HESI RN
HESI Leadership and Management
1. A healthcare professional is monitoring a client newly diagnosed with DM for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if blood glucose levels are not adequately managed?
- A. Polyuria
- B. Diaphoresis
- C. Pedal edema
- D. Proteinuria
Correct answer: D
Rationale: Proteinuria is the correct answer because it indicates kidney damage, which is a common complication of uncontrolled diabetes. Elevated blood glucose levels over time can damage the kidneys, leading to proteinuria. Polyuria (excessive urination) is a symptom of diabetes but does not specifically indicate a risk for chronic complications. Diaphoresis (excessive sweating) and pedal edema (swelling of the lower limbs) are not direct indicators of chronic complications related to uncontrolled diabetes.
2. The healthcare provider is preparing to administer intravenous immune globulin (IVIG) to a client with Guillain-Barre syndrome. Which assessment is most important before initiating the infusion?
- A. Lung sounds and respiratory status.
- B. Skin integrity and color.
- C. Neurological status and level of consciousness.
- D. Cardiac rate and rhythm.
Correct answer: D
Rationale: The correct answer is D, "Cardiac rate and rhythm." Monitoring cardiac rate and rhythm is crucial before initiating IVIG because bradycardia is a common side effect associated with this therapy. Assessing lung sounds and respiratory status (Choice A) is important, but cardiac monitoring takes precedence due to the risk of bradycardia. Skin integrity and color (Choice B) are important assessments, but they are not directly related to potential complications of IVIG infusion. Neurological status and level of consciousness (Choice C) are also vital assessments, but monitoring cardiac function is more pertinent in this scenario.
3. A healthcare professional is teaching a new colleague about the correct administration of subcutaneous (subQ) injections. Which instruction should the healthcare professional include?
- A. Insert the needle at a 90-degree angle for subQ injections
- B. Aspirate for blood return before injecting the medication
- C. Pinch the skin before inserting the needle
- D. Massage the site after administering the injection
Correct answer: C
Rationale: Pinching the skin before inserting the needle is essential in elevating the subcutaneous tissue away from the muscle. This technique ensures that the medication is administered into the correct tissue layer, promoting proper absorption and decreasing the risk of injecting into muscle tissue.
4. Which of the following data should not be included in the identification data of gynecological history?
- A. Parity
- B. Lost normal menstrual period
- C. EDD (Expected date of delivery)
- D. Last delivery
Correct answer: C
Rationale: The correct answer is C: EDD (Expected date of delivery). In a gynecological history, EDD is not typically included as it pertains more to obstetric history. Parity, lost normal menstrual period, and last delivery are important components of gynecological history. Parity refers to the number of times a woman has given birth to a fetus past 20 weeks' gestation. Lost normal menstrual period can provide insight into potential gynecological issues, while last delivery details the most recent childbirth experience. Therefore, EDD is the outlier in this context.
5. 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.