HESI RN
HESI Leadership and Management
1. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.
- A. Place the solution on an IV pump at the prescribed rate.
- B. Monitor blood glucose every twelve (12) hours.
- C. Weigh the client weekly, first thing in the morning.
- D. Change the IV tubing every three (3) days.
Correct answer: D
Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.
2. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
- A. Increasing saturated fat intake and fasting in the afternoon
- B. Increasing intake of vitamins B and D and taking iron supplements
- C. Eating a candy bar if lightheadedness occurs
- D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting
Correct answer: D
Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.
3. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?
- A. Interpersonal activities
- B. Decisional activities
- C. Informational activities
- D. Transformational activities
Correct answer: B
Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.
4. A client with type 1 diabetes mellitus is experiencing hypoglycemia. What should the nurse instruct the client to do?
- A. Administer insulin immediately
- B. Consume 15 grams of simple carbohydrates
- C. Drink plenty of water
- D. Avoid eating until symptoms resolve
Correct answer: B
Rationale: When a client with type 1 diabetes mellitus experiences hypoglycemia, the nurse should instruct them to consume 15 grams of simple carbohydrates. This is the recommended initial treatment for hypoglycemia as it helps quickly raise blood sugar levels to alleviate symptoms and prevent complications. Administering insulin immediately (Choice A) would further lower blood sugar levels, worsening the hypoglycemia. Drinking plenty of water (Choice C) and avoiding eating until symptoms resolve (Choice D) are not appropriate actions for treating hypoglycemia as they do not address the immediate need to raise blood sugar levels.
5. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?
- A. Weight loss
- B. Heat intolerance
- C. Bradycardia
- D. Diarrhea
Correct answer: C
Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.
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