HESI RN
HESI Leadership and Management
1. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?
- A. Hyperglycemia
- B. Hypotension
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.
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. Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?
- A. Tetanic contractions
- B. Neck vein distention
- C. Weight loss
- D. Polyuria
Correct answer: B
Rationale: Neck vein distention is a sign of fluid overload, a complication of SIADH due to water retention. Tetanic contractions (Choice A) are not typically associated with SIADH. Weight loss (Choice C) is not a common complication of SIADH, as patients often experience fluid retention and weight gain. Polyuria (Choice D) is also not a typical sign of SIADH, as the condition is characterized by water retention and decreased urine output.
4. The client with newly diagnosed diabetes mellitus is being taught about managing blood glucose levels. Which statement indicates a need for further teaching?
- A. I will rotate my insulin injection sites to avoid tissue damage.
- B. I will monitor my blood glucose levels before each meal.
- C. I can eat unlimited fruit as it is healthy.
- D. I should carry a fast-acting carbohydrate with me at all times.
Correct answer: C
Rationale: Choice C indicates a need for further teaching because stating 'I can eat unlimited fruit as it is healthy' is incorrect. While fruits are healthy, they also contain natural sugars that can affect blood glucose levels. Portion control is crucial to managing blood glucose levels effectively. Choices A, B, and D demonstrate correct understanding. Rotating insulin injection sites helps prevent tissue damage, monitoring blood glucose levels before meals aids in managing diabetes effectively, and carrying a fast-acting carbohydrate is essential to treat hypoglycemia promptly.
5. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?
- A. Weight gain
- B. Hypoglycemia
- C. Hyperglycemia
- D. Bradycardia
Correct answer: B
Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.
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