HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?
- A. The client with colitis
- B. The client with Cushing's syndrome
- C. The client who has been overusing laxatives
- D. The client who has sustained a traumatic burn
Correct answer: D
Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.
2. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?
- A. Hyperglycemia
- B. Hypotension
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.
3. When should a new nurse graduate consider applying for a position as a nurse manager?
- A. When she is comfortable in her current position
- B. When she begins mentoring other new nurses
- C. As soon as a position opens
- D. When she has developed leadership and clinical expertise
Correct answer: D
Rationale: A new nurse graduate should consider applying for a position as a nurse manager when she has developed leadership and clinical expertise. Option A, 'When she is comfortable in her current position,' is incorrect as comfort in the current position may not necessarily align with the skills required for a managerial role. Option B, 'When she begins mentoring other new nurses,' is not a definitive indicator of readiness for a managerial position. Option C, 'As soon as a position opens,' does not take into account the necessary skills and experience required for a nurse manager role. Therefore, the best time to consider applying for a nurse manager position is after developing the required leadership and clinical expertise.
4. 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.
5. A nurse manager is reviewing the nurse’s documentation on the unit. Which of the following best describes the importance of this review?
- A. The nurse manager’s review of documentation is crucial to ensure that it meets legal and ethical standards and accurately reflects the care provided to patients.
- B. The nurse manager’s review of documentation is important to ensure that it is thorough, accurate, and reflects the nurse’s accountability for patient care.
- C. The nurse manager’s review of documentation is necessary to ensure that it is consistent with the unit’s policies and procedures and that it accurately reflects the care provided.
- D. The nurse manager’s review of documentation is essential to ensure that it meets regulatory requirements and that it supports the delivery of safe and effective patient care.
Correct answer: D
Rationale: The nurse manager's review of documentation is a critical aspect of maintaining quality patient care. Choice D is the correct answer as it highlights the importance of ensuring that documentation meets regulatory requirements, supporting the delivery of safe and effective patient care. Regulatory requirements are established to ensure that healthcare facilities function within established guidelines and standards, promoting patient safety and quality of care. Choices A, B, and C, although important aspects of documentation review, do not fully encapsulate the significant role of regulatory compliance in ensuring the overall quality and safety of patient care.
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