[2024年11月] 最新のOMSB OMSB_OENテスト問題集とオンライン試験エンジン
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質問 # 38
Which of the following scenarios will present a LEAST professional obligation for unit in-charge role as an advocate?
- A. Allocations and increment issues of a newly appointed nurses
- B. An elder patient challenges with need for social support for discharge related plans
- C. Requirement of total twenty full time nurses to support community during COVID-19
- D. Human resources office rejection of three months sick leave claim submitted by novice nurse
正解：A
解説：
As an advocate, a unit in-charge is responsible for supporting patients and staff in various professional and personal matters. Allocations and increment issues of newly appointed nurses, while important, generally fall under administrative and human resource functions and present the least direct professional obligation compared to issues that directly impact patient care and staff well-being. Ensuring adequate staffing during a crisis like COVID-19, advocating for an elder patient's social support needs for discharge, and addressing a nurse's sick leave claim have more immediate and significant implications for patient care and staff advocacy.
質問 # 39
While caring for a patient with leg ulcers, the nurse expects the patient to receive which of the following medical managements?
- A. Decompression therapy
- B. Positive pressure therapy
- C. Hyperbaric oxygenation
- D. Anticoagulant therapy
正解：C
解説：
* Leg Ulcers Management:
* Leg ulcers, especially chronic ones, require specific treatments to promote healing and prevent infection.
* Medical Management Options:
* Anticoagulant therapy:Typically used for conditions like deep vein thrombosis, not directly for leg ulcers.
* Decompression therapy and Positive pressure therapy:Not standard treatments for leg ulcers.
* Hyperbaric Oxygenation:This treatment involves breathing pure oxygen in a pressurized environment. It increases oxygen delivery to tissues, promotes healing, reduces inflammation, and fights infection, making it an effective treatment for chronic leg ulcers.
References:
* Wound Healing Society guidelines on leg ulcer treatment
* National Institutes of Health (NIH) on Hyperbaric Oxygen Therapy
質問 # 40
A nurse understands that patient with blood transfusion reaction is at risk to develop which of the following types of jaundice?
- A. Hemolytic
- B. Hepatocellular
- C. Obstructive
- D. Chronic
正解：A
解説：
A blood transfusion reaction can lead to hemolytic jaundice. This type of jaundice occurs when there is an excessive breakdown of red blood cells, leading to an increase in bilirubin production. Hemolytic reactions during a blood transfusion cause the destruction of the transfused red bloodcells, releasing large amounts of hemoglobin into the bloodstream, which is then converted to bilirubin, resulting in jaundice.
質問 # 41
A nurse found two different readings while measuring a blood pressure for a client at primary health care.
According to the guideline of National Non-communicable Disease (NCD) screening program, which of the following is the BEST nurse's action?
- A. Ask the patient to lay down and check BP in both arms
- B. Record the highest reading for both arms
- C. Record the average of the reading
- D. Repeat blood pressure measurement and take the average of the two readings
正解：D
解説：
* Guideline for Accurate Blood Pressure Measurement:
* Ensuring accurate and reliable blood pressure readings is crucial in diagnosing and managing hypertension.
* Action Steps:
* Record the average of two readings:Ensures a more accurate representation of the patient's blood pressure by minimizing potential anomalies from a single reading.
* Highest reading or laying down:These methods may lead to inconsistent or inaccurate results.
* Re-measure and average:This method is recommended to ensure reliability and accuracy by averaging out any potential anomalies in the readings.
References:
* American Heart Association (AHA) guidelines on Blood Pressure Measurement
* National Institutes of Health (NIH) on Hypertension Management
質問 # 42
A researcher is conducting a study on population with similar age group to determine the exposure and observe who get infected by specific disease over a period of time.
Which of the following type of studies is BEST describe the scenario?
- A. Ecologic
- B. Cohort
- C. Case-control
- D. Experimental
正解：B
解説：
A cohort study involves following a group of people who share a common characteristic or experience within a defined period to determine how certain exposures affect outcomes over time. In this scenario, the researcher is following a population of a similar age group over time to observe the incidence of a specific disease. This longitudinal approach helps to identify the relationship between exposure and the development of the disease, making it a cohort study.
質問 # 43
A nurse is providing education to a new parent about the psychosocial development of the newborn.
Applying Erikson's psychosocial development theory, the nurse would BEST instruct the parents to:
- A. Anticipate and plan for the newborn demands
- B. Provide and maintain comfortable environment for newborn
- C. Observe and respond to the newborn signals of needs
- D. Ignore and distract the newborn when crying
正解：C
解説：
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.
References:
* Erikson, E. H. (1963). Childhood and Society.
* American Psychological Association (APA): Erikson's Stages of Psychosocial Development
質問 # 44
The nurse understands that caring for a woman with gestational diabetic complications is exhibited as an example of.
- A. Health maintenance
- B. Health promotion
- C. Health restoration
- D. Health rehabilitation
正解：C
解説：
Caring for a woman with gestational diabetes complications falls under health restoration. Health restoration involves actions taken to return a patient to their previous state of health or to manage chronic conditions. This includes managing and treating complications to improve health outcomes. Health promotion focuses on preventing health problems through lifestyle changes, health maintenance involves ongoing monitoring and prevention of deterioration, and health rehabilitation focuses on helping patients recover functionality after severe illness or injury.
質問 # 45
A client with schizophrenia is placed on chlorpromazine 50 mg PO bid, and Benztropine 2 mg PO bid PRN.
Which of the following nursing assessment findings would indicate a need to administer Benztropine?
- A. Client is agitated severely
- B. Client develops muscle spasm and tremors
- C. Client complains of a sore throat
- D. Client expresses suicidal thoughts
正解：B
解説：
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.
質問 # 46
A nurse caring for a 52-year-old patient who is scheduled for cardiac surgery understands that this patient would be experiencing which of the following type of stressors?
- A. Psychological
- B. Physical
- C. Physiological
- D. Social
正解：A
解説：
* Types of Stressors in Preoperative Patients:
* Social:Related to interactions with family, friends, and community.
* Physical:Directly affecting the body, such as pain or physical disability.
* Physiological:Body's physical response to stress.
* Psychological:Mental and emotional response to stressors, including anxiety, fear, and worry about the surgery and its outcomes.
* Stressors for Cardiac Surgery Patients:
* Psychological:Patients scheduled for cardiac surgery often experience significant psychological stress due to fear of the procedure, potential complications, and concerns about recovery.
References:
* American Psychological Association (APA) on Stress and Surgery
* Mayo Clinic on Preoperative Anxiety and Stress Management
質問 # 47
A nurse is conducting a physical assessment of a 12-month-old child whose birth weight was 3.2 kg.
What would be the child's expected current weight?
- A. 12.8 kg
- B. 9.6 kg
- C. 7.3 kg
- D. 6.4 kg
正解：B
解説：
* Weight Doubling by 5-6 Months:
* Typically, a newborn's birth weight doubles by the time they are 5-6 months old.
* For this child, that would be: 3.2kg×2=6.4kg3.2 \, \text{kg} \times 2 = 6.4 \,
\text{kg}3.2kg×2=6.4kg.
* Weight Tripling by 1 Year:
* By the age of 12 months, a child's birth weight is expected to triple.
* So, for a child with a birth weight of 3.2 kg, the expected weight at 12 months is:
3.2kg×3=9.6kg3.2 \, \text{kg} \times 3 = 9.6 \, \text{kg}3.2kg×3=9.6kg.
References:
* American Academy of Pediatrics (AAP)
* World Health Organization (WHO) Growth Standards
質問 # 48
A nurse is preparing to collect a throat culture for a middle-aged male patient.
The nurse is aware that the swabbing should be collected from:
- A. Tongue and right or left buccal mucosa
- B. Any site of oral cavity mucosa
- C. Mucosa of oropharynx and tonsillar region
- D. Uvula and soft palate
正解：C
解説：
* Purpose of Throat Culture: A throat culture is performed to detect the presence of pathogens (like bacteria) that cause infections such as strep throat.
* Correct Technique:
* Uvula and Soft Palate: These are not the primary sites for collecting throat cultures.
* Any site of Oral Cavity Mucosa: This is too broad and non-specific.
* Tongue and Buccal Mucosa: These sites are not typically infected in throat infections and do not provide accurate culture results.
* Oropharynx and Tonsillar Region: The mucosa of the oropharynx and tonsillar region is the most common site of infection in throat infections, making it the appropriate site for swabbing.
* Procedure: The nurse should gently swab the oropharynx and tonsillar area, avoiding the tongue and other parts of the oral cavity to avoid contamination and ensure accurate results.
Conclusion: The correct site for collecting a throat culture is the mucosa of the oropharynx and tonsillar region, ensuring the detection of the causative pathogens.References: Clinical nursing skills textbooks, NCLEX-RN review guides, guidelines for throat culture collection.
質問 # 49
A nurse is preparing to infuse 500 ml of 0.9% sodium chloride intravenous (IV) solution over 4 hours. The drip factor is 15 drops/ml.
Which of the following values is the flow rate in drops/minute?
- A. 31 drops/minute
- B. 134 drops/minute
- C. 133 drops/minute
- D. 32 drops/minute
正解：D
解説：
To calculate the flow rate in drops per minute (gtt/min), use the formula:
Flow rate (gtt/min) = (Total volume (ml) × Drop factor (gtt/ml)) / Time (minutes) Given:
* Total volume = 500 ml
* Drop factor = 15 gtt/ml
* Time = 4 hours (240 minutes)
Flow rate (gtt/min) = (500 ml × 15 gtt/ml) / 240 minutes = 7500 gtt / 240 minutes = 31.25 gtt/min Rounded to the nearest whole number, the flow rate is 32 drops/minute.
質問 # 50
During the planning phase, a healthcare organization states its purposes and fundamental aims to achieve in the long term.
This defines which of the following organizational concept?
- A. Mission
- B. Strategy
- C. Vision
- D. Values
正解：A
解説：
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.
質問 # 51
A nurse is aiming to utilize an evidence based process to improve pain management for patients with cancer.
The initial step the nurse should start with is:
- A. Writing an answerable question
- B. Formulating Hypothesis statement
- C. Selecting the study design
- D. Obtaining the ethical approval
正解：A
解説：
The initial step in an evidence-based process to improve pain management for patients with cancer is to write an answerable question.
* Writing an Answerable Question: This is often done using the PICO (Patient/Problem, Intervention, Comparison, Outcome) format to clearly define the clinical issue and guide the research.
* Selecting the Study Design: This comes after formulating the question and involves choosing an appropriate methodology to answer it.
* Obtaining Ethical Approval: This is essential for conducting research but comes after defining the question and designing the study.
* Formulating Hypothesis Statement: This is part of the research design and planning, following the creation of an answerable question.
References:
* Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice.
* National Institutes of Health (NIH): Evidence-Based Practice Resources
質問 # 52
A 50-year-old multi-para woman complains of a soft bulge of tissue in her vagina. It is uncomfortable to her and is protruding through her vaginal orifice. The woman expresses her anxiety regarding her situation.
What is the IMMEDIATE action of the nurse?
- A. Teaches the woman about Kegel exercises
- B. Reassures the woman about her condition
- C. Refers the woman to the doctor
- D. Educates the woman about her diet
正解：C
解説：
* Soft Bulge in Vagina:
* This symptom could indicate a pelvic organ prolapse, such as a uterine or bladder prolapse, which requires medical evaluation and treatment.
* Immediate Action:
* Referral to Doctor:Immediate referral is necessary for proper diagnosis and to plan appropriate treatment.
* Diet and Reassurance:These are important but secondary actions after the initial medical assessment.
* Kegel Exercises:While beneficial for pelvic floor strengthening, they are not the immediate action in response to a significant prolapse.
References:
* American College of Obstetricians and Gynecologists (ACOG)
* Mayo Clinic Guidelines on Pelvic Organ Prolapse
質問 # 53
The nurse cares for a 60-year-old patient who is post renal transplant and on Sandimmune (Cyclosporine).
While assessing the patient the nurse observed signs of septic shock.
Which of the following is a risk factor that predisposes the patient for septic shock?
- A. History of medication sensitivity
- B. Multiple surgeries
- C. Immunosuppression
- D. Age
正解：C
解説：
* 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
質問 # 54
A woman presents to the clinic with signs and symptoms of menopause. The doctor advised to start hormonal replacement therapy. The woman enquired about the adverse effects of this therapy.
Which of the following is an adverse effects of the hormonal replacement therapy?
- A. Osteoporosis
- B. Endometrial cancer
- C. Atherosclerosis
- D. Cerebrovascular accident
正解：B
解説：
Hormone replacement therapy (HRT) can have several adverse effects. One significant risk associated with HRT, especially if estrogen is given without progesterone to women with an intact uterus, is the increased risk of endometrial cancer. Estrogen stimulates the lining of the uterus, and without the balancing effect of progesterone, this can lead to endometrial hyperplasia and potentially cancer. Other risks include breast cancer, blood clots, and stroke, but endometrial cancer is a specific concern with unopposed estrogen therapy.
質問 # 55
A mother of a newborn is diagnosed with breast cancer, the surgeon recommended to carry out an emergency operation.
According to Freud's theory, which stage of newborn development is being affected?
- A. Anal stage
- B. Oral stage
- C. Phallic stage
- D. Latent stage
正解：B
解説：
According to Freud's theory of psychosexual development, the stage affected in a newborn is the oral stage.
* Oral Stage: This stage occurs from birth to about 18 months of age, where the infant's pleasure centers on the mouth through activities like sucking and biting.
* Anal Stage: This stage follows the oral stage, from 18 months to 3 years, focusing on bowel and bladder control.
* Phallic Stage: This occurs from 3 to 6 years, focusing on the genitals and the differences between males and females.
* Latent Stage: This stage occurs from 6 years to puberty, characterized by dormant sexual feelings and a focus on social and intellectual skills.
References:
* Freud, S. (1905). Three Essays on the Theory of Sexuality.
* National Institutes of Health (NIH): Child Development Theories
質問 # 56
A nurse is caring for a patient with retinal detachment who is posted for retinopexy surgery.
The INITIAL nursing intervention in order to maintain pressure for reattaching the sensory retina:
- A. Provide eye patch with intact dressing
- B. Keep the patient in prone position
- C. Follow aseptic technique when cleaning the eye
- D. Instruct the patient to avoid lying on the surgical side
正解：A
解説：
* Retinal Detachment and Retinopexy:
* Retinal detachment is a serious condition where the retina peels away from its underlying layer.
Retinopexy surgery is performed to reattach the retina.
* Initial Nursing Interventions:
* Eye patch and dressing:Helps maintain pressure on the retina and prevent movement that could disrupt the reattachment process.
* Prone position and avoiding lying on surgical side:These are not specific standard initial interventions.
* Aseptic technique:Important but not the primary initial intervention for maintaining retinal attachment pressure.
References:
* American Academy of Ophthalmology (AAO) guidelines on Retinal Detachment
* Mayo Clinic guidelines on Retinopexy Surgery
質問 # 57
A group of nurses conducting a systematic review to identify best practice evidence for hemodialysis in patient with anemia.
Which of the following should considered based on level of research evidence?
- A. Case-control studies
- B. Randomized control studies
- C. Quasi-experimental studies
- D. Non-experimental studies
正解：B
解説：
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.
質問 # 58
A nurse is preparing to give health education for a client on hemodialysis.
What instruction the nurse will include in the teaching plan regarding dietary restriction?
- A. Sodium intake is restricted to 4-5 g/kg
- B. Protein intake is restricted to 1.2-1.3 g/kg
- C. Potassium intake is restricted to 3-4 g/kg
- D. Fluid intake is restricted to 2000 ml/day
正解：B
解説：
For clients on hemodialysis, protein intake is usually restricted to 1.2-1.3 g/kg of body weight to prevent the accumulation of waste products while still providing enough protein to maintain muscle mass and overall health. Sodium intake, fluid intake, and potassium intake are also important to monitor, but the specific restrictions for sodium and potassium vary based on individual needs and lab results. Fluid intake is typically individualized and may be more restrictive than 2000 ml/day.
質問 # 59
A nurse responds to clients' health needs and communicates with authorities to ensure the accessibility of services in rural areas.
The nurse here assuming the role of:
- A. Protector
- B. Teacher
- C. Manager
- D. Advocate
正解：D
解説：
In this scenario, the nurse is assuming the role of an advocate. Advocacy involves acting on behalf of patients to ensure they receive the necessary services and support. This includes communicating with authorities to improve access to healthcare services, especially in underserved areas like rural communities. By addressing barriers and promoting patients' needs, the nurse helps to ensure equitable access to care and resources.
質問 # 60
The aim of outcome research in nursing is to:
- A. Focus on the perception and of nursing professional
- B. Assess and documents the effectiveness of health care services
- C. Explore and investigate nursing clinical interventions
- D. Analyze the cause and effect relationship based on nursing actions
正解：B
解説：
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.
質問 # 61
A nurse is providing health teaching for a group of nursing students regarding the diagnostic tests for patient who is suffering from hearing loss.
Which of the following is the most IMPORTANT diagnostic test for hearing loss?
- A. Auditory brain stem response
- B. Middle ear endoscopy
- C. Audiometry
- D. Tympanogram
正解：C
解説：
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.
質問 # 62
A nurse is visiting an Asian family and found that both parents have cardiac problems. The nurse is aware of Asian genetic predisposition to cardiovascular diseases.
The nurse assessment falls below which of the following cultural assessment category?
- A. Cultural dietary practices
- B. Ethnic/racial background
- C. Socio-cultural practices
- D. Bio-cultural factors
正解：D
解説：
When assessing the health of a family, considering their genetic predispositions to certain conditions falls under the category of bio-cultural factors. These factors include genetic traits, physical characteristics, and biological variations that can influence health. In this case, the nurse's awareness of the genetic predisposition of Asian individuals to cardiovascular diseases helps in understanding the family's health risks.
質問 # 63
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2024年最新のOMSB_OENテスト解説（更新されたのは99問があります)：https://www.passtest.jp/OMSB/OMSB_OEN-shiken.html
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