Most Recent OMSB_OEN Exam Questions & Answers

Role of Circulating Nurse: The circulating nurse manages the overall environment of the operating room, ensuring safety and coordination among the surgical team. They are responsible for maintaining patient safety, including correct positioning.

Prioritizing Safety:

Risk for anxiety: While relevant, managing anxiety is typically addressed preoperatively and postoperatively, not the immediate intraoperative period.

Risk for bleeding: While bleeding is a concern, it is primarily monitored and managed by the surgical team.

Risk for injury related to positioning: During surgery, improper positioning can lead to nerve damage, pressure sores, and musculoskeletal injuries. The circulating nurse must ensure that the patient is correctly positioned to avoid these injuries.

Risk for infection: Preventing infection is crucial, but the sterile field and surgical techniques primarily address this risk.

Conclusion: The highest priority for the circulating nurse is to ensure the patient is correctly positioned to prevent any injury related to positioning, as this is a direct and immediate responsibility during the surgical procedure. Reference: Surgical nursing textbooks, NCLEX-RN review guides, AORN (Association of periOperative Registered Nurses) guidelines.

When an incident such as a patient fall occurs, specific protocols must be followed to ensure proper documentation and quality improvement processes.

Writing the Incident Report Immediately: The nurse should document the incident as soon as possible to ensure accurate details are captured.

Investigating the Root Cause of the Incident: This is essential to prevent future occurrences and improve patient safety. It involves a thorough analysis of the factors that led to the incident.

Writing the Incident Report by the Assigned Nurse: The nurse who witnessed or discovered the incident is typically responsible for documenting it, ensuring first-hand accuracy.

Documenting the Incident Report in Patient's Record: This is incorrect. Incident reports are meant for internal use to track and analyze incidents and should not be included in the patient's medical record. Including it in the patient's record can potentially compromise confidentiality and affect the patient's care.

The Joint Commission: Sentinel Event Policy and Procedures

National Patient Safety Foundation: Guidelines for Incident Reporting

Understanding Mastitis: Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth, and redness. It often occurs in breastfeeding women.

Appropriate Management:

Continue Breastfeeding: It is generally recommended to continue breastfeeding or pumping to relieve milk stasis and prevent further complications.

Analgesia: Pain relief medications (analgesia) can help manage discomfort associated with mastitis.

Antibiotics: Antibiotics are often prescribed, and improvement is typically seen within 24-48 hours.

Warm Compression: Applying warm compresses before breastfeeding can help alleviate pain and improve milk flow.

Incorrect Belief: The statement 'I need to stop breastfeeding until this condition resolves' indicates a misunderstanding. Stopping breastfeeding can worsen the condition due to milk stasis and increased engorgement.

Conclusion: The statement indicates a need for further teaching as continuing breastfeeding is crucial for managing and resolving mastitis. Reference: Maternal and child nursing textbooks, NCLEX-RN review guides, clinical guidelines on breastfeeding and mastitis management.

Sleep Disorders in Kidney Failure:

Patients with kidney failure often experience various sleep disturbances due to factors like uremic toxins, restless legs syndrome, and sleep apnea.

Priority Intervention:

Somnolence and Parasomnia: These are conditions where patients may feel drowsy or experience abnormal behaviors during sleep, but they are not as immediately concerning.

Hypersomnia: Excessive sleepiness can significantly impact daily functioning and quality of life, making it a priority for intervention.

Somnambulism: Sleepwalking can pose safety risks but is less common and usually less impactful than hypersomnia in kidney failure patients.

National Kidney Foundation (NKF)

American Academy of Sleep Medicine (AASM)

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.