HESI RN
Leadership and Management HESI
1. The healthcare provider is assessing a client with hypothyroidism. Which of the following clinical findings would the healthcare provider expect?
- A. Tachycardia
- B. Weight loss
- C. Cold intolerance
- D. Diaphoresis
Correct answer: C
Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a reduced ability to regulate body temperature. As a result, individuals with hypothyroidism often feel cold, especially in their extremities. Tachycardia (A) is more commonly associated with hyperthyroidism due to the increased metabolic rate. Weight loss (B) is also a typical finding in hyperthyroidism, as the body burns calories at a faster rate. Diaphoresis (D), excessive sweating, is not a typical symptom of hypothyroidism.
2. A client with type 2 DM is being taught about the importance of foot care. Which instruction should the nurse include?
- A. Wear comfortable shoes that allow air circulation.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Soak your feet in hot water every night.
Correct answer: A
Rationale: The correct instruction for a client with type 2 diabetes mellitus (DM) regarding foot care is to wear comfortable shoes that allow air circulation. This recommendation helps prevent foot injuries and infections, which are common concerns for individuals with diabetes. Choice B, walking barefoot, can increase the risk of injuries and wounds due to reduced sensation in the feet often seen in diabetes. Choice C, using a heating pad, can lead to burns or skin damage if the temperature is not carefully monitored, making it an unsafe practice. Choice D, soaking feet in hot water every night, can also be harmful as it can cause burns and dry out the skin, leading to further complications for individuals with diabetes. Therefore, the most appropriate and safe advice is to wear comfortable shoes that promote air circulation to maintain foot health and prevent complications.
3. A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:
- A. Apples
- B. Carrots
- C. Spinach
- D. Avocado
Correct answer: A
Rationale: The correct answer is 'Apples.' Apples are the lowest in potassium among the given options. Carrots, spinach, and avocados are all higher in potassium content compared to apples. Carrots and spinach are vegetables known to have a moderate amount of potassium. Avocados, on the other hand, are a high-potassium fruit and would not be the lowest in potassium among the choices provided.
4. A client with hyperaldosteronism is at risk for which of the following electrolyte imbalances?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: C
Rationale: In hyperaldosteronism, there is an excessive secretion of aldosterone, a hormone that promotes potassium excretion in the kidneys. This leads to low potassium levels in the blood, known as hypokalemia. Therefore, the correct answer is hypokalemia (Choice C). Hyperkalemia (Choice A) is the opposite condition, where there is high potassium levels in the blood and is not typically associated with hyperaldosteronism. Hyponatremia (Choice B) is a low sodium level, which is not directly related to aldosterone function. Hypercalcemia (Choice D) is an elevated calcium level and is not typically a direct result of hyperaldosteronism.
5. When teaching a male client diagnosed with type 1 diabetes mellitus how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?
- A. You'll need more insulin when you exercise or increase your food intake.
- B. You'll need less insulin when you exercise or reduce your food intake.
- C. You'll need less insulin when you increase your food intake.
- D. You'll need more insulin when you exercise or decrease your food intake.
Correct answer: B
Rationale: When a person with type 1 diabetes exercises, it typically lowers blood glucose levels. As a result, insulin needs are reduced when exercise or food intake is decreased. Choice A is incorrect because more insulin is not typically needed when exercise or food intake is increased. Choice C is incorrect because increasing food intake would generally require more insulin to cover the additional glucose from the food. Choice D is incorrect as decreasing food intake usually leads to a lower need for insulin.
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