OMSB OMSB_OEN - Omani Examination for Nurses

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.

When a patient aged 19 years old is placed in seclusion or restraint, the renewal of the order must be done every 4 hours. This requirement is based on the guidelines provided by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS), which regulate the use of seclusion and restraints in healthcare settings.

Initial Order: The use of seclusion or restraint must be ordered by a licensed independent practitioner (LIP), such as a physician.

Time Limits: For adults aged 18 and older, the order must be renewed every 4 hours.

Renewal Process: This renewal must involve an assessment of the patient's condition and the need for continued seclusion or restraint.

Documentation: The rationale for using seclusion or restraint and the patient's response to the intervention must be documented thoroughly in the patient's medical record.

References:

The Joint Commission: Standards for Behavioral Health Care

Centers for Medicare & Medicaid Services (CMS): Conditions of Participation for Hospitals, 42 CFR 482.13(e)

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.

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.

Screening Programs and Fasting Requirements:

Certain screening tests, like fasting blood glucose or lipid profiles, require fasting for accurate results.

Nurse's Response:

Not Eligible:Incorrect as the patient can still participate in parts of the screening.

Come Tomorrow:Not the most efficient use of the patient’s time.

No Worries:Incorrect as fasting is important for some tests.

Take History Now, Blood Test Later:The best response as it makes efficient use of the current visit for history taking and schedules the blood test for another time when fasting can be ensured.

References:

American Diabetes Association (ADA) guidelines

U.S. Preventive Services Task Force (USPSTF) guidelines

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.

When teaching nursing students about the recommended diet for a patient with a myocardial infarction, it's crucial to emphasize a diet low in fat and cholesterol. This helps in reducing the risk of further cardiovascular complications.

Low Fat and Cholesterol: Foods low in saturated fat and cholesterol are recommended to prevent the build-up of plaque in the arteries and reduce the risk of another heart attack.

Avoiding Red Meat: High intake of red meat is discouraged because it is often high in saturated fat and cholesterol.

Dark Chocolate Intake: While some dark chocolate in moderation can have health benefits due to its antioxidant properties, the emphasis should be on a balanced diet.

Protein and Carbohydrates: Protein is essential for recovery, but the focus should be on lean sources. Carbohydrates should come from whole grains and other healthy sources rather than simple sugars.

References:

American Heart Association (AHA): Dietary Recommendations for Cardiovascular Health

National Institutes of Health (NIH): Heart-Healthy Eating

Insufficient Sleep and Obesity:

Lack of sleep disrupts hormones that regulate hunger, such as leptin and ghrelin, leading to increased appetite and potential weight gain.

Studies have shown a clear link between insufficient sleep and higher body mass index (BMI).

Other Statements:

Depression and Weight:Depression can affect weight, often leading to weight gain or loss.

Work Stress and Diabetes:Stress is linked to type 2 diabetes, not type 1.

Activity Levels:While obesity can reduce activity levels, it is not universally true that all obese individuals are less active than those of normal weight.

References:

Centers for Disease Control and Prevention (CDC)

National Institutes of Health (NIH)

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

Establishing a respectful therapeutic relationship involves actively including the client's ideas, preferences, and opinions in their care planning. This action demonstrates respect for the client's autonomy and individuality, fostering trust and cooperation. Discussing non-health-related topics may help build rapport but does not directly contribute to a therapeutic relationship. Being congruent and understanding the client's thoughts and feelings are important but are part of the overall communication process rather than a specific action to establish respect in the relationship.