NCLEX-PN Physiological Adaptation Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Hard

   A nurse in a long-term care facility cares for a client who has chronic obstructive pulmonary disease. Which finding best indicates that the client's condition is acutely worsening and requires immediate reporting?

   1. AA. Productive cough that is worse each morning
   2. BB. Barrel-shaped chest with prolonged expiration
   3. CC. New drowsiness with slow, shallow breathing
   4. DD. Clubbing of the fingertips for many years
   Show answer to question 1

   Answer: C. New drowsiness with slow, shallow breathing

   New drowsiness with slow, shallow breathing suggests carbon dioxide retention and impending respiratory failure, an acute change that needs prompt reporting.

   Why the other options are wrong

   • AA productive cough that is worse in the morning is an expected, chronic finding in COPD and is not a sudden change.
   • BBarrel chest and prolonged expiration are long-standing structural changes of COPD, not signs of acute worsening.
   • DClubbing develops over many years with chronic hypoxia and is not an acute change.

2. Question 2 of 25Easy

   The licensed practical nurse (LPN) is collecting data on a client diagnosed with heart failure who reports sudden, severe dyspnea and extreme anxiety. Which clinical finding should the nurse recognize as a hallmark manifestation of acute pulmonary edema?

   1. AA. Occurrence of severe flank pain radiating to the groin
   2. BB. Development of painful, generalized dry skin
   3. CC. Expectoration of frothy, pink-tinged sputum
   4. DD. Presence of bilateral calf redness and tenderness
   Show answer to question 2

   Answer: C. Expectoration of frothy, pink-tinged sputum

   Frothy, pink-tinged sputum is a classic hallmark sign of acute pulmonary edema, caused by fluid and red blood cells leaking into the alveoli under high hydrostatic pressure. Calf redness and tenderness suggest deep vein thrombosis rather than pulmonary edema. Flank pain radiating to the groin typically indicates renal calculi.

3. Question 3 of 25Medium

   A nurse in a clinic reinforces teaching with a client who has a history of anaphylaxis to insect stings and is prescribed an epinephrine auto-injector. Which client statement shows understanding of the teaching?

   1. AA. "I will wait 30 minutes to see if my symptoms get any worse first."
   2. BB. "I will inject into my buttock so the medicine works much faster."
   3. CC. "I will use my outer thigh, then call 911 even if I feel better."
   4. DD. "I will call 911 only if I need to give myself a second injection."
   Show answer to question 3

   Answer: C. "I will use my outer thigh, then call 911 even if I feel better."

   Epinephrine is injected into the outer mid-thigh at the first signs of anaphylaxis, and emergency services must be called afterward because symptoms can return or worsen.

   Why the other options are wrong

   • AWaiting 30 minutes to inject delays epinephrine and risks rapid airway and circulatory collapse.
   • BThe buttock is not the recommended site, and the outer thigh gives more reliable absorption.
   • DEmergency care is needed after any epinephrine use, not only when a second injection is required.

4. Question 4 of 25Medium

   A home health nurse visits a 78-year-old man who has had vomiting and diarrhea for 3 days. Which findings best support a fluid volume deficit?

   1. AA. Weight gain of 2 lb with bounding pulses and swollen ankles
   2. BB. Jugular vein distention with bibasilar crackles on lung exam
   3. CC. Moist mucous membranes with pale, plentiful urine output
   4. DD. Rapid heart rate, low blood pressure, and scant dark urine
   Show answer to question 4

   Answer: D. Rapid heart rate, low blood pressure, and scant dark urine

   Fluid loss lowers circulating volume, causing compensatory tachycardia, low blood pressure, and concentrated, decreased urine output.

   Why the other options are wrong

   • AWeight gain, bounding pulses, and swollen ankles suggest fluid volume excess, not fluid loss.
   • BJugular vein distention and bibasilar crackles are signs of fluid overload, not deficit.
   • CMoist mucous membranes and plentiful pale urine indicate adequate hydration, not dehydration.

5. Question 5 of 25Medium

   A clinic nurse checks a client's abdominal incision 3 days after surgery. Which finding is consistent with the normal inflammatory phase of healing and does NOT need to be reported?

   1. AA. Mild redness, warmth and slight swelling at the incision edges
   2. BB. Yellow-green drainage with a foul odor coming from the incision
   3. CC. Red streaks extending outward from the incision into nearby skin
   4. DD. Separation of the incision edges with deeper tissue now visible
   Show answer to question 5

   Answer: A. Mild redness, warmth and slight swelling at the incision edges

   Early healing involves inflammation, with vasodilation causing mild local redness, warmth and swelling that stay limited to the incision edges.

   Why the other options are wrong

   • BFoul-smelling, discolored drainage suggests a wound infection and must be reported.
   • CRed streaks spreading from the incision suggest infection moving through the lymphatic vessels.
   • DSeparation of the edges with visible deeper tissue indicates dehiscence and must be reported.

6. Question 6 of 25Medium

   During a home visit, a 70-year-old client reports vomiting and diarrhea for two days. Which assessment findings best support a fluid volume deficit?

   1. AA. Bounding pulse and crackles in both lung bases
   2. BB. Rapid, weak pulse and dark, concentrated urine
   3. CC. Weight gain and pitting edema of the ankles
   4. DD. Distended neck veins and elevated blood pressure
   Show answer to question 6

   Answer: B. Rapid, weak pulse and dark, concentrated urine

   Fluid loss lowers circulating volume, causing a rapid, weak pulse as the heart compensates, and the kidneys conserve water, producing dark, concentrated urine.

   Why the other options are wrong

   • ABounding pulse and crackles suggest fluid volume excess, not loss.
   • CWeight gain and edema indicate retained fluid; fluid loss causes weight loss.
   • DDistended neck veins and high blood pressure are signs of fluid overload.

7. Question 7 of 25Hard

   In a primary care clinic, a 24-year-old male client develops lip swelling, wheezing, and dizziness after an injection. The provider gave intramuscular epinephrine 5 minutes ago and emergency services are on the way. The client now has persistent wheezing, a blood pressure of 82/50 mm Hg, and a weak, rapid pulse. Which action by the nurse is most appropriate?

   1. AA. Keep the client supine with legs raised, monitor airway and vital signs, and notify the provider
   2. BB. Help the client sit upright in a chair to ease breathing and give an oral antihistamine tablet
   3. CC. Reassure the client that the reaction is improving and recheck his vital signs in 15 minutes
   4. DD. Move the client to the waiting room with a family member so the exam room can be prepared for others
   Show answer to question 7

   Answer: A. Keep the client supine with legs raised, monitor airway and vital signs, and notify the provider

   Persistent wheezing and hypotension after epinephrine indicate an inadequate response. The nurse keeps the client supine with legs elevated, monitors closely, and informs the provider so that repeat epinephrine or other treatment can be ordered.

   Why the other options are wrong

   • BSitting upright can worsen hypotension, and an oral tablet is unsafe and too slow with airway swelling.
   • CThe findings are not improving, and waiting 15 minutes to reassess is unsafe for an unstable client.
   • DAn unstable client must not be moved to a waiting room where he cannot be closely monitored.

8. Question 8 of 25Medium

   A client with type 1 diabetes mellitus who has had the flu and vomiting for two days has a blood glucose of 480 mg/dL. Which finding reflects the body's attempt to compensate for metabolic acidosis?

   1. AA. Slow, shallow breathing with cool, clammy skin
   2. BB. Deep, rapid respirations with fruity breath odor
   3. CC. Tremors, sweating, and intense hunger with pallor
   4. DD. Slow heart rate with warm, moist, flushed skin
   Show answer to question 8

   Answer: B. Deep, rapid respirations with fruity breath odor

   Without enough insulin, ketone acids build up. The lungs blow off carbon dioxide through deep, rapid Kussmaul respirations, and acetone gives the breath a fruity odor.

   Why the other options are wrong

   • ASlow, shallow breathing would worsen acidosis, and cool, clammy skin fits hypoglycemia rather than ketoacidosis.
   • CTremors, sweating, hunger, and pallor are classic signs of hypoglycemia, not hyperglycemia with acidosis.
   • DKetoacidosis with dehydration usually causes a rapid heart rate and dry skin, not a slow rate and moist skin.

9. Question 9 of 25Hard

   A nurse is caring for a client receiving a continuous heparin infusion. The nurse notes blood-tinged urine, a pulse of 112 and a blood pressure of 94/58 mm Hg, down from 128/76 mm Hg earlier. Which action should the nurse take?

   1. AA. Continue the infusion as ordered and recheck vital signs in 1 hour
   2. BB. Send a urine specimen for culture and document the findings in the chart
   3. CC. Encourage oral fluids and walking to help clear the blood-tinged urine
   4. DD. Report the findings to the RN immediately and stay to recheck vital signs
   Show answer to question 9

   Answer: D. Report the findings to the RN immediately and stay to recheck vital signs

   Hematuria with tachycardia and falling blood pressure suggests significant bleeding and early shock from anticoagulant therapy. Immediate reporting and close monitoring take priority.

   Why the other options are wrong

   • AWaiting an hour while the infusion runs risks progression of blood loss in an unstable client.
   • BA culture and documentation do not address the possible hemorrhage and delay notification of the RN.
   • CWalking can worsen hypotension and bleeding risk in a client who may be unstable.

10. Question 10 of 25Medium

    A client with heart failure received furosemide for fluid overload. Which finding best indicates that the treatment has been effective?

    1. AA. Increased swelling in both lower legs
    2. BB. Heart rate rising from 82 to 110 beats per minute
    3. CC. Weight gain of 2 pounds in 24 hours
    4. DD. Weight loss of 1 kilogram with clearer lungs
    Show answer to question 10

    Answer: D. Weight loss of 1 kilogram with clearer lungs

    Effective diuresis removes excess fluid, which shows as weight loss and reduced pulmonary congestion, so breath sounds improve.

    Why the other options are wrong

    • AIncreasing swelling in both legs means fluid is still accumulating and the therapy is not working.
    • BA rising heart rate may signal volume depletion or worsening cardiac status, not improvement.
    • CA rapid weight gain of 2 pounds in one day indicates continued fluid retention, not effective diuresis.

11. Question 11 of 25Medium

    A client admitted with upper gastrointestinal bleeding has a nasogastric tube connected to low intermittent wall suction. Which observation requires immediate reporting to the supervising registered nurse?

    1. AA. Drainage that changes from dark brown to bright red
    2. BB. Absence of bowel sounds during the initial assessment
    3. CC. Gastric aspirate pH reading between 1.5 and 3.5
    4. DD. Intermittent light green drainage in the collection canister
    Show answer to question 11

    Answer: A. Drainage that changes from dark brown to bright red

    A shift in nasogastric drainage from dark brown coffee-ground material to bright red blood indicates fresh, active hemorrhage that requires urgent provider notification. Dark brown drainage represents older, digested blood that has already been exposed to gastric acid. An acidic pH is expected in gastric contents, and green drainage reflects normal bile exposure rather than active bleeding.

12. Question 12 of 25Medium

    A licensed practical nurse (LPN) is checking the bedside supplies for a client admitted with a tracheostomy. Which piece of equipment is essential to keep at the bedside at all times for airway safety?

    1. AA. An obturator matching the size of the client's tracheostomy tube
    2. BB. A sterile chest tube insertion tray for emergency decompression
    3. CC. An oral airway sized to fit over the client's stoma opening
    4. DD. A bottle of hydrogen peroxide for routine inner cannula cleaning
    Show answer to question 12

    Answer: A. An obturator matching the size of the client's tracheostomy tube

    The obturator from the client's current tracheostomy tube must be kept at the bedside at all times along with a spare tracheostomy tube of the same size and one smaller, allowing rapid reinsertion if accidental decannulation occurs. An oral airway cannot be used in a tracheal stoma, hydrogen peroxide is not an emergency airway rescue item and can irritate tissues, and a chest tube tray is not indicated for tracheostomy maintenance.

13. Question 13 of 25Medium

    A licensed practical nurse (LPN) auscultates the lung sounds of a client admitted 30 minutes ago with a severe asthma exacerbation. The client initially had loud, bilateral expiratory wheezing but now has very faint breath sounds with no audible wheezes, accompanied by marked lethargy. How should the LPN interpret this change?

    1. AA. Severe airway narrowing has led to impending respiratory failure.
    2. BB. Airway secretions have cleared from the bronchial tree.
    3. CC. The client has stabilized and entered normal restful sleep.
    4. DD. Bronchodilator therapy has successfully opened the airways.
    Show answer to question 13

    Answer: A. Severe airway narrowing has led to impending respiratory failure.

    The sudden disappearance of wheezing accompanied by diminished breath sounds, known as a silent chest, indicates severe airflow limitation and impending respiratory arrest. Wheezing requires adequate airflow to vibrate narrowed airways; when movement of air becomes critically low, wheezing ceases entirely. Decreasing breath sounds paired with lethargy represents an emergency requiring immediate intervention, not clinical improvement or rest.

14. Question 14 of 25Medium

    The practical nurse is reinforcing teaching with a client who is prescribed graduated compression stockings for chronic venous insufficiency. Which action by the client indicates a need for further instruction?

    1. AA. Applying the stockings early in the morning before getting out of bed
    2. BB. Rolling the top band down two inches to relieve tightness behind the knee
    3. CC. Hand-washing the stockings with mild soap and laying them flat to dry
    4. DD. Inspecting the skin on both lower legs daily for redness or breakdown
    Show answer to question 14

    Answer: B. Rolling the top band down two inches to relieve tightness behind the knee

    Rolling or folding down the top band of compression stockings creates a constricting band that acts like a tourniquet, impeding venous return and increasing the risk of skin breakdown or venous stasis. Applying stockings before dependent edema develops in the morning, inspecting the skin daily, and washing them gently are all correct practices.

15. Question 15 of 25Hard

    The practical nurse (PN) assists in evaluating a client using the bedside Quick Sepsis-related Organ Failure Assessment (qSOFA) tool. Which combination of findings meets the criteria for this screening tool?

    1. AA. Systolic blood pressure 94 mm Hg, respiratory rate 24 breaths/min, acute lethargy
    2. BB. Respiratory rate 16 breaths/min, urine output 60 mL/hr, capillary refill 2 seconds
    3. CC. Oxygen saturation 97% on room air, blood pressure 118/76 mm Hg, heart rate 62 beats/min
    4. DD. Blood pressure 146/92 mm Hg, heart rate 112 beats/min, oral temperature 102.2°F (39.0°C)
    Show answer to question 15

    Answer: A. Systolic blood pressure 94 mm Hg, respiratory rate 24 breaths/min, acute lethargy

    The qSOFA screening tool identifies clients outside the intensive care unit who are at high risk for poor outcomes from sepsis using three specific criteria: systolic blood pressure of 100 mm Hg or less, respiratory rate of 22 breaths/min or greater, and altered mental status. Isolated tachycardia, fever, or normal physiological values do not meet the standardized qSOFA scoring criteria.

16. Question 16 of 25Easy

    A nurse is assisting in the plan of care for a client recovering from deep partial-thickness burns to the anterior neck and upper chest. Which intervention should the nurse include to prevent contractures?

    1. AA. Keep the head turned toward the affected side when resting
    2. BB. Apply an ice pack directly to the neck every 2 hours
    3. CC. Place two pillows behind the head to promote neck flexion
    4. DD. Place a rolled towel under the shoulders to extend the neck
    Show answer to question 16

    Answer: D. Place a rolled towel under the shoulders to extend the neck

    Burns to the anterior neck predispose the client to severe flexion contractures; positioning the neck in hyperextension by placing a small roll under the shoulders and eliminating head pillows counteracts this tendency. Placing pillows behind the head forces the neck into flexion, which promotes tissue shortening and contracture formation. Applying ice packs to burn injuries causes vasoconstriction and further tissue ischemia.

17. Question 17 of 25Easy

    A client who has been taking a loop diuretic has a serum potassium level of 2.9 mEq/L. Which finding should the nurse expect?

    1. AA. Tall, peaked T waves on the ECG tracing
    2. BB. Hyperactive deep tendon reflexes
    3. CC. Muscle weakness with leg cramps
    4. DD. Diarrhea with hyperactive bowel sounds
    Show answer to question 17

    Answer: C. Muscle weakness with leg cramps

    Hypokalemia impairs nerve and muscle function, causing weakness, leg cramps, constipation and ECG changes such as flattened T waves.

    Why the other options are wrong

    • ATall, peaked T waves are an ECG change of hyperkalemia, not hypokalemia.
    • BHypokalemia reduces deep tendon reflexes; hyperactive reflexes are not expected.
    • DLow potassium slows gastrointestinal motility, causing constipation, decreased bowel sounds or ileus rather than diarrhea.

18. Question 18 of 25Easy

    A nurse is assisting in triage during a residential house fire. Which client should the nurse identify as having the highest risk for an inhalation injury?

    1. AA. A client with small soot deposits on the clothing and hands
    2. BB. A client who has singed nasal hairs and a hoarse voice
    3. CC. A client with partial-thickness burns on both lower legs
    4. DD. A client reporting severe stinging pain in both eyes
    Show answer to question 18

    Answer: B. A client who has singed nasal hairs and a hoarse voice

    Singed nasal hairs and hoarseness are primary clinical indicators of upper airway burn injury and edema, which can progress rapidly to total airway obstruction. Burns on the lower extremities without facial involvement do not typically indicate respiratory tract injury. Soot on clothing and eye irritation indicate exposure to smoke, but do not provide definitive evidence of internal airway compromise.

19. Question 19 of 25Medium

    A client one day after total thyroidectomy reports numbness around the mouth and tingling in the fingertips. Which additional finding would support the nurse's suspicion of hypocalcemia?

    1. AA. Flaccid muscles with absent deep tendon reflexes
    2. BB. Bradycardia with a sudden drop in blood pressure
    3. CC. Carpal spasm with blood pressure cuff inflation
    4. DD. Decreased bowel sounds with abdominal distention
    Show answer to question 19

    Answer: C. Carpal spasm with blood pressure cuff inflation

    Carpal spasm with cuff inflation is Trousseau's sign, a sign of neuromuscular irritability from hypocalcemia. Parathyroid gland injury or removal during thyroidectomy can lower calcium. The nurse should report findings promptly.

    Why the other options are wrong

    • AFlaccid muscles and absent reflexes occur with hypercalcemia or hypermagnesemia, which depress neuromuscular activity.
    • BHypocalcemia more often causes tachydysrhythmias or a prolonged QT interval, not bradycardia with sudden hypotension.
    • DDecreased bowel sounds and distention are more typical of hypercalcemia or hypokalemia; hypocalcemia tends to cause cramping and diarrhea.

20. Question 20 of 25Easy

    A 68-year-old male client in a long-term care facility collapses in the dayroom. He is unresponsive and not breathing normally, and no pulse is felt after a check of no more than 10 seconds. Help and an AED have been requested. Which technique should the nurse use for chest compressions?

    1. AA. Compress about 1 inch at 60 to 80 per minute and pause often to recheck for a pulse
    2. BB. Compress about 1.5 inches at 80 to 100 per minute and keep the hands resting on the chest between compressions
    3. CC. Compress at least 2 inches at 100 to 120 per minute and allow full chest recoil after each compression
    4. DD. Compress at least 2 inches at 120 to 140 per minute and pause after every 5 compressions for a breath
    Show answer to question 20

    Answer: C. Compress at least 2 inches at 100 to 120 per minute and allow full chest recoil after each compression

    Current AHA adult BLS guidance calls for compressions at least 2 inches (5 cm) deep at a rate of 100 to 120 per minute, with full chest recoil and minimal interruptions.

    Why the other options are wrong

    • AThis depth and rate are too shallow and too slow, and frequent pauses reduce blood flow to the brain and heart.
    • BThis depth and rate are inadequate, and resting the hands on the chest prevents full recoil.
    • DThe rate is too fast to allow adequate depth and recoil, and pausing every 5 compressions is excessive interruption.

21. Question 21 of 25Hard

    A nurse in a dialysis clinic reviews morning data for four clients. Which client needs the most immediate follow-up with the RN or provider?

    1. AA. A client with a sodium of 133 mEq/L, mild nausea, and a mild headache
    2. BB. A client with a potassium of 6.3 mEq/L, peaked T waves, and weakness
    3. CC. A client with a calcium of 8.8 mg/dL, no symptoms, and stable vitals
    4. DD. A client with a phosphorus of 4.0 mg/dL and itching over both arms
    Show answer to question 21

    Answer: B. A client with a potassium of 6.3 mEq/L, peaked T waves, and weakness

    Significant hyperkalemia with ECG changes and weakness risks life-threatening dysrhythmias and cardiac arrest, so it takes priority.

    Why the other options are wrong

    • AMild hyponatremia with nausea and a mild headache is less urgent and can be reported after the unstable client.
    • CA calcium of 8.8 mg/dL is near normal, and the client has no symptoms and stable vitals.
    • DA phosphorus of 4.0 mg/dL is within normal range, and itching is not an immediate threat.

22. Question 22 of 25Hard

    An LPN is reviewing clinical findings for a client receiving intravenous gentamicin therapy for osteomyelitis. Which finding should the nurse recognize as an unexpected adverse effect of this medication?

    1. AA. Mild metallic taste in the mouth following medication infusion
    2. BB. Gradual reduction in systemic body temperature and pulse rate
    3. CC. Localized redness and soreness at the peripheral infusion site
    4. DD. Persistent ringing in the ears and decreased urine volume
    Show answer to question 22

    Answer: D. Persistent ringing in the ears and decreased urine volume

    Aminoglycoside antibiotics like gentamicin carry significant risks of ototoxicity and nephrotoxicity; persistent tinnitus and oliguria indicate damage to the eighth cranial nerve and renal tubules, requiring immediate dosage re-evaluation. Localized erythema and tenderness at the IV site suggest phlebitis or superficial irritation rather than a drug-specific toxic effect. A decrease in body temperature reflects expected therapeutic resolution of infection, and a transient metallic taste is not a sign of aminoglycoside organ toxicity.

23. Question 23 of 25Easy

    A home health nurse visits a 66-year-old client who has a draining leg wound. Which finding at the wound site best indicates a localized infection?

    1. AA. Pale, cool skin surrounding the wound edges
    2. BB. Warmth, redness, swelling and new tenderness
    3. CC. Dry, flat wound edges with decreasing drainage
    4. DD. Pink tissue with new skin growing at the edges
    Show answer to question 23

    Answer: B. Warmth, redness, swelling and new tenderness

    Localized infection triggers an inflammatory response, causing heat, redness, swelling, pain and often purulent drainage at the site.

    Why the other options are wrong

    • APale, cool skin suggests poor perfusion, not the vasodilation seen with infection.
    • CDry wound edges with decreasing drainage suggest the wound is healing, not infected.
    • DPink tissue with new skin growing at the edges is a sign of normal wound healing.

24. Question 24 of 25Hard

    A practical nurse reviews arterial blood gas results for a stable client with severe chronic obstructive pulmonary disease (COPD): pH 7.36, PaCO2 58 mm Hg, and HCO3- 32 mEq/L. Which interpretation best explains these findings?

    1. AA. Fully compensated respiratory acidosis supported by renal bicarbonate retention
    2. BB. Uncompensated respiratory acidosis requiring emergency assisted ventilation
    3. CC. Acute respiratory alkalosis accompanied by metabolic compensation
    4. DD. Partially compensated metabolic alkalosis with compensatory hypoventilation
    Show answer to question 24

    Answer: A. Fully compensated respiratory acidosis supported by renal bicarbonate retention

    The pH is within the normal reference range (7.35 to 7.45) but on the acidotic side, accompanied by an elevated carbon dioxide level and an elevated bicarbonate level, which reflects long-term renal retention of bicarbonate to balance chronic carbon dioxide retention. Uncompensated respiratory acidosis would present with an abnormally low pH (less than 7.35) and a bicarbonate level that remains within normal limits.

25. Question 25 of 25Easy

    A nurse in a long-term care facility is setting up the room for a client with a tracheostomy. Which equipment should be kept at the bedside in case of accidental decannulation?

    1. AA. A nasopharyngeal airway and a nasal suction catheter set
    2. BB. A handheld peak flow meter and an incentive spirometer
    3. CC. An oral airway and a rigid tonsil-tip suction catheter
    4. DD. An obturator and spare tubes, same size and one smaller
    Show answer to question 25

    Answer: D. An obturator and spare tubes, same size and one smaller

    If the tube comes out, the stoma must be kept open and a tube reinserted quickly. An obturator plus spare tubes of the same size and one size smaller should always be at the bedside.

    Why the other options are wrong

    • AA nasopharyngeal airway and nasal suction equipment serve the upper airway and do not help reinsert a tube into the stoma.
    • BA peak flow meter and incentive spirometer assess or exercise lung function and do not secure the airway.
    • CAn oral airway and tonsil-tip suction catheter manage the mouth and throat and do not keep the tracheal stoma open.

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