HESI RN
Leadership and Management HESI
1. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?
- A. Administer insulin
- B. Encourage increased fluid intake
- C. Monitor for signs of dehydration
- D. Check blood glucose levels
Correct answer: D
Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.
2. A client with type 2 DM is being treated with metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?
- A. Take the medication with meals.
- B. Take the medication on an empty stomach.
- C. Take the medication before bedtime.
- D. Avoid taking the medication if you miss a meal.
Correct answer: A
Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.
3. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
- A. 2 to 5 g of a simple carbohydrate.
- B. 10 to 15 g of a simple carbohydrate.
- C. 18 to 20 g of a simple carbohydrate.
- D. 25 to 30 g of a simple carbohydrate.
Correct answer: B
Rationale: The correct answer is B: 10 to 15 g of a simple carbohydrate. In the treatment of hypoglycemia, it is important to administer a specific amount of simple carbohydrates to raise blood glucose levels effectively without causing hyperglycemia. 10 to 15 g of simple carbohydrates, such as glucose tablets, fruit juice, or regular soft drinks, is recommended to rapidly increase blood sugar levels in clients experiencing hypoglycemia. Choices A, C, and D are incorrect as they either provide too little or too much glucose, which may not effectively treat the hypoglycemic episode or may lead to rebound hyperglycemia.
4. The client with DM is being taught about the signs of hyperglycemia. Which symptom should the nurse include?
- A. Excessive thirst
- B. Sweating
- C. Shaking
- D. Hunger
Correct answer: A
Rationale: Excessive thirst, also known as polydipsia, is a hallmark symptom of hyperglycemia. When blood glucose levels are high, the body tries to eliminate the excess glucose through urine, leading to increased urination and subsequent thirst. Sweating, shaking, and hunger are more commonly associated with hypoglycemia, not hyperglycemia. Sweating can occur when blood sugar levels drop too low, shaking is a sign of hypoglycemia, and hunger is often a result of low blood sugar levels triggering the body to seek fuel.
5. Which of the following statements is true regarding ethical principles and laws?
- A. The government enforces ethics.
- B. Laws establish standards that aid in decision-making.
- C. Ethics are highly specific.
- D. Ethical principles can serve as the foundation for laws.
Correct answer: D
Rationale: The correct answer is D. Ethical principles can influence the creation of laws but are not equivalent to laws themselves. Laws are established by governing bodies to provide a framework for society, whereas ethical principles guide individuals' moral conduct. Choice A is incorrect because governments enforce laws, not ethics. Choice B is incorrect as laws set legal standards rather than ethical ones. Choice C is incorrect because ethics are principles that guide behavior but are not necessarily highly specific.
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