HESI RN
Leadership HESI
1. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?
- A. Acromegaly
- B. Type 1 diabetes mellitus
- C. Hypothyroidism
- D. Deficient growth hormone
Correct answer: A
Rationale: The correct answer is Acromegaly. Jemma's symptoms of large hands, hoarse voice, and snoring are indicative of acromegaly, a disorder caused by excessive growth hormone production. Acromegaly can lead to insulin resistance, which can result in hyperglycemia. Choice B, Type 1 diabetes mellitus, is unlikely in this case as the symptoms and presentation are more suggestive of acromegaly. Choice C, Hypothyroidism, typically presents with different symptoms such as weight gain, fatigue, and cold intolerance, not consistent with Jemma's symptoms. Choice D, Deficient growth hormone, would not lead to the signs and symptoms observed in Jemma, as her condition is characterized by excessive growth hormone production.
2. A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?
- A. I should brush and floss my teeth regularly.
- B. I should take the medication with antacids.
- C. I can stop taking the medication once my seizures are controlled.
- D. I should avoid drinking milk while taking this medication.
Correct answer: A
Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).
3. A child with ADHD needs help with homework. What should the nurse encourage the parents to do?
- A. Encourage the parents to help the child with homework.
- B. Do the homework for the child.
- C. Set a regular homework schedule.
- D. Provide a quiet environment for homework.
Correct answer: A
Rationale: Encouraging parents to help the child with homework is the most appropriate course of action. By assisting the child, parents can provide necessary support and guidance without taking over the task entirely. This approach fosters independence and helps the child develop academic skills. Option B, doing the homework for the child, is counterproductive as it does not empower the child to learn and grow independently. Option C, setting a regular homework schedule, is important but does not address the immediate need for assistance. Option D, providing a quiet environment for homework, is helpful but does not directly involve parents in supporting the child's academic progress.
4. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:
- A. Both are weak potassium-losing diuretics.
- B. The combination of these medications prevents renal toxicity.
- C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
- D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Correct answer: D
Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.
5. The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible to contracting lead poisoning?
- A. An 8-year-old living in a housing project.
- B. A 2-year-old playing on aging playground equipment.
- C. An adolescent working in a paint factory.
- D. A 10-year-old with Type 1 diabetes.
Correct answer: B
Rationale: The correct answer is B. Young children, like the 2-year-old playing on aging playground equipment, are more susceptible to lead poisoning from environmental sources due to their behaviors like hand-to-mouth contact and exploratory behaviors. Choices A, C, and D are less likely to be at high risk for lead poisoning compared to young children due to differences in exposure levels and behaviors related to potential sources of lead contamination.