HESI RN
Leadership and Management HESI
1. A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?
- A. The client taking diuretics
- B. The client with renal failure
- C. The client with an ileostomy
- D. The client who requires gastrointestinal suctioning
Correct answer: B
Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.
2. Which of the following describes an effective method of communication?
- A. A unit manager meets with a new nurse to discuss what is going well and areas for improvement.
- B. A unit manager meets with a new nurse to explain departmental policies.
- C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing further safety events.
- D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.
Correct answer: A
Rationale: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.
3. A nurse manager is reviewing data from the unit. More than 50% of new nurses hired left within 1 year of being hired. Which of the following implementations should the nurse manager consider to improve retention of newly hired nurses?
- A. Increase the length of time new hires spend in training.
- B. Conduct a performance review at 3, 6, and 9 months to review the new nurse’s weaknesses.
- C. Stress the importance of continuity of care to new hires.
- D. Build the manager’s own leadership skills through building relationships with staff members.
Correct answer: D
Rationale: To improve retention of newly hired nurses, the nurse manager should focus on building their own leadership skills and relationships with staff members. By creating a supportive environment and demonstrating effective leadership, the manager can positively impact staff retention. Options A, B, and C do not directly address the core issue of creating a supportive work environment and effective leadership, which are crucial for retaining newly hired nurses.
4. A client with hyperaldosteronism is at risk for which of the following electrolyte imbalances?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: C
Rationale: In hyperaldosteronism, there is an excessive secretion of aldosterone, a hormone that promotes potassium excretion in the kidneys. This leads to low potassium levels in the blood, known as hypokalemia. Therefore, the correct answer is hypokalemia (Choice C). Hyperkalemia (Choice A) is the opposite condition, where there is high potassium levels in the blood and is not typically associated with hyperaldosteronism. Hyponatremia (Choice B) is a low sodium level, which is not directly related to aldosterone function. Hypercalcemia (Choice D) is an elevated calcium level and is not typically a direct result of hyperaldosteronism.
5. A client with hyperthyroidism is being treated with radioactive iodine. The nurse should teach the client to expect which of the following side effects?
- A. Increased heart rate
- B. Hypothyroidism
- C. Hypercalcemia
- D. Weight loss
Correct answer: B
Rationale: When a client with hyperthyroidism undergoes radioactive iodine treatment, it often leads to hypothyroidism due to the destruction of thyroid tissue. This occurs as a desired outcome of the treatment to reduce the overactive thyroid function. Choices A, C, and D are incorrect. Increased heart rate, hypercalcemia, and weight loss are not expected side effects of radioactive iodine treatment for hyperthyroidism. Instead, the goal is to suppress the overactive thyroid, leading to a hypothyroid state.
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