HESI RN
Leadership and Management HESI
1. The client with DM is being taught about foot care. The nurse instructs the client to:
- A. Avoid hot water when bathing the feet.
- B. Apply a moisturizing lotion to the feet, especially between the toes.
- C. Use a heating pad to warm the feet if they feel cold.
- D. Go barefoot at home to allow the feet to air out.
Correct answer: A
Rationale: The correct answer is to avoid hot water when bathing the feet. This instruction is crucial because clients with diabetes may have decreased sensation in their feet, which can put them at risk of burns from hot water. Choice B is incorrect because applying moisturizing lotion between the toes can increase moisture and promote fungal growth. Choice C is incorrect because using a heating pad can also lead to burns due to decreased sensation. Choice D is incorrect as going barefoot can increase the risk of injury and infections in clients with diabetes.
2. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?
- A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
- B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
- C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
- D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.
Correct answer: A
Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.
3. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?
- A. Serum glucose of 180 mg/dL
- B. Serum bicarbonate of 22 mEq/L
- C. Blood pH of 7.25
- D. Urine specific gravity of 1.020
Correct answer: C
Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.
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. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:
- A. Increase metabolism
- B. Reduce anxiety
- C. Decrease heart rate
- D. Increase blood pressure
Correct answer: C
Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.
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