HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. A nurse is preparing to administer insulin to a client with DM. The nurse understands that the peak time for rapid-acting insulin, such as lispro (Humalog), is:
- A. 30 minutes to 1 hour after administration.
- B. 1 to 2 hours after administration.
- C. 2 to 4 hours after administration.
- D. 3 to 5 hours after administration.
Correct answer: A
Rationale: The correct answer is A: 30 minutes to 1 hour after administration. Rapid-acting insulins like lispro, such as Humalog, peak quickly within 30 minutes to 1 hour after administration. This peak time is crucial to monitor for potential hypoglycemia, which is most likely to occur during this period. Choice B is incorrect as it suggests a longer peak time for rapid-acting insulin, which is inaccurate. Choices C and D are also incorrect because they indicate even longer peak times, which do not align with the rapid onset and peak action of lispro insulin.
2. A healthcare provider caring for a client with severe malnutrition reviews the laboratory results and notes a magnesium level of 1.0 mg/dL. Which electrocardiographic change would the healthcare provider expect to note based on the magnesium level?
- A. Prominent U waves
- B. Prolonged PR interval
- C. Depressed ST segment
- D. Widened QRS complexes
Correct answer: C
Rationale: A magnesium level of 1.0 mg/dL can cause a depressed ST segment on the ECG. Magnesium deficiency commonly leads to ST segment depression on an electrocardiogram. Prominent U waves are associated with hypokalemia, prolonged PR interval is seen in conditions like first-degree heart block, and widened QRS complexes are typically related to conditions affecting the conduction system of the heart, such as bundle branch blocks.
3. 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.
4. When should a new nurse graduate consider applying for a position as a nurse manager?
- A. When she is comfortable in her current position
- B. When she begins mentoring other new nurses
- C. As soon as a position opens
- D. When she has developed leadership and clinical expertise
Correct answer: D
Rationale: A new nurse graduate should consider applying for a nurse manager position when they have developed both leadership and clinical expertise. This ensures that they are well-prepared for the responsibilities of the role. Choice A is incorrect because being comfortable in the current position does not necessarily equate to having the required skills for a nurse manager role. Choice B is incorrect as mentoring other new nurses, while valuable, may not directly align with the skills needed for a managerial position. Choice C is incorrect as applying for a nurse manager position solely because a position is available does not guarantee readiness for the role.
5. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?
- A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
- B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
- C. Body image disturbance related to weight gain and edema
- D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Correct answer: D
Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.
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