HESI RN
Leadership HESI
1. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. The nurse should instruct the client to do which of the following?
- A. Eat a high-protein snack
- B. Consume 15 grams of simple carbohydrates
- C. Drink a glass of water
- D. Administer an extra dose of insulin
Correct answer: B
Rationale: Consuming 15 grams of simple carbohydrates is the recommended treatment for mild hypoglycemia to quickly raise blood sugar levels. Simple carbohydrates are rapidly absorbed and provide a quick source of glucose to combat low blood sugar. Eating a high-protein snack (Choice A) would delay the rise in blood sugar as proteins take longer to be broken down. Drinking water (Choice C) does not directly address the low blood sugar levels associated with hypoglycemia. Administering an extra dose of insulin (Choice D) would further lower blood sugar levels, worsening the hypoglycemic state.
2. A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?
- A. The client taking diuretics
- B. The client with renal failure
- C. The client with an ileostomy
- D. The client who requires gastrointestinal suctioning
Correct answer: B
Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.
3. The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?
- A. Increase your sodium intake during periods of stress.
- B. Avoid all types of exercise.
- C. Decrease your fluid intake to prevent fluid overload.
- D. Stop corticosteroid therapy once symptoms improve.
Correct answer: A
Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.
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 client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?
- A. Serum calcium.
- B. Serum phosphorus.
- C. Serum potassium.
- D. Serum sodium.
Correct answer: C
Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.
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