HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?
- A. They contain exudate and provide a moist wound environment.
- B. They protect the wound from mechanical trauma and promote healing.
- C. They debride the wound and promote healing by secondary intention.
- D. They prevent the entrance of microorganisms and minimize wound discomfort.
Correct answer: C
Rationale: Wet-to-dry dressings are utilized in this case to debride the wound by removing dead tissue and promoting healing by secondary intention. Choice A is incorrect as wet-to-dry dressings do not provide a moist wound environment; instead, they promote drying to aid in debridement. Choice B is incorrect because their primary purpose is not to protect the wound but to remove dead tissue. Choice D is incorrect as the main function of wet-to-dry dressings is not to prevent the entrance of microorganisms or minimize wound discomfort.
2. The nurse is caring for a client with a history of adrenal insufficiency. The nurse should monitor for which of the following signs of an Addisonian crisis?
- A. Hypertension
- B. Hyperglycemia
- C. Severe hypotension
- D. Tachycardia
Correct answer: C
Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.
3. A client with type 1 DM is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should prioritize which action?
- A. Administering intravenous fluids.
- B. Administering oral glucose.
- C. Administering a fever-reducing medication.
- D. Administering oxygen therapy.
Correct answer: A
Rationale: Administering intravenous fluids is the priority in treating DKA for several reasons. DKA is characterized by severe dehydration and electrolyte imbalances due to hyperglycemia. IV fluids help to correct dehydration, restore electrolyte balance, and decrease blood glucose levels. Administering oral glucose (Choice B) would be contraindicated in DKA as the primary issue is high blood glucose levels. Administering a fever-reducing medication (Choice C) is not the priority in managing DKA. Administering oxygen therapy (Choice D) may be necessary in some cases, but correcting dehydration and electrolyte imbalances take precedence in the management of DKA.
4. A nurse manager is working to improve patient satisfaction on the unit. Which of the following best describes the nurse manager’s role in this process?
- A. The nurse manager should set clear expectations for patient satisfaction, monitor progress, and provide feedback to staff members to continuously improve patient care.
- B. The nurse manager should gather data on patient satisfaction, identify areas for improvement, and implement strategies to enhance the patient experience.
- C. The nurse manager should develop a patient satisfaction improvement plan, set measurable goals, and track progress over time to ensure continuous improvement.
- D. The nurse manager should involve patients and families in the patient satisfaction improvement process, gather feedback, and use it to make improvements to care delivery.
Correct answer: A
Rationale: The correct answer is A. The nurse manager's role in improving patient satisfaction involves setting clear expectations for patient satisfaction, monitoring progress, and providing feedback to staff members to continuously improve patient care. Choice B is incorrect as gathering data and implementing strategies are typically part of quality improvement initiatives but do not solely define the nurse manager's role. Choice C is incorrect because the nurse manager is responsible for setting expectations and monitoring progress rather than developing the improvement plan. Choice D is incorrect as involving patients and families and gathering feedback are important aspects, but the question specifically asks about the nurse manager's role, which primarily involves setting expectations, monitoring progress, and providing feedback to staff.
5. A client with DM visits the health care clinic. The client's diabetes has been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Atenolol (Tenormin)
- B. Prednisone (Deltasone)
- C. Phenelzine (Nardil)
- D. Allopurinol (Zyloprim)
Correct answer: B
Rationale: The correct answer is B. Prednisone is a corticosteroid that can cause hyperglycemia by increasing glucose production in the liver. Atenolol (Choice A) is a beta-blocker that typically does not affect blood glucose levels significantly. Phenelzine (Choice C) is a monoamine oxidase inhibitor used for depression and does not directly impact blood glucose levels. Allopurinol (Choice D) is a xanthine oxidase inhibitor used to manage gout and does not contribute to hyperglycemia.
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