Most Recent OMSB_OEN Exam Questions & Answers

Applying Erikson's psychosocial development theory, the nurse should instruct the parents to observe and respond to the newborn's signals of needs. According to Erikson, the first stage of psychosocial development is 'Trust vs. Mistrust,' which occurs from birth to approximately 18 months.

Trust vs. Mistrust: In this stage, infants learn to trust their caregivers when their needs for food, comfort, and affection are consistently met. If caregivers are responsive to the infant's needs, the infant develops a sense of trust and security.

Ignoring and Distracting the Newborn: This approach may lead to feelings of mistrust as the infant's needs are not being adequately addressed.

Anticipating and Planning for the Newborn's Demands: While planning is important, it is more crucial to be responsive to the infant's immediate signals.

Providing a Comfortable Environment: This is beneficial but must be combined with responsive caregiving to establish trust.

Erikson, E. H. (1963). Childhood and Society.

American Psychological Association (APA): Erikson's Stages of Psychosocial Development

Handling Medication Refusal:

When a patient refuses medication, the nurse must assess the reason and ensure the patient's safety and adherence to treatment plans.

Best Actions:

Report to the Physician: Ensures the healthcare provider is aware and can make necessary adjustments or provide alternatives.

Crushing Medication and Mixing: Bisacodyl tablets should not be crushed as it can alter the drug's effectiveness and increase side effects.

Informing about Dosing: Not helpful if the patient is already refusing.

Ice Chips: Not relevant to enhancing medication compliance.

American Nurses Association (ANA) on patient medication administration

Pharmacology guidelines on Bisacodyl administration

Nurse's Advocacy Role:

Advocacy involves supporting and promoting the interests and well-being of patients, especially when they are unable to do so themselves due to various barriers.

Case Analysis:

70-year-old stroke patient with son: Likely has family support and an advocate in the son.

Newborn with mother for breastfeeding: Mother is present to provide care and advocacy.

15-year-old awaiting consent for surgery: Typically has parental or guardian support for decision-making.

40-year-old with language barrier: This patient needs advocacy to ensure clear communication and understanding of postoperative care and complications due to the language barrier.

American Nurses Association (ANA) on Patient Advocacy

Joint Commission guidelines on effective communication in healthcare

Understanding Anion Gap:

The anion gap is a calculated value based on the concentrations of cations (positively charged ions) and anions (negatively charged ions) in the blood, used to identify the causes of metabolic acidosis.

Normal and Abnormal Values:

Normal Anion Gap: Typically ranges from 8-12 mEq/L, though some sources consider 6-12 mEq/L as normal.

High Anion Gap (> 12): Indicates metabolic acidosis, often due to conditions like ketoacidosis, lactic acidosis, or ingestion of toxins.

Low Anion Gap (< 8): Not typically associated with metabolic alkalosis; other conditions like hypoalbuminemia may cause it.

Clinical Relevance:

Anion gap helps clinicians determine the underlying cause of acid-base imbalances and guide appropriate treatment.

American Association for Clinical Chemistry (AACC)

Mayo Clinic on Anion Gap

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