HESI RN
Leadership HESI
1. A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?
- A. Dry skin
- B. Decreased urinary output
- C. Hyperactive bowel sounds
- D. Increased specific gravity of the urine
Correct answer: C
Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.
2. The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.
- A. Is the patient expressing suicidal thoughts?
- B. Does the patient have experiences with either community or inpatient mental healthcare facilities?
- C. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
- D. Is the patient experiencing delusions or hallucinations?
Correct answer: B
Rationale: To determine whether a community outpatient or inpatient setting is most appropriate for a patient experiencing psychotic symptoms, it is crucial to consider if the patient has had experiences with either community or inpatient mental healthcare facilities. This helps assess the familiarity and comfort level of the patient in those settings, aiding in decision-making regarding the level of care needed. Choice A, addressing suicidal thoughts, is important for risk assessment and safety planning but does not directly help in determining the setting appropriateness between community outpatient or inpatient care. Choice C, about the need for a therapeutic environment, is significant but does not specifically assist in deciding between outpatient or inpatient care. Choice D, related to delusions or hallucinations, is relevant in assessing the symptomatology but does not directly guide the choice between community outpatient or inpatient care.
3. What type of epithelium lines the urinary bladder?
- A. Transitional epithelium.
- B. Stratified epithelium.
- C. Glandular tissue.
- D. Endometrium.
Correct answer: A
Rationale: The correct answer is A: Transitional epithelium. The urinary bladder is lined with transitional epithelium, a specialized type of epithelial tissue that can stretch and recoil to accommodate changes in volume as the bladder fills and empties. Stratified epithelium (choice B) is not the main lining of the urinary bladder and is found in other areas like the skin. Glandular tissue (choice C) is responsible for producing secretions and is not typically found lining the urinary bladder. Endometrium (choice D) is the inner lining of the uterus and is not present in the urinary bladder.
4. While teaching a group of adults about health promotion activities, a nurse identifies a behavior that poses the most significant risk factor for the development of skin cancer. Which behavior should the nurse address?
- A. Consuming a high-fat diet
- B. Using tanning beds
- C. Smoking cigarettes
- D. Drinking alcohol
Correct answer: B
Rationale: Using tanning beds is the most significant risk factor for developing skin cancer. Ultraviolet (UV) radiation from tanning beds damages the skin and increases the risk of skin cancer. Consuming a high-fat diet, smoking cigarettes, and drinking alcohol are unhealthy behaviors but are not directly linked to the development of skin cancer like UV exposure from tanning beds.
5. A client with heart failure has a prescription for digoxin. The nurse is aware that sufficient potassium should be included in the diet because hypokalemia in combination with this medication:
- A. Can predispose to dysrhythmias
- B. May lead to oliguria
- C. May cause irritability and anxiety
- D. Sometimes alters consciousness
Correct answer: A
Rationale: The correct answer is A: Hypokalemia increases the risk of dysrhythmias when taking digoxin, making potassium intake crucial. Digoxin toxicity is more likely in patients with low potassium levels, leading to an increased risk of dysrhythmias. Choices B, C, and D are incorrect because hypokalemia in combination with digoxin is primarily associated with dysrhythmias rather than oliguria, irritability, anxiety, or alteration of consciousness.