HESI RN
Leadership HESI
1. A client with type 2 diabetes mellitus is being discharged after receiving initial treatment. What should the nurse emphasize as a crucial instruction?
- A. Take insulin as prescribed, even if you are not eating.
- B. Avoid all forms of physical exercise to prevent hypoglycemia.
- C. Monitor blood glucose levels regularly and report any changes.
- D. Stop taking oral antidiabetic medication if your blood glucose levels are normal.
Correct answer: C
Rationale: Monitoring blood glucose levels regularly is a critical aspect of managing type 2 diabetes mellitus. This allows the individual to track their blood sugar levels, understand the effectiveness of the treatment plan, and detect any fluctuations promptly. Option A is incorrect because insulin should be taken based on a prescribed schedule that correlates with meals to prevent hypoglycemia or hyperglycemia. Option B is incorrect as physical exercise is beneficial for managing diabetes but should be done cautiously with adjustments in insulin or food intake. Option D is incorrect because discontinuing oral antidiabetic medications without healthcare provider guidance can lead to uncontrolled blood glucose levels.
2. A client with deep vein thrombosis (DVT) is prescribed anticoagulants. What should the nurse monitor closely?
- A. Monitor for signs of bleeding, such as bruising.
- B. Monitor the client’s vital signs every hour.
- C. Monitor for pain in the affected limb.
- D. Assess for signs of pulmonary embolism, such as sudden shortness of breath.
Correct answer: D
Rationale: In clients with DVT, assessing for pulmonary embolism is crucial as a clot in the lungs can be life-threatening. Sudden shortness of breath or chest pain are key signs of a pulmonary embolism. While monitoring for signs of bleeding is important due to anticoagulant therapy, the immediate concern is detecting a potential pulmonary embolism. Monitoring vital signs and pain in the affected limb are relevant aspects of care but are not as urgent as assessing for pulmonary embolism in this scenario.
3. The healthcare provider provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the healthcare provider include in the teaching plan? (select one that does not apply.)
- A. wash all fruits and vegetables thoroughly in running tap water
- B. identify all sexual contacts since the evacuation process
- C. take all doses of prophylactic prescriptions for diarrhea
- D. clean hands using soap, clean water, or waterless antibacterial solutions
Correct answer: B
Rationale: In the aftermath of a flooding disaster, educating evacuees on proper hygiene practices like washing fruits and vegetables, taking prophylactic prescriptions, and practicing hand hygiene is crucial to prevent the spread of diseases. Option B, identifying sexual contacts, is not relevant to preventing post-disaster health risks and should not be included in the teaching plan.
4. Which cell structure is responsible for efficiently packaging DNA into a small volume to fit into the nucleus of a cell and protect the DNA structure and sequence?
- A. Golgi apparatus
- B. Chromatin
- C. Smooth endoplasmic reticulum
- D. Mitochondria
Correct answer: B
Rationale: The correct answer is B: Chromatin. Chromatin is responsible for packaging DNA into a more compact, dense shape to fit into the nucleus of a cell. This compact packaging helps protect the DNA structure and regulate gene expression. The Golgi apparatus is involved in modifying, sorting, and packaging proteins. The smooth endoplasmic reticulum is involved in lipid metabolism and detoxification. Mitochondria are known as the powerhouse of the cell, producing energy in the form of ATP.
5. A client presses the call bell and requests pain medication for a severe headache. To assess the quality of the client's pain, which approach should the nurse use?
- A. Use the Wong-Baker Faces pain rating scale
- B. Assess vital signs to gauge pain severity
- C. Ask the client to describe the pain
- D. Offer a 1-10 pain scale
Correct answer: C
Rationale: Asking the client to describe the pain is the most appropriate approach to assess the quality of pain. It provides valuable qualitative information that aids in understanding the nature, cause, and potential management strategies for the headache. While pain rating scales like the Wong-Baker Faces scale and using vital signs can help quantify pain severity, they do not offer specific descriptive details that can give insights into the type and characteristics of the pain experienced by the client.