HESI RN
Leadership HESI
1. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should be reported to the healthcare provider immediately?
- A. Hyperglycemia
- B. Hypertension
- C. Low-grade fever
- D. Weight gain
Correct answer: C
Rationale: In a client with Cushing's syndrome, a low-grade fever should be reported immediately as it may indicate an infection. Clients with Cushing's syndrome are immunosuppressed, making them more susceptible to infections. Hyperglycemia and hypertension are common findings in Cushing's syndrome and are managed as part of the condition. Weight gain is also a common symptom in Cushing's syndrome and may not require immediate reporting unless it is sudden and severe.
2. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
- A. Diabetic ketoacidosis
- B. Thyroid crisis
- C. Hypoglycemia
- D. Tetany
Correct answer: B
Rationale: The correct answer is B: Thyroid crisis. Thyroid crisis, also known as thyroid storm, is a life-threatening condition that can occur after a thyroidectomy. Symptoms include high fever, tachycardia, extreme restlessness, and other signs of severe hyperthyroidism. Diabetic ketoacidosis (choice A) is a complication of diabetes characterized by hyperglycemia, ketosis, and acidosis, not typically seen post-thyroidectomy. Hypoglycemia (choice C) is low blood sugar levels and would not present with the symptoms described. Tetany (choice D) is a condition of involuntary muscle spasms due to low calcium levels and is not directly related to the symptoms observed in this scenario.
3. The nurse is caring for a client with hyperaldosteronism. Which of the following laboratory results would the nurse expect?
- A. Hypokalemia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hypocalcemia
Correct answer: A
Rationale: In hyperaldosteronism, there is an excess of aldosterone production, leading to increased sodium retention and potassium excretion by the kidneys. This results in hypokalemia (low potassium levels). Therefore, the correct answer is hypokalemia (Choice A). Hypernatremia (Choice B) is an incorrect choice as hyperaldosteronism primarily affects potassium and not sodium levels. Hyperkalemia (Choice C) is also incorrect because hyperaldosteronism causes potassium excretion, leading to low levels. Hypocalcemia (Choice D) is not typically associated with hyperaldosteronism; instead, it is more related to conditions affecting calcium regulation.
4. The client with type 2 DM is learning to manage blood glucose levels. When should the client monitor blood glucose?
- A. Only when feeling unwell.
- B. Only before meals.
- C. Before meals and at bedtime.
- D. Only after meals.
Correct answer: C
Rationale: The correct answer is to monitor blood glucose before meals and at bedtime. This timing allows the client to assess fasting levels and make informed decisions about mealtime insulin or medication doses. Monitoring only when feeling unwell (choice A) is not sufficient for proper glucose management as it may miss important trends. Monitoring only before meals (choice B) is helpful but does not provide a complete picture of the client's glucose control throughout the day. Monitoring only after meals (choice D) is less beneficial than monitoring before meals as it does not capture fasting levels. Therefore, monitoring before meals and at bedtime (choice C) is the most comprehensive approach to maintain good glucose control and prevent complications.
5. The nurse is preparing to administer NPH insulin to a client. The nurse should administer the insulin at which site for the best absorption?
- A. The deltoid muscle
- B. The anterior thigh
- C. The abdomen
- D. The gluteal muscle
Correct answer: C
Rationale: The abdomen is the preferred site for insulin injection due to its consistent absorption rate. Insulin injected into the abdomen is absorbed more consistently and predictably than in other sites. The deltoid muscle and the anterior thigh are not recommended for insulin injections due to inconsistent absorption rates. The gluteal muscle is avoided for insulin injections due to the risk of hitting the sciatic nerve or causing discomfort to the client.
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