HESI RN
HESI Leadership and Management
1. A nurse manager is reviewing the nurse’s documentation on the unit. Which of the following best describes the importance of this review?
- A. The nurse manager’s review of documentation is crucial to ensure that it meets legal and ethical standards and accurately reflects the care provided to patients.
- B. The nurse manager’s review of documentation is important to ensure that it is thorough, accurate, and reflects the nurse’s accountability for patient care.
- C. The nurse manager’s review of documentation is necessary to ensure that it is consistent with the unit’s policies and procedures and that it accurately reflects the care provided.
- D. The nurse manager’s review of documentation is essential to ensure that it meets regulatory requirements and that it supports the delivery of safe and effective patient care.
Correct answer: D
Rationale: The nurse manager's review of documentation is a critical aspect of maintaining quality patient care. Choice D is the correct answer as it highlights the importance of ensuring that documentation meets regulatory requirements, supporting the delivery of safe and effective patient care. Regulatory requirements are established to ensure that healthcare facilities function within established guidelines and standards, promoting patient safety and quality of care. Choices A, B, and C, although important aspects of documentation review, do not fully encapsulate the significant role of regulatory compliance in ensuring the overall quality and safety of patient care.
2. A client with type 2 DM is being taught about the importance of foot care. Which instruction should the nurse include?
- A. Wear comfortable shoes that allow air circulation.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Soak your feet in hot water every night.
Correct answer: A
Rationale: The correct instruction for a client with type 2 diabetes mellitus (DM) regarding foot care is to wear comfortable shoes that allow air circulation. This recommendation helps prevent foot injuries and infections, which are common concerns for individuals with diabetes. Choice B, walking barefoot, can increase the risk of injuries and wounds due to reduced sensation in the feet often seen in diabetes. Choice C, using a heating pad, can lead to burns or skin damage if the temperature is not carefully monitored, making it an unsafe practice. Choice D, soaking feet in hot water every night, can also be harmful as it can cause burns and dry out the skin, leading to further complications for individuals with diabetes. Therefore, the most appropriate and safe advice is to wear comfortable shoes that promote air circulation to maintain foot health and prevent complications.
3. A client with Cushing's syndrome is being monitored for complications. Which of the following findings should the nurse report to the healthcare provider immediately?
- A. Hypertension
- B. Hyperglycemia
- C. Low-grade fever
- D. Weight gain
Correct answer: C
Rationale: The correct answer is C: Low-grade fever. A low-grade fever may indicate an infection, which is a serious concern in clients with Cushing's syndrome due to their immunosuppressed state. Hypertension and hyperglycemia are common manifestations of Cushing's syndrome and may not require immediate reporting unless severe or uncontrolled. Weight gain is also a common symptom in clients with Cushing's syndrome and may not warrant immediate reporting unless it is sudden and significant.
4. A female client with physical findings suggestive of a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, necessitating a transsphenoidal hypophysectomy. The evening before the surgery, Nurse Jacob reviews preoperative and postoperative instructions provided to the client earlier. Which postoperative instruction should the nurse emphasize?
- A. You must lie flat for 24 hours after surgery.
- B. You must avoid coughing, sneezing, and blowing your nose.
- C. You must restrict your fluid intake.
- D. You must report ringing in your ears immediately.
Correct answer: B
Rationale: Following a transsphenoidal hypophysectomy, it is crucial to avoid activities such as coughing, sneezing, and blowing the nose to prevent an increase in intracranial pressure or the risk of cerebrospinal fluid leakage. Coughing, sneezing, or nose blowing can strain the surgical site, potentially leading to complications. Lying flat for 24 hours is not typically required after this surgery. Fluid intake should be encouraged to prevent dehydration. Ringing in the ears is not a common complication associated with this type of surgery.
5. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager's actions?
- A. Resource allocation
- B. Monitoring
- C. Job analysis and redesign
- D. Planning for the future
Correct answer: D
Rationale: The correct answer is 'Planning for the future.' In this scenario, the nurse manager is engaging in strategic planning by considering policy changes and community dynamics to forecast potential impacts on the unit's functioning. This decisional activity involves anticipating future changes, challenges, and opportunities, and preparing the unit to adapt accordingly. Choice A, 'Resource allocation,' involves distributing resources effectively to support daily operations, which is not the primary focus of the nurse manager's actions described. Choice B, 'Monitoring,' typically involves overseeing current activities and performance to ensure adherence to standards and goals, rather than proactively planning for future changes as the nurse manager is doing. Choice C, 'Job analysis and redesign,' pertains to evaluating and modifying job roles and responsibilities within the unit, which is not directly related to the strategic forecasting and planning involved in anticipating organizational and community impacts.
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