HESI RN
Leadership and Management HESI
1. The patient expects that a type 1 diabetic may receive ____ of their morning dose of insulin preoperatively:
- A. 10-20%.
- B. 25-40%.
- C. 50-60%.
- D. 85-90%.
Correct answer: B
Rationale: It is common practice to administer 25-40% of the morning dose of insulin preoperatively to prevent hypoglycemia during surgery. Giving a lower percentage (A) may not provide sufficient glycemic control, while higher percentages (C, D) can increase the risk of hypoglycemia during the surgical procedure.
2. Which of the following is a primary goal of nursing?
- A. Assist patients in achieving a peaceful death.
- B. Enhance personal knowledge and skills to improve patient outcomes.
- C. Champion quality of life over quantity of life.
- D. Manage costs to enhance patients' quality of life.
Correct answer: A
Rationale: The primary goal of nursing is to assist patients in achieving a peaceful death if recovery is not feasible. This involves providing comfort, dignity, and support during the end-of-life process. Choice B is incorrect because while improving personal knowledge and skills is important, it is not the primary goal of nursing. Choice C, advocating for quality of life over quantity of life, is a valid aspect of nursing care but may not always be the primary goal. Choice D, managing costs to enhance patients' quality of life, is not a primary goal of nursing, as the focus should primarily be on patient care and well-being, rather than financial considerations.
3. The client with type 1 DM asks why it is necessary to rotate injection sites when managing insulin therapy. The nurse's best response is:
- A. It helps prevent skin irritation.
- B. It helps prevent scar tissue buildup.
- C. It ensures more consistent insulin absorption.
- D. It makes the injections less painful.
Correct answer: C
Rationale: Rotating injection sites is necessary to ensure more consistent insulin absorption. This practice helps maintain stable blood glucose levels by preventing the formation of lipohypertrophy (fatty lumps under the skin) at injection sites. Choices A and B are incorrect as the primary purpose of rotating injection sites is not focused on preventing skin irritation or scar tissue buildup. While rotating injection sites may contribute to reducing pain over time, the primary benefit is the consistency in insulin absorption to support glycemic control, making choice D less relevant.
4. A client with DM is being taught about the importance of monitoring blood glucose levels. The nurse should instruct the client to monitor blood glucose:
- A. Before meals and at bedtime.
- B. Only after meals.
- C. Only in the morning.
- D. Only when feeling unwell.
Correct answer: A
Rationale: The correct answer is to monitor blood glucose levels before meals and at bedtime. This timing allows for a comprehensive understanding of how the body responds to food intake and to assess fasting glucose levels. Monitoring blood glucose only after meals (Choice B) may miss important pre-meal fluctuations. Checking glucose levels only in the morning (Choice C) overlooks the impact of meals throughout the day. Monitoring blood glucose only when feeling unwell (Choice D) is reactive and does not provide consistent data for managing diabetes effectively. Therefore, monitoring blood glucose before meals and at bedtime helps in maintaining good glucose control and preventing complications.
5. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should the healthcare provider report?
- A. Hypotension
- B. Hyperglycemia
- C. Weight loss
- D. Hypokalemia
Correct answer: B
Rationale: In Cushing's syndrome, hyperglycemia is a common finding due to increased cortisol levels leading to insulin resistance. This can have serious implications such as diabetes mellitus and should be promptly reported for appropriate management. Hypotension (choice A) is more commonly associated with Addison's disease, not Cushing's syndrome. Weight gain rather than weight loss (choice C) is typically observed in clients with Cushing's syndrome. While hypokalemia (choice D) can occur in Cushing's syndrome due to excess cortisol affecting potassium levels, it is not as critical as hyperglycemia and may not be the priority for immediate reporting.
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