HESI RN
Leadership and Management HESI
1. A nurse caring for a client with hypocalcemia would expect to note which of the following changes on the electrocardiogram?
- A. Widened T wave
- B. Prominent U wave
- C. Prolonged QT interval
- D. Shortened ST segment
Correct answer: C
Rationale: In hypocalcemia, a decreased level of calcium can lead to a prolonged QT interval on the ECG due to its role in myocardial repolarization. A widened T wave (Choice A) is typically seen in hyperkalemia. A prominent U wave (Choice B) is associated with hypokalemia. A shortened ST segment (Choice D) is not a typical ECG finding in hypocalcemia.
2. Nurse Noemi administers glucagon to her diabetic client and then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
- A. Oral anticoagulants
- B. Anabolic steroids
- C. Beta-adrenergic blockers
- D. Thiazide diuretics
Correct answer: A
Rationale: The correct answer is A: Oral anticoagulants. Glucagon may enhance the anticoagulant effect of oral anticoagulants, increasing the risk of bleeding. This interaction can be dangerous for the patient, leading to serious complications. Choices B, C, and D are incorrect because anabolic steroids, beta-adrenergic blockers, and thiazide diuretics do not typically interact adversely with glucagon. It is crucial for healthcare providers to be aware of potential drug interactions to ensure patient safety and optimal outcomes.
3. The nurse is providing dietary instructions to a client with DM. The nurse instructs the client to include which item in the diet?
- A. High-fat foods
- B. Low-carbohydrate foods
- C. High-protein foods
- D. High-fiber foods
Correct answer: D
Rationale: High-fiber foods are beneficial for clients with diabetes because they help regulate blood glucose levels by slowing down the absorption of sugar. Additionally, high-fiber foods aid in maintaining satiety, supporting weight management, and preventing constipation. High-fat foods (choice A) are not recommended for clients with diabetes due to their potential negative impact on heart health and weight. While low-carbohydrate foods (choice B) can be part of a diabetes-friendly diet, high-fiber foods are more specifically beneficial for managing blood sugar levels. High-protein foods (choice C) can be included in moderation in a diabetic diet, but they are not the primary focus when it comes to improving glycemic control.
4. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except:
- A. Integumentary inspection for the presence of brown spots on the lower extremities.
- B. Observation for paleness of the lower extremities.
- C. Observation for blanching of the feet after the legs are elevated for 60 seconds.
- D. Palpation for increased pulse volume in the arteries of the lower extremities.
Correct answer: D
Rationale: In a patient with impaired peripheral arterial circulation, clinical nursing assessment should include integumentary inspection for the presence of brown spots, observation for paleness of the lower extremities, and observation for blanching of the feet after the legs are elevated for 60 seconds. Palpation for increased pulse volume in the arteries of the lower extremities is not consistent with impaired circulation, as pulses are typically diminished in this condition. Therefore, palpation for increased pulse volume is not relevant to the assessment of impaired peripheral arterial circulation.
5. A nurse manager has detected a potential problem with staffing and has asked staff members for their thoughts on the matter. Which of the following best describes the informational activity this manager is engaging in?
- A. Spokesperson
- B. Reporting
- C. Monitoring
- D. Job analysis and redesign
Correct answer: C
Rationale: The correct answer is C: 'Monitoring.' Monitoring involves regularly checking and observing the status of a unit or situation. In this scenario, the nurse manager is actively seeking feedback from staff members to assess and keep track of the staffing situation. Choice A, 'Spokesperson,' refers to a role where someone represents or speaks on behalf of a group or organization, which is not the primary activity in this case. Choice B, 'Reporting,' typically involves presenting information or data about a specific topic or issue but does not capture the ongoing observation and assessment aspect seen in monitoring. Choice D, 'Job analysis and redesign,' involves assessing and restructuring job roles, responsibilities, and tasks, which is not directly related to the action of monitoring staffing levels.
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