a nurse is caring for a client who wanders through the halls yelling obscenities at staff other clients and visitors which of the following actions sh
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HESI Leadership and Management Quizlet

1. A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following actions should the nurse take?

Correct answer: B

Rationale: When dealing with a client exhibiting disruptive behavior like yelling obscenities, involving a family member can provide emotional support and help in de-escalating the situation. Keeping the client isolated in their room (Choice A) may lead to further agitation. Placing the client in a wheelchair (Choice C) or administering a sedative (Choice D) should not be the first interventions for managing behavioral issues.

2. How many calories per kilogram does an average full-term infant require when the infant is around 1-2 months old?

Correct answer: B

Rationale: An average full-term infant requires about 120 calories per kilogram per day at 1-2 months old. This amount is essential for their growth and development during this critical stage. Choices A, C, and D are incorrect as they provide calorie amounts that are either too high or too low for an average full-term infant at 1-2 months old, which could potentially lead to health issues or inadequate nutrition.

3. A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?

Correct answer: C

Rationale: An ethical dilemma involves a situation where moral principles conflict, such as in the case of a parent wanting their adolescent to receive treatment against their will. In option A, a minor burn from spilled coffee does not present a conflict of moral principles. Option B describes a medical error, not necessarily a conflict of moral principles. Option D involves an issue of professional practice and patient safety but does not inherently pose a conflict of moral principles.

4. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

5. A client has a new diagnosis of chlamydia. Which of the following actions should the nurse take?

Correct answer: A

Rationale: The correct answer is to report the infection to the local health department. Chlamydia is a reportable disease, meaning healthcare providers are required to report cases to public health authorities for tracking and control measures. Choice B is incorrect because chlamydia is a bacterial infection, not a viral infection, so antiviral cream would not be effective. Choice C is important advice for preventing the spread of chlamydia but is not the priority in this scenario. Choice D is not necessary for chlamydia, as it is primarily transmitted through sexual contact.

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