HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. A client with type 1 DM is taught to take NPH and regular insulin every morning. The nurse should provide which instructions to the client?
- A. Take the NPH insulin first, then the regular insulin.
- B. Take the regular insulin first, then the NPH insulin.
- C. It does not matter which insulin is drawn up first.
- D. Contact the healthcare provider if the order for insulin is unclear.
Correct answer: B
Rationale: The correct answer is to take the regular insulin first, then the NPH insulin. Regular insulin should be drawn up before NPH insulin to prevent contamination of the regular insulin vial with the longer-acting insulin. Choice A is incorrect as it suggests taking the NPH insulin first, which is not the recommended practice. Choice C is incorrect because the order of drawing up insulin does matter to prevent contamination. Choice D is not the most appropriate action in this scenario, as the nurse should provide clear instructions to the client based on best practices.
2. Which of the following symptoms would be most concerning in a client with diabetes insipidus?
- A. Polydipsia
- B. Polyuria
- C. Nocturia
- D. Hypertension
Correct answer: D
Rationale: In a client with diabetes insipidus, excessive thirst (polydipsia) and excessive urination (polyuria) are expected symptoms due to the inability to concentrate urine, leading to dilute urine production. Nocturia, waking up at night to urinate, is also common. However, hypertension is not a typical symptom of diabetes insipidus. The correct answer is D because hypertension may indicate a complication such as dehydration or electrolyte imbalances, which would require further assessment in a client with diabetes insipidus.
3. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?
- A. Administer intravenous fluids
- B. Provide a warming blanket
- C. Administer levothyroxine intravenously
- D. Place the client in Trendelenburg position
Correct answer: C
Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.
4. What is the approximate duration of action for intermediate-acting insulins like NPH?
- A. 6-8 hours.
- B. 10-14 hours.
- C. 16-20 hours.
- D. 24-28 hours.
Correct answer: C
Rationale: The correct answer is C: '16-20 hours.' Intermediate-acting insulins like NPH typically have a duration of action of approximately 16-20 hours. This prolonged action makes them effective in managing blood glucose levels over an extended period. Choices A, B, and D are incorrect because they do not align with the typical duration of action for intermediate-acting insulins. Choice A (6-8 hours) is too short, choice B (10-14 hours) is also shorter than the typical duration, and choice D (24-28 hours) is too long for intermediate-acting insulins like NPH.
5. Which of the following is true about effective leadership?
- A. Leadership traits can be learned through experience and reflection.
- B. Nurses can learn to become good leaders by acting as good leaders and reflecting on leadership qualities they have and those they can improve upon.
- C. Focus on leadership activities required for the day is essential for effective leadership.
- D. Taking advantage of every opportunity to be a leader is crucial, creating those opportunities as often as possible, especially after gaining experience as a nurse.
Correct answer: B
Rationale: Choice B is correct because nurses can develop effective leadership skills by actively engaging as good leaders and reflecting on their existing leadership qualities and areas for improvement. This process of self-assessment and continuous improvement is crucial in becoming a successful leader. Choice A is incorrect as leadership traits can be learned through experience and reflection rather than being impossible to acquire from a book. Choice C is incorrect as effective leadership involves focusing on long-term goals and strategies, not just daily activities. Choice D is incorrect because while seizing leadership opportunities is important, it should be done strategically and with a solid foundation of experience in nursing to ensure successful leadership outcomes.
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