JPNTest OMSB_OEN問題集99問でOMSB Certificationを確実実践
リアル最新OMSB_OEN試験問題OMSB_OEN問題集
質問 # 51
A nurse participated in the implementation phase of a national measles vaccination campaign.
Which of the following represents the role of the nurse in this phase?
- A. Reporting a vaccination rate to the Ministry of Health
- B. Identifying population at-risk
- C. Setting outreach strategies for unvaccinated
- D. Monitoring the vaccination rate and surveillance activities
正解：D
解説：
* 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
質問 # 52
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. Socio-cultural practices
- C. Bio-cultural factors
- D. Ethnic/racial background
正解：C
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 # 53
While caring for a patient diagnosed with cerebrovascular accident, the nurse noted that the patient is unable to recognize familiar objects.
The nurse would use which of the following terms to describe the finding?
- A. Aphasia
- B. Apraxia
- C. Agnosia
- D. Anopsia
正解：C
解説：
Agnosia is the term used to describe a condition where a person is unable to recognize familiar objects, even though their sensory modalities (like vision or hearing) are intact. This can occur after a cerebrovascular accident (stroke) if the part of the brain responsible for processing sensory information is damaged. Apraxia refers to the inability to perform purposeful movements or tasks despite having the desire and physical ability to do so. Aphasia is a condition characterized by the inability to understand or express speech. Anopsia refers to a defect in the visual field.
質問 # 54
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. Tympanogram
- B. Audiometry
- C. Auditory brain stem response
- D. Middle ear endoscopy
正解：B
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 # 55
While caring for a patient with leg ulcers, the nurse expects the patient to receive which of the following medical managements?
- A. Hyperbaric oxygenation
- B. Positive pressure therapy
- C. Decompression therapy
- D. Anticoagulant therapy
正解：A
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 # 56
A 10-year-old child with asthma has been on Fluticasone metered-dose inhaler for six months with no improvement seen in the pulmonary function tests.
Which of the following strategies would help the child have better control over the symptoms?
- A. Perform chest physiotherapy every 4-6 hours
- B. Add Salmeterol metered-dose inhaler to the treatment regimen
- C. Increase oral fluid intake to loosen the secretions
- D. Change Fluticasone to intravenous hydrocortisone
正解：B
解説：
* Asthma Management:
* When a patient does not respond to a single controller medication like Fluticasone (a corticosteroid), a step-up in therapy is often required.
* Treatment Strategies:
* Chest Physiotherapy and Increased Oral Fluid:Helpful but not primary interventions for improving pulmonary function in asthma.
* Intravenous Hydrocortisone:Typically for acute severe exacerbations, not chronic management.
* Adding Salmeterol (Long-acting Beta Agonist):Combined with an inhaled corticosteroid (ICS), it can improve asthma control by reducing symptoms and preventing exacerbations.
References:
* Global Initiative for Asthma (GINA) guidelines
* National Heart, Lung, and Blood Institute (NHLBI)
質問 # 57
A seven-year-old boy with autism is admitted with a leg fracture. The child has been following up in the rehabilitation center for speech and occupational therapies for the past two years.
How should the nurse address the child's speech and social needs during hospitalization?
- A. Review the child's therapy plan from the rehabilitation center
- B. Refer the child to the in-hospital speech and occupational therapy department
- C. Modify the child's daily routines
- D. Develop an occupational and speech care plan
正解：A
解説：
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.
質問 # 58
The aim of outcome research in nursing is to:
- A. Assess and documents the effectiveness of health care services
- B. Analyze the cause and effect relationship based on nursing actions
- C. Focus on the perception and of nursing professional
- D. Explore and investigate nursing clinical interventions
正解：A
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 # 59
A nursing director wishes to improve the job performance of a group of medical orderlies who are ineffective in their job.
Using Herzberg's theory of motivation, what would be the most appropriate motivator?
- A. Offering them opportunities for achievement and recognition
- B. Setting up a break room where they could socialize with staff nurses
- C. Redecorating their office so that they are pleasant and comfortable
- D. Providing them with a better healthcare plan
正解：A
解説：
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.
質問 # 60
A nurse is checking laboratory findings of a patient with Sickle Cell Disease (SCD).
Which of the following laboratory values would be MOSTLY seen in this disease?
- A. Low hematocrit level
- B. Low leucocyte level
- C. High reticulocyte level
- D. High platelet level
正解：C
解説：
In patients with Sickle Cell Disease (SCD), a high reticulocyte level is commonly observed.
* High Platelet Level: This is not typically associated with SCD.
* Low Hematocrit Level: While common in SCD due to anemia, it is not as specific as reticulocyte count.
* Low Leucocyte Level: This is not characteristic of SCD.
* High Reticulocyte Level: Elevated reticulocyte count indicates increased red blood cell production in response to chronic hemolysis (breakdown of red blood cells) seen in SCD.
References:
* National Heart, Lung, and Blood Institute (NHLBI): Sickle Cell Disease
* American Society of Hematology (ASH): Sickle Cell Disease and Reticulocyte Count
質問 # 61
A nurse is caring for an adult client with cancer who is complaining of acute pain.
The MOST appropriate pain assessment would be:
- A. The client's pain rating
- B. Pain relief after appropriate nursing intervention
- C. Nonverbal cues from the client
- D. The nurses' impression of the client's pain
正解：A
解説：
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.
質問 # 62
The nurse understands that caring for a woman with gestational diabetic complications is exhibited as an example of.
- A. Health promotion
- B. Health restoration
- C. Health rehabilitation
- D. Health maintenance
正解：B
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 # 63
A couple attends infertility clinic to review the investigation results. The laboratory results show that the man has aspermia. He asked the nurse about the meaning of aspermia.
The nurse replied that: "the aspermia means
- A. sperms count is lower than 20 million/milliliter"
- B. prematurity of sperms"
- C. abnormalities of the sperms'"
- D. absence of sperms"
正解：D
解説：
* Aspermia Definition:
* Aspermia is a medical term used to describe the complete absence of semen, which includes the absence of sperms.
* This condition can result from various factors such as hormonal imbalances, obstruction of the reproductive tract, or surgeries like vasectomy.
* Differentiation from Other Terms:
* Prematurity of Sperms:Refers to sperm cells that are not fully mature.
* Abnormalities of Sperms:Indicates that the sperm present have structural or functional defects.
* Low Sperm Count (Oligospermia):Describes a condition where the sperm count is lower than the normal threshold (20 million/milliliter).
References:
* Mayo Clinic
* American Society for Reproductive Medicine (ASRM)
質問 # 64
What is the maximum duration for therapeutic bath effects for a 45-year-old patient with perineum irritation?
- A. 10 minutes
- B. 90 minutes
- C. 15 minutes
- D. 5 minutes
正解：C
解説：
The maximum duration for the therapeutic effects of a bath, especially for conditions like perineum irritation, is generally 15 minutes. This duration is sufficient to provide relief and ensure the therapeutic benefits without causing skin maceration or other complications. Shorter durations may not provide adequate relief, and significantly longer baths can lead to issues like skin breakdown.
質問 # 65
A nursing instructor provides a session to a group of nursing students about the importance of anion gap in an acid base imbalance.
Which of the following statements if made by the nursing student would indicate the understanding of the teaching?
- A. The normal anion gap value is 6-8 mEq/L
- B. Anion gap of > 12 indicates metabolic acidosis
- C. Anion gap is calculated to decide the dose of soda bicarbonate
- D. Anion gap of < 8 indicates metabolic alkalosis
正解：B
解説：
* 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.
References:
* American Association for Clinical Chemistry (AACC)
* Mayo Clinic on Anion Gap
質問 # 66
Babies born to mothers with diabetes mellitus should be thoroughly assessed for which of the following conditions?
- A. Developmental dysplasia of the hip
- B. Cystic fibrosis
- C. Polycystic kidney disease
- D. Congenital heart defects
正解：D
解説：
* Diabetes Mellitus and Pregnancy:
* Mothers with diabetes mellitus, especially if poorly controlled, have a higher risk of having babies with congenital anomalies.
* Common Conditions in Infants:
* Congenital Heart Defects (CHDs):These are the most common congenital anomalies seen in babies born to mothers with diabetes. This includes conditions like ventricular septal defect, atrial septal defect, and transposition of the great arteries.
* Other Possible Conditions:Although cystic fibrosis, polycystic kidney disease, and
* developmental dysplasia of the hip can occur in newborns, they are not directly associated with maternal diabetes.
References:
* American Diabetes Association (ADA)
* Centers for Disease Control and Prevention (CDC)
質問 # 67
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 complains of a sore throat
- B. Client expresses suicidal thoughts
- C. Client develops muscle spasm and tremors
- D. Client is agitated severely
正解：C
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 # 68
The unit in-charge is following up an incident report for a patient who fell down from the bed to be written by the nurse.
Which of the following actions if done by the nurse needs to be corrected?
- A. Writing the incident report immediately
- B. Investigating the root cause of the incidence
- C. Documenting the incident report in patient's record
- D. Writing the incident report by the assigned nurse
正解：C
解説：
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.
References:
* The Joint Commission: Sentinel Event Policy and Procedures
* National Patient Safety Foundation: Guidelines for Incident Reporting
質問 # 69
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. Advocate
- B. Protector
- C. Teacher
- D. Manager
正解：A
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 # 70
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. Follow aseptic technique when cleaning the eye
- C. Keep the patient in prone position
- 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 # 71
A nurse is providing health education and instructions to a woman who has been diagnosed with mastitis.
Which of the following statements if made by the woman indicates a need for further teaching?
- A. "Analgesia will help me to alleviate some of the discomfort."
- B. "Warm compression to the breasts before feeding may be useful."
- C. "1 need to stop breastfeeding until this condition resolves."
- D. "1 need to take antibiotics and 1 will feel better in 24-48 hours."
正解：C
解説：
* 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.References: Maternal and child nursing textbooks, NCLEX-RN review guides, clinical guidelines on breastfeeding and mastitis management.
質問 # 72
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. Record the highest reading for both arms
- B. Ask the patient to lay down and check BP in both arms
- C. Repeat blood pressure measurement and take the average of the two readings
- D. Record the average of the reading
正解：C
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 # 73
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