HESI RN
HESI Fundamentals Quizlet
1. The healthcare provider is caring for a client diagnosed with type 2 diabetes mellitus. Which intervention should the healthcare provider implement to assess the client’s glycemic control?
- A. Monitor fasting blood glucose levels
- B. Check urine for ketones
- C. Evaluate hemoglobin A1c levels
- D. Assess the client’s dietary intake
Correct answer: C
Rationale: Evaluating hemoglobin A1c levels is the most appropriate intervention to assess glycemic control in a client with type 2 diabetes mellitus. Hemoglobin A1c levels reflect the average blood glucose control over the past 2-3 months, providing valuable information for monitoring and managing diabetes. Monitoring fasting blood glucose levels (Choice A) is important for daily management but does not provide a long-term view like hemoglobin A1c. Checking urine for ketones (Choice B) is more relevant for assessing diabetic ketoacidosis. Assessing dietary intake (Choice D) is crucial for overall diabetes management but does not directly assess glycemic control.
2. The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?
- A. Decreased blood glucose levels
- B. Decreased urine ketones
- C. Increased serum bicarbonate
- D. Increased anion gap
Correct answer: D
Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.
3. One hour after delivery, the nurse is unable to palpate the uterine fundus of a client and notes a large amount of lochia on the perineal pad. Which intervention should the nurse implement first?
- A. Empty the bladder using an indwelling urinary catheter
- B. Increase the rate of the IV containing oxytocin (Pitocin)
- C. Assess for shock by determining the blood pressure
- D. Perform gentle massage at the level of the umbilicus
Correct answer: D
Rationale: Gentle massage at the level of the umbilicus is the initial intervention to help contract the uterus and reduce bleeding, which is crucial in managing postpartum hemorrhage. Emptying the bladder can help with fundal displacement, but massage should be done first to stimulate uterine contractions. Increasing the IV oxytocin rate is a possible intervention but not the initial priority. Assessing for shock is important, but addressing the uterine atony through massage takes precedence to prevent further hemorrhage.
4. A nurse is assessing the learning needs of a client who is diagnosed with Addison's disease. Which statement indicates that the client needs further teaching?
- A. I should take my medications daily to replace necessary hormones
- B. I need to eat a diet high in protein and carbohydrates
- C. I should avoid drinking fluids with caffeine
- D. I should notify my healthcare provider if I start feeling dizzy
Correct answer: B
Rationale: The correct answer is B. A diet high in protein and carbohydrates is not specifically required for Addison's disease. The focus should be on maintaining a balanced diet that is rich in fruits, vegetables, whole grains, and adequate protein sources. Choice A is correct as adherence to medication therapy is crucial in managing Addison's disease. Choice C is correct as caffeine can exacerbate symptoms of Addison's disease. Choice D is correct as dizziness can be a sign of adrenal crisis in Addison's disease, and prompt notification of healthcare providers is essential.
5. During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?
- A. At least once a week
- B. At least three times a week
- C. At least five times a week
- D. Every day
Correct answer: C
Rationale: Exercising at least five times a week is recommended to meet the goals of planned exercise for diabetic clients. This frequency helps in managing blood sugar levels effectively and improving overall health. Exercising once a week (Choice A) may not provide sufficient benefits or consistency required for diabetic clients. Exercising three times a week (Choice B) is better but may still fall short of the recommended frequency for optimal outcomes. Exercising every day (Choice D) may lead to burnout or overtraining if not properly balanced with rest days, which could be counterproductive for diabetic clients.