OMSB OMSB_OEN Practice Test Questions Answers

The patient's symptoms—crackles in the lung bases, elevated blood pressure, and rapid weight gain—are indicative of fluid overload, which is a common issue in chronic renal failure due to the kidneys' inability to excrete excess fluid.

Increased Cardiac Output Related to Fluid Overload: Increased cardiac output would not typically result from fluid overload; rather, fluid overload can lead to decreased cardiac output due to strain on the heart.

Ineffective Tissue Perfusion Related to Interrupted Arterial Blood Flow: This diagnosis does not directly correlate with the symptoms of fluid overload observed in this patient.

Imbalanced Nutrition More Than Body Requirements Related to Dietary Excess: This diagnosis is not relevant to the observed symptoms, which are more clearly related to fluid retention rather than dietary intake.

Excess Fluid Volume Related to the Kidney's Inability to Maintain Fluid Balance: This is the most appropriate nursing diagnosis as it directly addresses the kidney's failure to regulate fluid balance, leading to the observed clinical signs.

References:

National Kidney Foundation: Clinical Practice Guidelines for Chronic Kidney Disease

Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care

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

Treatment and Contagious Period:

Streptococcal pharyngitis (strep throat) is highly contagious, and patients need to follow specific guidelines to prevent spreading the infection.

Health Instructions:

Full course of therapy:Ensures complete eradication of the bacteria and reduces the risk of complications.

Replace toothbrush:Prevents reinfection from bacteria that may remain on the old toothbrush.

Avoid sharing food:Prevents transmission of the infection to others.

Returning to work:Patients should wait until they are no longer contagious, usually 24 hours after starting antibiotic therapy and being fever-free, before returning to work.

References:

Centers for Disease Control and Prevention (CDC) guidelines on Strep Throat

Mayo Clinic guidelines on Streptococcal Pharyngitis

A history of chlamydial infection is a significant risk factor for ectopic pregnancy. Chlamydia can cause scarring and damage to the fallopian tubes, increasing the likelihood of a fertilized egg implanting outside the uterus. Oral contraceptive usage generally reduces the risk of ectopic pregnancy. The frequency of sexual activity and history of urinary tract infections are not directly related to the risk of ectopic pregnancy. Identifying and understanding these risk factors is essential for appropriate management and prevention strategies.

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.