HESI RN
Leadership and Management HESI
1. What is the most common cause of hyperaldosteronism?
- A. Excessive sodium intake
- B. A pituitary adenoma
- C. Deficient potassium intake
- D. An adrenal adenoma
Correct answer: D
Rationale: An adrenal adenoma is the most common cause of primary hyperaldosteronism. Hyperaldosteronism is typically caused by an adrenal adenoma, a benign tumor in the adrenal gland that leads to excessive aldosterone production. Excessive sodium intake (Choice A) does not directly cause hyperaldosteronism. Pituitary adenoma (Choice B) is associated with conditions like Cushing's disease, not hyperaldosteronism. Deficient potassium intake (Choice C) can lead to hypokalemia but is not a common cause of hyperaldosteronism.
2. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?
- A. Serum glucose of 180 mg/dL
- B. Serum bicarbonate of 22 mEq/L
- C. Blood pH of 7.25
- D. Urine specific gravity of 1.020
Correct answer: C
Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.
3. 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.
4. What health concerns should Nurse Oliver expect a client with hypothyroidism to report?
- A. Increased appetite and weight loss
- B. Puffiness of the face and hands
- C. Nervousness and tremors
- D. Thyroid gland swelling
Correct answer: B
Rationale: Puffiness of the face and hands is a classic symptom of hypothyroidism. This occurs due to fluid retention and is commonly observed in individuals with an underactive thyroid gland. Increased appetite and weight loss (Choice A) are more indicative of hyperthyroidism, where there is an overproduction of thyroid hormones leading to increased metabolism. Nervousness and tremors (Choice C) are associated with hyperthyroidism, not hypothyroidism. Thyroid gland swelling (Choice D) typically indicates goiter, which can be present in both hyperthyroidism and hypothyroidism but is not a specific symptom that clients with hypothyroidism commonly report.
5. Why is it important to control blood glucose levels in type 2 DM?
- A. Hypertension and kidney disease.
- B. Weight gain and obesity.
- C. Improved wound healing.
- D. Decreased cholesterol levels.
Correct answer: A
Rationale: Controlling blood glucose levels in type 2 DM is crucial to prevent complications. High blood glucose levels can lead to hypertension and kidney disease, as seen in diabetic nephropathy and diabetic nephropathy. These are common complications of uncontrolled diabetes. Weight gain and obesity (choice B) are influenced by factors such as diet and physical activity rather than blood glucose levels. Improved wound healing (choice C) is not directly related to blood glucose control but can be affected by it indirectly. Decreased cholesterol levels (choice D) are not a direct consequence of high blood glucose levels and are more related to dietary and lifestyle factors.
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