HESI RN
HESI Leadership and Management
1. A client with type 1 DM is experiencing hypoglycemia. Which symptom should the nurse expect to observe?
- A. Tachycardia
- B. Polyuria
- C. Flushed skin
- D. Dry mouth
Correct answer: A
Rationale: The correct answer is A: Tachycardia. In hypoglycemia, the body releases adrenaline in response to low blood glucose levels, leading to symptoms such as tachycardia (rapid heart rate). Choice B, polyuria, refers to excessive urination and is not a typical symptom of hypoglycemia. Choice C, flushed skin, is not a common symptom of hypoglycemia; instead, pale skin and sweating are more characteristic. Choice D, dry mouth, is not directly associated with hypoglycemia; rather, it can be a symptom of hyperglycemia or dehydration.
2. Which of the following ethical principles involves the fair and equitable distribution of resources?
- A. Justice
- B. Fidelity
- C. Autonomy
- D. Veracity
Correct answer: A
Rationale: The correct answer is A: Justice. Justice is the ethical principle that focuses on the fair and equitable distribution of resources, ensuring that all individuals receive appropriate care based on their needs. Fidelity (B) refers to being faithful or loyal to commitments and obligations. Autonomy (C) relates to respecting an individual's right to make their own decisions. Veracity (D) pertains to truthfulness and honesty in communication with patients.
3. Albert refuses his bedtime snack. This should alert the healthcare provider to assess for:
- A. Elevated serum bicarbonate and decreased blood pH.
- B. Signs of hypoglycemia earlier than expected.
- C. Symptoms of hyperglycemia due to NPH insulin peak time.
- D. Presence of sugar in the urine.
Correct answer: B
Rationale: When a patient like Albert refuses his bedtime snack, it can lead to hypoglycemia, especially if they are on medication such as insulin. Hypoglycemia can occur earlier than expected due to the lack of carbohydrate intake before bedtime. This situation warrants the healthcare provider to monitor for signs and symptoms of hypoglycemia. Choice A is incorrect because the given scenario is more indicative of hypoglycemia than metabolic alkalosis. Choice C is incorrect as NPH insulin peak time is not directly related to skipping a bedtime snack. Choice D is incorrect as sugar in the urine typically indicates hyperglycemia, not hypoglycemia.
4. The client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:
- A. I need to skip meals if my blood glucose level is elevated.
- B. I need to eat a small meal or snack every 2 to 3 hours.
- C. I need to avoid using concentrated sweets in my diet.
- D. I need to eat a high-protein, low-carbohydrate diet.
Correct answer: C
Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.
5. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:
- A. The test needs to be repeated following a 12-hour fast.
- B. It appears you aren't following the prescribed diabetic diet.
- C. It tells us about your sugar control for the last 3 months.
- D. Your insulin regimen needs to be significantly altered.
Correct answer: C
Rationale: The correct answer is C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past 3 months. This test is used to assess long-term blood sugar control in individuals with diabetes. Choice A is incorrect because fasting is not required for an HbA1c test. Choice B is judgmental and not supported by the information provided. Choice D is not the most accurate statement to make based on the HbA1c result; adjusting insulin would depend on a more comprehensive assessment of the client's overall diabetes management.
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