HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. A healthcare professional is preparing to care for a client with a potassium deficit. The healthcare professional reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:
- A. Has renal failure.
- B. Requires nasogastric suction.
- C. Has a history of Addison's disease.
- D. Is taking a potassium-sparing diuretic.
Correct answer: B
Rationale: Nasogastric suction can lead to significant potassium loss due to the continuous drainage of gastric contents, increasing the risk of a potassium deficit. Choices A, C, and D do not directly result in the significant loss of potassium. Renal failure may lead to potassium retention rather than a deficit. Addison's disease is associated with adrenal insufficiency, not potassium depletion. Potassium-sparing diuretics, as the name suggests, typically help retain potassium rather than cause a deficit.
2. Which of the following is a priority nursing diagnosis for a client with Addison's disease?
- A. Fluid volume deficit
- B. Risk for infection
- C. Imbalanced nutrition: Less than body requirements
- D. Disturbed body image
Correct answer: A
Rationale: The priority nursing diagnosis for a client with Addison's disease is 'Fluid volume deficit.' Addison's disease is characterized by adrenal insufficiency, resulting in decreased aldosterone production. Aldosterone plays a key role in sodium and water retention in the body. With its deficiency, there is an increased risk of dehydration and electrolyte imbalance, leading to fluid volume deficit. While infection risk, nutrition issues, and body image disturbances are also important considerations for holistic care, addressing the fluid volume deficit takes precedence due to the immediate physiological impact on the client's health and well-being.
3. The client has been diagnosed with primary aldosteronism. Which of the following clinical findings would the nurse expect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct answer: B
Rationale: Primary aldosteronism involves the overproduction of aldosterone by the adrenal glands. Aldosterone increases potassium excretion, leading to hypokalemia. Therefore, in primary aldosteronism, the nurse would expect to find hypokalemia, not hyperkalemia (choice A), hyponatremia (choice C), or hypercalcemia (choice D).
4. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?
- A. Insulin
- B. Hydrocortisone
- C. Levothyroxine
- D. Methimazole
Correct answer: B
Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.
5. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?
- A. Encourage increased fluid intake
- B. Administer hypertonic saline
- C. Monitor for signs of dehydration
- D. Restrict oral fluids
Correct answer: D
Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.
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