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OMSB Leadership, Ethics & Prioritisation Practice Questions
Leadership questions test which patient to see first, what can be delegated, ethical principles and safe communication such as SBAR handover. Below are 5 free sample questions for the OMSB nursing exam, each with the answer and a rationale.
What this topic covers
- Prioritisation: ABCs and unstable vs stable
- Delegation to nursing assistants
- SBAR handover
- Ethical principles and confidentiality
- Informed consent and advocacy
- Disaster triage (START)
The full bank has 70 leadership, ethics & prioritisation questions, part of 1,500 questions across 16 nursing topics.
Free OMSB leadership, ethics & prioritisation questions
1. A nurse is caring for a patient from a culture where the family traditionally makes decisions together. The competent patient wants the family involved. What should the nurse do?
- A. Exclude the family to protect confidentiality
- B. Tell the patient they alone must decide
- C. Ask the family to decide without the patient
- D. Respect the patient's wish and involve the family in discussions
Show answer and rationale
A competent patient may choose to involve family in decisions; respecting this honours both autonomy and cultural values.
Reference: Standard nursing – cultural competence
2. A nurse speaks with the doctor because a patient's pain is not controlled by the current prescription. This is an example of:
- A. Delegation
- B. Negligence
- C. Advocacy
- D. Paternalism
Show answer and rationale
Advocacy means acting on behalf of the patient to ensure their needs and interests are met.
Reference: Standard nursing ethics – advocacy
3. A nurse believes a prescribed dose is unsafely high. The doctor insists it is correct without explanation. What should the nurse do?
- A. Withhold the dose and escalate to a senior doctor or nurse in charge
- B. Give the dose because the doctor is responsible
- C. Give half the dose as a compromise
- D. Ask the patient to decide
Show answer and rationale
Nurses are accountable for medications they give and should not administer a dose they believe is unsafe; they escalate through the chain of command and document.
Reference: Standard nursing professional practice – questioning orders
4. Using START triage, a non-walking casualty is breathing 20/min, has a radial pulse and can follow simple commands. How is this casualty tagged?
- A. Red (immediate)
- B. Black (expectant)
- C. Yellow (delayed)
- D. Green (minor)
Show answer and rationale
A non-walking casualty with respirations under 30/min, adequate perfusion and ability to follow commands is tagged yellow (delayed).
Reference: START triage – mass casualty principles
5. After receiving handover, which patient should the nurse see first?
- A. A patient with chronic kidney disease awaiting morning dialysis
- B. A patient 2 days after hip replacement requesting pain relief (pain 4/10)
- C. A patient with asthma who is newly using accessory muscles and speaking in single words
- D. A patient with diabetes whose breakfast tray has arrived
Show answer and rationale
Airway and breathing problems take priority; accessory muscle use and inability to speak in sentences indicate severe, acute respiratory distress. The others are stable or expected.
Reference: Saunders NCLEX review – prioritisation (ABC)
Study tip
For 'who first' questions, look for the patient whose airway, breathing or circulation is at risk right now.
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