HESI RN
Leadership and Management HESI
1. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he's impotent and says he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to:
- A. Encourage the client to ask questions about personal sexuality.
- B. Provide time for privacy.
- C. Provide support for the spouse or significant other.
- D. Suggest referral to a sex counselor or other appropriate professional.
Correct answer: D
Rationale: The most appropriate intervention for a postoperative male client with diabetes mellitus who reports impotence and concerns about its impact on his marriage is to suggest referral to a sex counselor or other appropriate professional. Impotence can have significant emotional and relational effects, and a sex counselor is specifically trained to address such concerns. Encouraging the client to ask questions about personal sexuality (Choice A) may not provide the specialized support needed in this situation. Providing time for privacy (Choice B) is important but may not directly address the client's concerns about impotence. Providing support for the spouse or significant other (Choice C) is valuable but may not be as effective as seeking professional help to address the client's specific issue of impotence.
2. What symptoms suggest the dosage of levothyroxine sodium is too high in a 26-year-old client with simple goiter?
- A. Bradycardia and constipation.
- B. Palpitations and shortness of breath.
- C. Lethargy and lack of appetite.
- D. Muscle cramps and dry skin.
Correct answer: B
Rationale: The correct answer is B: Palpitations and shortness of breath. These symptoms suggest excessive thyroid hormone levels, indicating that the levothyroxine dose is too high. Bradycardia and constipation (choice A) are more indicative of hypothyroidism, which occurs when thyroid hormone levels are low. Lethargy and lack of appetite (choice C) are also common symptoms of hypothyroidism. Muscle cramps and dry skin (choice D) can be associated with various conditions but are not specific to a high dosage of levothyroxine.
3. A 3-year-old child is brought to the clinic by the parents who are concerned that the child is not yet potty trained. What is the nurse’s best response?
- A. Most children are potty trained by this age, so you should not be concerned
- B. Every child develops at their own pace. Let’s discuss some strategies to help
- C. Your child may need to be evaluated for developmental delays
- D. It’s best to force your child to use the potty to encourage training
Correct answer: B
Rationale: The correct answer is B because it is important to acknowledge that children develop at different rates. By offering support and discussing strategies for potty training, the nurse can provide the necessary guidance without causing unnecessary concern or pressure on the parents. Choice A is incorrect because it dismisses the parents' concerns. Choice C is incorrect because jumping to the conclusion of developmental delays without further assessment or discussion can cause undue anxiety. Choice D is incorrect because forcing a child to use the potty can lead to resistance and negative associations with potty training.
4. A client with hypothyroidism is at risk for which of the following complications?
- A. Thyroid storm
- B. Myxedema coma
- C. Cushing's syndrome
- D. Diabetic ketoacidosis
Correct answer: B
Rationale: Myxedema coma is a severe, life-threatening complication that can occur in individuals with untreated or inadequately treated hypothyroidism. It is characterized by extreme hypothyroidism leading to decreased mental status, hypothermia, bradycardia, and respiratory depression. Thyroid storm (Choice A) is a severe complication of hyperthyroidism, not hypothyroidism. Cushing's syndrome (Choice C) results from prolonged exposure to high levels of cortisol, not related to hypothyroidism. Diabetic ketoacidosis (Choice D) is a complication of uncontrolled diabetes, not directly associated with hypothyroidism.
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 D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.