HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. A client with DM is scheduled for surgery. The nurse should plan to:
- A. Monitor the client's blood glucose level closely during the perioperative period.
- B. Give the client a regular diet as ordered.
- C. Have the client stop taking insulin 48 hours before surgery.
- D. Hold the client's insulin on the morning of surgery.
Correct answer: A
Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.
2. A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
- A. Phentolamine (Regitine)
- B. Methyldopa (Aldomet)
- C. Mannitol (Osmitrol)
- D. Felodipine (Plendil)
Correct answer: A
Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.
3. Which of the following best describes the nurse's responsibility in obtaining informed consent?
- A. The nurse is responsible for ensuring that the patient understands the procedure and has the opportunity to ask questions.
- B. The nurse should ensure that the patient signs the consent form before the procedure begins.
- C. The nurse is responsible for witnessing the patient sign the consent form and documenting the event.
- D. The nurse should delegate the task of obtaining informed consent to another healthcare provider.
Correct answer: A
Rationale: The correct answer is A. Informed consent is a process where the healthcare provider, in this case, the nurse, ensures that the patient understands the procedure, risks, benefits, and alternatives before they agree to it. The nurse plays a crucial role in facilitating this understanding by explaining the information in a clear and understandable manner and providing the patient with the opportunity to ask questions. Choice B is incorrect because merely obtaining the patient's signature on the consent form does not ensure that the patient truly understands what they are consenting to. Choice C is not fully accurate as the nurse's role goes beyond just witnessing the signature; it involves actively ensuring the patient's comprehension. Choice D is incorrect as the responsibility of obtaining informed consent should not be delegated to another healthcare provider, as it is the nurse's duty to ensure proper communication and understanding with the patient.
4. An RN enters a patient's room to place an indwelling urinary catheter, as ordered by the healthcare professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct answer: A
Rationale: False imprisonment occurs when a person is prevented from leaving against their will. By telling the patient they are not allowed to leave, the RN is restricting the patient’s freedom unlawfully. Choice B is focused on understanding the patient's reasons for leaving and does not involve restricting the patient's freedom. Choice C aims to assess the patient's understanding of their medical condition, which is unrelated to false imprisonment. Choice D involves obtaining consent for leaving against medical advice, which is a legal and ethical process and not false imprisonment.
5. The nurse and an unlicensed nursing assistant are caring for a group of clients. Which nursing intervention should the nurse perform?
- A. Measure the client's output from the indwelling catheter.
- B. Record the client's intake and output on the I & O sheet.
- C. Instruct the client on appropriate fluid restrictions.
- D. Provide water for a client diagnosed with diabetes insipidus.
Correct answer: C
Rationale: Instructing the client on appropriate fluid restrictions is a nursing intervention that requires professional judgment and should be performed by the nurse. In this scenario, the nurse should provide education regarding fluid restrictions based on the client's individual needs. Measuring the client's output from the indwelling catheter (choice A) and recording intake and output (choice B) can be tasks delegated to the unlicensed nursing assistant. Providing water for a client diagnosed with diabetes insipidus (choice D) is not appropriate as these clients often require careful fluid management to prevent complications.
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