HESI RN
Leadership HESI
1. The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?
- A. I should take my medication every day as prescribed.
- B. I need to avoid foods high in iodine.
- C. I can skip my medication on days when I feel fine.
- D. I should monitor my pulse regularly.
Correct answer: C
Rationale: Clients with hyperthyroidism should take their medication consistently and not skip doses, even if they feel well.
2. 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.
3. Which of the following actions could be considered a breach of patient confidentiality?
- A. Discussing patient information with other healthcare providers in a private setting.
- B. Sharing patient information with family members without the patient's consent.
- C. Discussing patient information in public areas where others may overhear.
- D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.
Correct answer: C
Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.
4. A client with diabetes insipidus is receiving desmopressin therapy. The nurse should monitor for which of the following potential side effects?
- A. Hyponatremia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used to treat diabetes insipidus, can cause the retention of water without sodium, leading to dilutional hyponatremia. This occurs because desmopressin increases water reabsorption in the kidneys without affecting sodium levels. Hypernatremia (choice B) is unlikely because desmopressin does not cause excessive sodium retention. Hypokalemia (choice C) and hypercalcemia (choice D) are not typically associated with desmopressin therapy for diabetes insipidus.
5. 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.
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