness.

During the planning phase, a healthcare organization defines its mission, which states its purpose and fundamental aims to achieve in the long term. The mission statement outlines the organization’s core purpose, target population, and primary objectives. It provides direction and guides decision-makingand strategic planning. Vision, on the other hand, describes what the organization aspires to become in the future. Strategy refers to the specific actions and plans to achieve the mission and vision, while values are the principles and beliefs that guide the organization's behavior.

Implementation Phase in Vaccination Campaign:

During the implementation phase, the focus is on executing the vaccination plan, ensuring coverage, and monitoring progress.

Role of the Nurse:

Identifying Population at-risk:Typically part of the planning phase.

Setting Outreach Strategies:Also part of planning to ensure all populations are covered.

Reporting Vaccination Rates:This is part of the evaluation phase.

Monitoring Vaccination Rate and Surveillance:Involves actively overseeing the ongoing vaccination activities, ensuring proper documentation, and surveillance for adverse events or outbreaks, making it the correct answer.

References:

World Health Organization (WHO) guidelines on Immunization

Centers for Disease Control and Prevention (CDC) on Vaccine Implementation