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. Water is a polar molecule that can be:
- A. cohesive and corrosive
- B. cohesive and adhesive
- C. electrostatic and ionic
- D. repellent and attractive
Correct answer: B
Rationale: Water is a polar molecule due to an uneven distribution of electrons, allowing it to form hydrogen bonds. This property makes water both cohesive (attracted to itself) and adhesive (attracted to other substances). Choice A is incorrect because water is not corrosive; rather, it is a solvent. Choices C and D are incorrect as they do not describe the cohesive and adhesive properties of water.
3. A client who is pregnant and has hyperemesis gravidarum is being taught about nutrition at home by a nurse. Which of the following statements indicate that the client understands the teachings?
- A. I will drink water with my meals.
- B. I will eat every 6 hours throughout the day.
- C. I will eat crackers before I get out of bed in the morning.
- D. I will limit my protein intake.
Correct answer: C
Rationale: The correct answer is C. Eating crackers before getting out of bed can help manage nausea associated with hyperemesis gravidarum. Choice A is incorrect because drinking water with meals may exacerbate nausea. Choice B is incorrect as eating every 6 hours may not be frequent enough to combat nausea and vomiting. Choice D is incorrect because protein intake should not be limited during pregnancy, especially in cases of hyperemesis gravidarum.
4. What intervention should the healthcare provider include in the plan of care for a client receiving treatment with an Unna's paste boot for leg ulcers due to chronic venous insufficiency?
- A. Check capillary refill of toes on the lower extremity with the Unna's paste boot.
- B. Apply dressing to the wound area before applying the Unna's paste boot.
- C. Wrap the leg from the knee down towards the foot.
- D. Remove the Unna's paste boot every 8 hours to assess wound healing.
Correct answer: A
Rationale: When an Unna's paste boot is applied for leg ulcers due to chronic venous insufficiency, it is crucial to check the capillary refill of the toes on the lower extremity to ensure adequate circulation. The Unna's paste boot can become rigid after drying, potentially affecting circulation distally. Monitoring capillary refill helps assess the perfusion status of the distal extremity and ensures that the treatment is not compromising circulation to the toes.
5. The nurse is planning care for a client admitted with a diagnosis of pheochromocytoma. Which intervention has the highest priority for inclusion in this client's plan of care?
- A. Record urine output every hour
- B. Monitor blood pressure frequently
- C. Evaluate neurological status
- D. Maintain seizure precautions
Correct answer: B
Rationale: Monitoring blood pressure frequently is the highest priority intervention for a client diagnosed with pheochromocytoma. This rare tumor can lead to life-threatening hypertension due to catecholamine secretion. Evaluating neurological status and maintaining seizure precautions are important but are not the highest priority in this case. Recording urine output, though essential for overall assessment, is not the priority compared to monitoring blood pressure in a client with pheochromocytoma.