HESI RN
Leadership and Management HESI
1. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?
- A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
- B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
- C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
- D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.
Correct answer: A
Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.
2. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
- A. Infusing I.V. fluids rapidly as ordered
- B. Encouraging increased oral intake
- C. Restricting fluids
- D. Administering glucose-containing I.V. fluids as ordered
Correct answer: C
Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.
3. Scientific management and human relations-based approach are two major theoretical management schools of thought. Which of the following best describes the scientific model of management?
- A. A nurse manager considers methods of motivating the staff to do their assigned tasks.
- B. A nurse manager commends staff for the work they do, reminding them of the importance of their work and the lives they have saved.
- C. A nurse manager analyzes the role of each staff member on the unit to determine ways to increase efficiency.
- D. A conflict between two staff nurses has impacted an entire unit. The unit manager meets with the nurses and entire staff to promote mutual understanding.
Correct answer: C
Rationale: The correct answer is C because scientific management focuses on improving efficiency through the analysis of tasks and work processes. Choice A is more aligned with a human relations-based approach, which emphasizes motivation and relationships. Choice B reflects recognition and morale boosting, which is also characteristic of the human relations approach. Choice D involves conflict resolution and promoting mutual understanding, which is related to the human relations approach rather than scientific management.
4. 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.
5. The nurse is caring for a client with hyperparathyroidism. Which of the following clinical manifestations is consistent with this condition?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperphosphatemia
Correct answer: B
Rationale: In hyperparathyroidism, there is an overproduction of parathyroid hormone, leading to increased calcium levels in the blood (hypercalcemia). This occurs as the parathyroid hormone stimulates the release of calcium from the bones and enhances calcium absorption in the intestines and kidneys. Therefore, the correct answer is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not consistent with hyperparathyroidism, as this condition is characterized by high calcium levels. Hypokalemia (Choice C) and hyperphosphatemia (Choice D) are not typically associated with hyperparathyroidism and are not primary manifestations of this condition.
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