HESI RN
Leadership and Management HESI
1. Knowing that gluconeogenesis helps to maintain blood glucose levels, a healthcare provider should:
- A. Document weight changes due to fatty acid mobilization.
- B. Evaluate the patient's sensitivity to low room temperatures due to decreased adipose tissue insulation.
- C. Protect the patient from sources of infection due to decreased cellular protein deposits.
- D. Do all of the above.
Correct answer: D
Rationale: Gluconeogenesis is a process where the body synthesizes glucose from non-carbohydrate sources to maintain blood glucose levels. Documenting weight changes due to fatty acid mobilization is important as it can impact the patient's metabolic status. Evaluating the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation is crucial to prevent hypothermia. Protecting the patient from sources of infection due to decreased cellular protein deposits is essential to prevent complications. Therefore, all the options are relevant considerations in managing a patient undergoing gluconeogenesis, making option D the correct answer.
2. A client with hyperthyroidism is receiving radioactive iodine therapy. The nurse should monitor for which of the following side effects?
- A. Hypothyroidism
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hypothyroidism. Radioactive iodine therapy is used to treat hyperthyroidism by destroying thyroid tissue and reducing hormone production. This can lead to an underactive thyroid, resulting in hypothyroidism. Hyperkalemia (choice B) is an elevated potassium level, usually not associated with radioactive iodine therapy. Hyponatremia (choice C) is a low sodium level, which is also not a common side effect of this therapy. Hypercalcemia (choice D) is an elevated calcium level, unrelated to radioactive iodine therapy for hyperthyroidism.
3. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?
- A. Administer insulin
- B. Encourage increased fluid intake
- C. Monitor for signs of dehydration
- D. Check blood glucose levels
Correct answer: D
Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.
4. A client with hypoparathyroidism is at risk for which of the following complications?
- A. Hypercalcemia
- B. Hypocalcemia
- C. Hyperkalemia
- D. Hypernatremia
Correct answer: B
Rationale: Hypoparathyroidism is characterized by decreased levels of parathyroid hormone, leading to reduced calcium levels in the blood, which results in hypocalcemia. Therefore, the correct answer is B. Choices A, C, and D are incorrect because hypoparathyroidism does not typically lead to hypercalcemia, hyperkalemia, or hypernatremia. Hypercalcemia is more commonly associated with hyperparathyroidism, where there is excess secretion of parathyroid hormone.
5. Which of the following clinical findings would be most concerning in a client with hypothyroidism?
- A. Bradycardia
- B. Dry skin
- C. Constipation
- D. Depression
Correct answer: A
Rationale: Bradycardia in a client with hypothyroidism is the most concerning finding as it may indicate severe hypothyroidism, leading to decreased heart rate. Bradycardia can be a sign of myxedema coma, a life-threatening condition that requires immediate medical attention. Dry skin, constipation, and depression are common symptoms associated with hypothyroidism but are not as acutely concerning as bradycardia.
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