a client with dm is scheduled for surgery the nurse should plan to

HESI RN

HESI RN Nursing Leadership and Management Exam 6

1. A client with DM is scheduled for surgery. The nurse should plan to:

A. Monitor the client's blood glucose level closely during the perioperative period.
B. Give the client a regular diet as ordered.
C. Have the client stop taking insulin 48 hours before surgery.
D. Hold the client's insulin on the morning of surgery.

Correct answer: A

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.

2. The client with newly diagnosed diabetes mellitus is receiving education from the nurse on managing blood glucose levels. Which statement indicates a need for further teaching?

A. I will monitor my blood glucose levels regularly.
B. I can eat whatever I want as long as I take my medication.
C. I should exercise regularly to help control my blood sugar.
D. I will rotate my injection sites to avoid tissue damage.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because it suggests that the client can eat whatever they want as long as they take their medication, which is incorrect. Clients with diabetes mellitus need to follow a healthy and balanced diet in addition to taking their medication to effectively manage blood glucose levels. Choices A, C, and D are correct statements for managing diabetes. Monitoring blood glucose levels regularly, engaging in regular exercise to help control blood sugar, and rotating injection sites to avoid tissue damage are all important aspects of diabetes management.

3. Which of the following is true about effective leadership?

A. Leadership traits can be learned through experience and reflection.
B. Nurses can learn to become good leaders by acting as good leaders and reflecting on leadership qualities they have and those they can improve upon.
C. Focus on leadership activities required for the day is essential for effective leadership.
D. Taking advantage of every opportunity to be a leader is crucial, creating those opportunities as often as possible, especially after gaining experience as a nurse.

Correct answer: B

Rationale: Choice B is correct because nurses can develop effective leadership skills by actively engaging as good leaders and reflecting on their existing leadership qualities and areas for improvement. This process of self-assessment and continuous improvement is crucial in becoming a successful leader. Choice A is incorrect as leadership traits can be learned through experience and reflection rather than being impossible to acquire from a book. Choice C is incorrect as effective leadership involves focusing on long-term goals and strategies, not just daily activities. Choice D is incorrect because while seizing leadership opportunities is important, it should be done strategically and with a solid foundation of experience in nursing to ensure successful leadership outcomes.

4. A client with type 2 diabetes mellitus is prescribed metformin. The nurse should monitor the client for which of the following potential side effects?

A. Lactic acidosis
B. Hypokalemia
C. Hyperglycemia
D. Weight gain

Correct answer: A

Rationale: The correct answer is A, lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or predisposing factors. Monitoring for signs of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or uneven heart rate, is crucial to prevent serious complications. Choices B, C, and D are incorrect as metformin does not typically cause hypokalemia, hyperglycemia, or weight gain as its primary side effects.

5. Which of the following clinical findings would be most concerning in a client with hypothyroidism?

A. Bradycardia
B. Dry skin
C. Constipation
D. Depression

Correct answer: A

Rationale: Bradycardia in a client with hypothyroidism is the most concerning finding as it may indicate severe hypothyroidism, leading to decreased heart rate. Bradycardia can be a sign of myxedema coma, a life-threatening condition that requires immediate medical attention. Dry skin, constipation, and depression are common symptoms associated with hypothyroidism but are not as acutely concerning as bradycardia.