HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. When implementing a new policy on the unit, what process should a nurse manager follow?
- A. The nurse manager should involve staff members in the decision-making process, gather input, and communicate the reasons for the policy change to ensure buy-in from the team.
- B. The nurse manager should implement the policy change immediately and monitor staff compliance to ensure that the new policy is being followed.
- C. The nurse manager should delegate the implementation of the policy change to a staff member and provide support as needed to ensure that the change is successful.
- D. The nurse manager should communicate the policy change to staff members, provide training as needed, and monitor the implementation process to ensure that the change is effective.
Correct answer: A
Rationale: When introducing a new policy on the unit, it is essential for the nurse manager to involve staff members in the decision-making process. This approach helps in gathering input and insights from the team, fostering a sense of ownership and commitment. By communicating the reasons behind the policy change, the nurse manager ensures transparency and promotes understanding among the staff, leading to buy-in and acceptance of the new policy. Choice B is incorrect because implementing a policy change without involving staff and explaining the rationale may lead to resistance or lack of understanding. Choice C is not ideal as delegation without active involvement and communication with the team may result in misunderstandings or incomplete implementation. Choice D lacks the crucial step of involving staff in the decision-making process, which is important for successful policy implementation and team engagement.
2. A client with DM visits the health care clinic. The client's diabetes has been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Atenolol (Tenormin)
- B. Prednisone (Deltasone)
- C. Phenelzine (Nardil)
- D. Allopurinol (Zyloprim)
Correct answer: B
Rationale: The correct answer is B. Prednisone is a corticosteroid that can cause hyperglycemia by increasing glucose production in the liver. Atenolol (Choice A) is a beta-blocker that typically does not affect blood glucose levels significantly. Phenelzine (Choice C) is a monoamine oxidase inhibitor used for depression and does not directly impact blood glucose levels. Allopurinol (Choice D) is a xanthine oxidase inhibitor used to manage gout and does not contribute to hyperglycemia.
3. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?
- A. Administer intravenous fluids
- B. Provide a warming blanket
- C. Administer levothyroxine intravenously
- D. Place the client in Trendelenburg position
Correct answer: C
Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.
4. Skillful communication is one behavior of an effective leader. 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 what improvements the new nurse can make.
- B. A unit manager meets with a new nurse to explain departmental policy.
- C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent 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: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.
5. A client with hyperparathyroidism is at risk for which of the following complications?
- A. Hypocalcemia
- B. Osteoporosis
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: A client with hyperparathyroidism is at risk for osteoporosis, not hypocalcemia, hypokalemia, or hyponatremia. Hyperparathyroidism results in increased levels of parathyroid hormone, which causes excessive breakdown of bone tissue to release calcium into the bloodstream. This process can lead to weakened bones and an increased risk of osteoporosis. Hypocalcemia is unlikely in hyperparathyroidism as the condition is characterized by elevated calcium levels due to the abnormal activity of the parathyroid glands. Hypokalemia and hyponatremia are not directly associated with hyperparathyroidism; they are more commonly linked to other conditions affecting potassium and sodium levels in the body.
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