HESI RN
Leadership HESI
1. A psychological contract exists between staff members and nurse managers. Which of the following best describes this relationship?
- A. Nurse managers provide positive evaluations, and in turn, staff members do what managers ask of them.
- B. Nurse managers coordinate multiple departments and supervise multiple staff members.
- C. Staff members do what managers ask of them and, in turn, are rewarded through assignments, promotions, and evaluations.
- D. Nurse managers advocate for staff and support nursing roles and ethical practice.
Correct answer: C
Rationale: The correct answer is C. In a psychological contract between staff members and nurse managers, staff members are expected to fulfill the requests of managers, and in return, they are rewarded with assignments, promotions, and evaluations. This reciprocal relationship forms the basis of the psychological contract. Choices A, B, and D are incorrect because they do not accurately capture the essence of the psychological contract. While nurse managers may provide positive evaluations, coordinate departments, supervise staff, advocate for staff, and support nursing roles, these actions alone do not define the specific reciprocal nature of the psychological contract outlined in choice C.
2. The client with hyperthyroidism is receiving propylthiouracil (PTU). The nurse should monitor for which of the following potential side effects?
- A. Leukopenia
- B. Hyperglycemia
- C. Hypertension
- D. Weight gain
Correct answer: A
Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.
3. The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?
- A. Soak your feet in hot water every night.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Wear comfortable shoes that allow air circulation.
Correct answer: D
Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.
4. 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.
5. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?
- A. Weight gain
- B. Hypoglycemia
- C. Hyperglycemia
- D. Bradycardia
Correct answer: B
Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.
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