HESI RN
Leadership and Management HESI
1. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?
- A. Administer desmopressin while the suspension is cold.
- B. Your condition isn't chronic, so you won't need to wear a medical identification bracelet.
- C. You may not be able to use desmopressin nasally if you have nasal discharge or blockage.
- D. You won't need to monitor your fluid intake and output after you start taking desmopressin.
Correct answer: C
Rationale: The correct instruction is choice C: 'You may not be able to use desmopressin nasally if you have nasal discharge or blockage.' Nasal congestion or blockage can interfere with the absorption of nasally administered desmopressin. Choices A, B, and D are incorrect. Choice A is unnecessary as the temperature of the suspension does not impact desmopressin administration. Choice B is incorrect as wearing a medical identification bracelet is essential for individuals with diabetes insipidus to alert healthcare providers in case of emergencies. Choice D is incorrect as monitoring fluid intake and output is crucial when taking desmopressin to ensure proper hydration and medication effectiveness.
2. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical findings should the nurse expect?
- A. Hyponatremia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypernatremia
Correct answer: A
Rationale: In SIADH, there is excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Hyponatremia is a hallmark finding in SIADH due to the imbalance between water and sodium levels. Hyperkalemia (Choice B) is not typically associated with SIADH. Hypercalcemia (Choice C) involves elevated calcium levels, which are not directly related to SIADH. Hypernatremia (Choice D) is the opposite of what occurs in SIADH, where sodium levels are usually diluted due to water retention.
3. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?
- A. Serum glucose of 180 mg/dL
- B. Serum bicarbonate of 22 mEq/L
- C. Blood pH of 7.25
- D. Urine specific gravity of 1.020
Correct answer: C
Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.
4. The client has been diagnosed with primary aldosteronism. Which of the following clinical findings would the nurse expect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct answer: B
Rationale: Primary aldosteronism involves the overproduction of aldosterone by the adrenal glands. Aldosterone increases potassium excretion, leading to hypokalemia. Therefore, in primary aldosteronism, the nurse would expect to find hypokalemia, not hyperkalemia (choice A), hyponatremia (choice C), or hypercalcemia (choice D).
5. A client with Cushing's syndrome has been prescribed a diet low in sodium. The nurse knows that the client should avoid which of the following foods?
- A. Bananas
- B. Spinach
- C. Processed meats
- D. Oatmeal
Correct answer: C
Rationale: The correct answer is C: Processed meats. Clients with Cushing's syndrome who are on a low-sodium diet should avoid processed meats because they are typically high in sodium. Bananas, spinach, and oatmeal are generally low in sodium and can be included in a low-sodium diet. Bananas are a good source of potassium, spinach is rich in vitamins and minerals, and oatmeal is a healthy whole grain option. Therefore, choices A, B, and D are not the best options to avoid for a client with Cushing's syndrome following a low-sodium diet.
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