HESI RN
Leadership and Management HESI
1. A client with hyperparathyroidism is at risk for which of the following complications?
- A. Hypocalcemia
- B. Osteoporosis
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: A client with hyperparathyroidism is at risk for osteoporosis, not hypocalcemia, hypokalemia, or hyponatremia. Hyperparathyroidism results in increased levels of parathyroid hormone, which causes excessive breakdown of bone tissue to release calcium into the bloodstream. This process can lead to weakened bones and an increased risk of osteoporosis. Hypocalcemia is unlikely in hyperparathyroidism as the condition is characterized by elevated calcium levels due to the abnormal activity of the parathyroid glands. Hypokalemia and hyponatremia are not directly associated with hyperparathyroidism; they are more commonly linked to other conditions affecting potassium and sodium levels in the body.
2. Before administering a client's medication, the nurse assesses a change in the client's condition and decides to withhold the medication until consulting with the healthcare provider. After consultation with the healthcare provider, the dose of the medication is changed, and the nurse administers the newly prescribed dose an hour later than the originally scheduled time. What action should the nurse take in response to this situation?
- A. Notify the charge nurse that a medication error occurred.
- B. Submit a medication variance report to the supervisor.
- C. Document the events that occurred in the nurse's notes.
- D. Discard the original medication administration record.
Correct answer: C
Rationale: In this scenario, the nurse acted appropriately by withholding the medication, consulting with the healthcare provider, and administering the newly prescribed dose, albeit with a delay. The correct course of action for the nurse is to document all these events in the nurse's notes. Documenting the sequence of actions taken is crucial for maintaining an accurate record of the client's care, ensuring transparency, and providing essential information for future reference and continuity of care. Notifying the charge nurse or submitting a medication variance report may not be necessary as the situation was managed appropriately, and discarding the original medication administration record is not recommended as it is part of the client's medical record and should be kept for documentation purposes.
3. A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client’s dietary teaching? (Select all that apply.)
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. A and B
- D. Reduce your intake of milk and other dairy products.
Correct answer: C
Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation. Therefore, choices A and B are correct. Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake. Choices A and B address these dietary modifications, making them the correct options for this client. Choices D, which is not directly related to calcium phosphate stones, is incorrect.
4. Skillful communication is one behavior of an effective leader. Which of the following describes an effective method of communication?
- A. A unit manager meets with a new nurse to discuss what is going well and what improvements the new nurse can make.
- B. A unit manager meets with a new nurse to explain departmental policy.
- C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent further safety events.
- D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.
Correct answer: A
Rationale: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.
5. Which actions are likely to help promote the self-esteem of a male client with major depression?
- A. Ask the client about his long-term goals.
- B. Discuss the challenges of his medical condition.
- C. Include the client in determining treatment protocol.
- D. Encourage the client to engage in recreational therapy.
Correct answer: C
Rationale: Including the client in determining the treatment protocol is the most suitable action to promote the self-esteem of a male client with major depression. This approach empowers the client, involves him in decision-making regarding his care, and fosters a sense of control and self-worth. Option A, asking about his long-term goals, may not directly address his immediate self-esteem needs related to his current condition. Option B, discussing the challenges of his medical condition, may inadvertently focus on negative aspects and potentially lower self-esteem. Option D, encouraging engagement in recreational therapy, is beneficial but may not directly address the client's sense of control and self-worth in decision-making related to his treatment.