HESI RN
HESI Leadership and Management
1. A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicates an inadequate understanding of the peak action of NPH insulin and exercise?
- A. The best time for me to exercise is every afternoon.
- B. The best time for me to exercise is right after I eat.
- C. The best time for me to exercise is after breakfast.
- D. The best time for me to exercise is after my morning snack.
Correct answer: A
Rationale: Exercising in the afternoon may coincide with the peak action of NPH insulin, increasing the risk of hypoglycemia. The peak action of NPH insulin typically occurs 4-12 hours after administration, so exercising during this time can further lower blood sugar levels. Choices B, C, and D are better options as they suggest exercising at times that are less likely to overlap with the peak insulin action, reducing the risk of hypoglycemia.
2. A client with diabetes insipidus is being treated with desmopressin. The nurse should monitor for which of the following side effects?
- A. Hyponatremia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used in diabetes insipidus, can cause water retention by increasing water reabsorption in the kidneys. This excess water retention can lead to dilutional hyponatremia, where sodium levels in the body become too low. Monitoring for hyponatremia is crucial to prevent complications such as neurological symptoms. Choices B, C, and D are incorrect because desmopressin is not known to cause hypernatremia, hypokalemia, or hypercalcemia.
3. Why have recent polls placed nursing as one of the most trusted professions?
- A. Nurses engage in lifelong learning.
- B. Nurses abide by a dress code.
- C. Nurses have the skills needed to care for diverse populations.
- D. Nurses must pass the NCLEX in order to obtain a license to practice.
Correct answer: C
Rationale: Recent polls have identified nursing as one of the most trusted professions primarily because nurses possess the essential skills required to provide care to diverse populations. This includes cultural competence, empathy, effective communication, and clinical expertise. Choice A, engaging in lifelong learning, is indeed an important aspect of nursing practice; however, it is not the primary reason for the high level of trust placed in nurses. Choice B, abiding by a dress code, is a professional conduct issue and not directly linked to the trustworthiness of nurses. Choice D, passing the NCLEX exam for licensure, is a regulatory requirement and does not directly contribute to the trust placed in nurses by the public.
4. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?
- A. Administer intravenous fluids
- B. Provide a warming blanket
- C. Administer levothyroxine intravenously
- D. Place the client in Trendelenburg position
Correct answer: C
Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.
5. In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Pancreas
- C. Adrenal medulla
- D. Parathyroid
Correct answer: A
Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.
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