HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:
- A. Serum glucose level.
- B. Hair loss.
- C. Bone mineralization.
- D. Menstrual flow.
Correct answer: A
Rationale: The correct answer is A: Serum glucose level. In Cushing's syndrome, there is excess cortisol production which can lead to hyperglycemia. Successful treatment of Cushing's syndrome aims to normalize cortisol levels, resulting in a decline in serum glucose levels. Choice B, hair loss, is not specifically associated with Cushing's syndrome or its treatment. Choice C, bone mineralization, is often compromised in Cushing's syndrome due to the effects of excess cortisol on bones; however, successful treatment would aim to improve bone health rather than decline it. Choice D, menstrual flow, is not directly linked to Cushing's syndrome or its treatment, so a decline in menstrual flow would not be an expected outcome of successful treatment.
2. 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.
3. Nurse Noemi administers glucagon to her diabetic client and then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
- A. Oral anticoagulants
- B. Anabolic steroids
- C. Beta-adrenergic blockers
- D. Thiazide diuretics
Correct answer: A
Rationale: The correct answer is A: Oral anticoagulants. Glucagon may enhance the anticoagulant effect of oral anticoagulants, increasing the risk of bleeding. This interaction can be dangerous for the patient, leading to serious complications. Choices B, C, and D are incorrect because anabolic steroids, beta-adrenergic blockers, and thiazide diuretics do not typically interact adversely with glucagon. It is crucial for healthcare providers to be aware of potential drug interactions to ensure patient safety and optimal outcomes.
4. A client with diabetes mellitus is being educated on the importance of foot care. Which of the following instructions should the nurse include?
- A. Soak your feet daily to maintain cleanliness.
- B. Wear tight-fitting shoes to protect your feet.
- C. Apply lotion between your toes to prevent dryness.
- D. Inspect your feet daily for any cuts or sores.
Correct answer: D
Rationale: The correct answer is to instruct the client to inspect their feet daily for any cuts or sores. This is crucial for individuals with diabetes as they are at a higher risk of developing foot problems. Soaking feet daily can lead to skin breakdown and infections, making choice A incorrect. Tight-fitting shoes can cause pressure points and increase the risk of foot injuries, so choice B is incorrect. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections, making choice C incorrect.
5. Which of the following is an example of nonmaleficence in nursing practice?
- A. Administering pain medication as prescribed to prevent patient discomfort.
- B. Ensuring that a patient does not receive a treatment that they have refused.
- C. Ensuring that a patient receives appropriate care without causing harm.
- D. Encouraging a patient to express their concerns and fears about a procedure.
Correct answer: B
Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.
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