HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. A healthcare professional reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the healthcare professional note on the electrocardiogram as a result of the laboratory value?
- A. U waves
- B. Absent P waves
- C. Elevated T waves
- D. Elevated ST segment
Correct answer: A
Rationale: The correct answer is A: U waves. A low potassium level (hypokalemia) can manifest as U waves on an ECG. U waves are small, extra deflections seen after the T wave and may indicate cardiac irritability. Absent P waves (Choice B) are associated with conditions like atrial fibrillation. Elevated T waves (Choice C) can be seen in hyperkalemia, not hypokalemia. Elevated ST segment (Choice D) is not typically associated with low potassium levels but can be seen in conditions like myocardial infarction.
2. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?
- A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
- B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
- C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
- D. It regulates the threshold for water reabsorption in the kidneys.
Correct answer: C
Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.
3. How often should rotation sites for insulin injection be separated from one another?
- A. Every third day.
- B. Every week.
- C. Every 2-3 weeks.
- D. Every 2-4 weeks.
Correct answer: C
Rationale: Insulin injection sites should be rotated every 2-3 weeks to prevent lipodystrophy and ensure proper insulin absorption. Option A ('Every third day') is too frequent and does not allow enough time for the previous site to heal properly. Option B ('Every week') might not provide adequate time for the tissue to recover. Option D ('Every 2-4 weeks') could potentially lead to overuse of a single injection site, increasing the risk of lipodystrophy and inconsistent insulin absorption. Therefore, the recommended interval of every 2-3 weeks is optimal for insulin injection site rotation.
4. 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.
5. The client with hyperthyroidism is receiving propylthiouracil (PTU). The nurse should monitor for which of the following potential side effects?
- A. Leukopenia
- B. Hyperglycemia
- C. Hypertension
- D. Weight gain
Correct answer: A
Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.
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