HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. A client with Graves' disease is prescribed propranolol. The nurse understands that the purpose of this medication is to:
- A. Treat the underlying cause of the disease
- B. Reduce thyroid hormone production
- C. Alleviate symptoms such as tachycardia and tremors
- D. Increase energy levels
Correct answer: C
Rationale: The correct answer is C: Alleviate symptoms such as tachycardia and tremors. Propranolol is a beta-blocker that helps manage symptoms like tachycardia (fast heart rate) and tremors in patients with Graves' disease. Choice A is incorrect because propranolol does not address the underlying cause of Graves' disease, which is autoimmune in nature. Choice B is incorrect because propranolol does not directly reduce thyroid hormone production; it mainly targets the symptoms. Choice D is incorrect because while propranolol may help with symptoms like tachycardia, it is not intended to increase energy levels.
2. What is the priority nursing assessment immediately following the birth of an infant with esophageal atresia and a tracheoesophageal (TE) fistula?
- A. Body temperature.
- B. Level of pain.
- C. Time of first void.
- D. Number of vessels in the cord.
Correct answer: D
Rationale: The priority nursing assessment immediately following the birth of an infant with esophageal atresia and a tracheoesophageal (TE) fistula is to check the number of vessels in the cord. This assessment is crucial to identify any potential anomalies related to the TE fistula, as abnormalities in the cord vessels may indicate associated congenital anomalies that need immediate attention.
3. What is the most important assessment for a nurse to conduct on a child diagnosed with intussusception?
- A. Monitor for signs of infection.
- B. Measure abdominal girth and monitor for pain.
- C. Check for bowel movement and changes in stool.
- D. Assess hydration status and monitor urine output.
Correct answer: C
Rationale: The correct answer is C: 'Check for bowel movement and changes in stool.' Intussusception can cause obstruction in the bowel, leading to symptoms like abdominal pain, vomiting, and 'currant jelly' stools. Monitoring for changes in bowel movement, especially the passage of 'currant jelly' stools, is crucial for early detection of worsening conditions. Choices A, B, and D are important assessments in pediatric care but are not as specific or crucial as checking for changes in bowel movement in a child diagnosed with intussusception.
4. A client is receiving external beam radiation to the mediastinum for treatment of bronchial cancer. Which of the following should take priority in planning care?
- A. Esophagitis
- B. Leukopenia
- C. Fatigue
- D. Skin irritation
Correct answer: B
Rationale: The correct answer is B: Leukopenia. Leukopenia, or a low white blood cell count, is a critical concern in clients undergoing radiation therapy due to the increased risk of infection. While esophagitis, fatigue, and skin irritation are also potential side effects of radiation therapy, leukopenia poses a higher risk as it compromises the body's ability to fight infections effectively.
5. The nurse is caring for a child immediately after surgical correction of a ventricular septal defect. Which of the following nursing assessments should be a priority?
- A. Assess nail beds for color and refill
- B. Assess for postoperative arrhythmias
- C. Auscultate for pulmonary congestion
- D. Monitor equality of peripheral pulses
Correct answer: B
Rationale: Postoperative arrhythmias are a common and potentially serious complication after cardiac surgery, making them a priority to monitor. Assessing for postoperative arrhythmias takes precedence over other assessments like checking nail beds for color and refill, auscultating for pulmonary congestion, or monitoring peripheral pulses as arrhythmias can have immediate and severe implications for the child's health.