HESI RN
Leadership and Management HESI
1. A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?
- A. A client with a colostomy
- B. A client with congestive heart failure
- C. A client with decreased kidney function
- D. A client receiving frequent wound irrigations
Correct answer: A
Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.
2. A client with hyperparathyroidism is at risk for which of the following complications?
- A. Hypocalcemia
- B. Osteoporosis
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: A client with hyperparathyroidism is at risk for osteoporosis, not hypocalcemia, hypokalemia, or hyponatremia. Hyperparathyroidism results in increased levels of parathyroid hormone, which causes excessive breakdown of bone tissue to release calcium into the bloodstream. This process can lead to weakened bones and an increased risk of osteoporosis. Hypocalcemia is unlikely in hyperparathyroidism as the condition is characterized by elevated calcium levels due to the abnormal activity of the parathyroid glands. Hypokalemia and hyponatremia are not directly associated with hyperparathyroidism; they are more commonly linked to other conditions affecting potassium and sodium levels in the body.
3. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. Which of the following is the nurse's priority action?
- A. Administer glucagon
- B. Check the client's blood glucose level
- C. Give the client a snack
- D. Notify the healthcare provider
Correct answer: B
Rationale: The correct answer is to check the client's blood glucose level. This is the priority action to confirm hypoglycemia before implementing further interventions. Administering glucagon (Choice A) may be necessary in severe cases of hypoglycemia, but confirming the low blood glucose level is crucial before administering any treatment. Giving the client a snack (Choice C) can help raise blood sugar levels but should come after confirming the hypoglycemia. Notifying the healthcare provider (Choice D) is important, but the immediate priority is to assess and address the hypoglycemia.
4. The client with DM is being taught by the nurse about the importance of monitoring blood glucose levels. The nurse should instruct the client to:
- A. Check blood glucose only when feeling unwell.
- B. Check blood glucose before meals and at bedtime.
- C. Check blood glucose only after meals.
- D. Check blood glucose only in the morning.
Correct answer: B
Rationale: The correct answer is to check blood glucose before meals and at bedtime. Monitoring blood glucose levels before meals allows the client to adjust their insulin or oral antidiabetic medications based on their current levels. Checking at bedtime helps in ensuring blood glucose levels are at a safe range throughout the night. Option A is incorrect because blood glucose should be monitored regularly as part of diabetes management, not just when feeling unwell. Option C is incorrect because checking only after meals does not provide a complete picture of blood glucose control throughout the day. Option D is incorrect as checking only in the morning does not cover the full spectrum of blood glucose variations that can occur during the day.
5. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperphosphatemia
Correct answer: B
Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.
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