HESI RN
HESI Leadership and Management
1. The healthcare provider is caring for a client with Cushing's syndrome. Which of the following nursing interventions is appropriate?
- A. Monitor blood glucose levels
- B. Restrict fluid intake
- C. Administer potassium supplements
- D. Encourage a high-protein diet
Correct answer: A
Rationale: Clients with Cushing's syndrome are at risk for hyperglycemia due to the effects of cortisol on glucose metabolism. Monitoring blood glucose levels is crucial to detect and manage hyperglycemia promptly. Restricting fluid intake (choice B) is not necessary unless specifically indicated for another condition, as clients with Cushing's syndrome are prone to fluid imbalances. Administering potassium supplements (choice C) is not appropriate as clients with Cushing's syndrome often have elevated potassium levels due to the effects of cortisol. Encouraging a high-protein diet (choice D) is not recommended as clients with Cushing's syndrome should focus on a balanced diet to manage their condition effectively.
2. When caring for a female client with a history of hypoglycemia, Nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?
- A. Sulfisoxazole (Gantrisin)
- B. Mexiletine (Mexitil)
- C. Prednisone (Orasone)
- D. Lithium carbonate (Lithobid)
Correct answer: A
Rationale: The correct answer is A, Sulfisoxazole (Gantrisin). Sulfisoxazole is known to potentiate hypoglycemia, making it unsafe for clients with a history of hypoglycemia. Choice B, Mexiletine, is a medication used to treat certain heart rhythm problems and is not associated with hypoglycemia. Choice C, Prednisone, is a corticosteroid and does not potentiate hypoglycemia. Choice D, Lithium carbonate, is commonly used to treat bipolar disorder and does not typically potentiate hypoglycemia. Therefore, the drug that Nurse Ruby should avoid in this case is Sulfisoxazole (Gantrisin) to prevent worsening the client's hypoglycemic condition.
3. A client with type 1 DM is experiencing signs of hypoglycemia. The nurse should expect which of the following symptoms?
- A. Tachycardia
- B. Polyuria
- C. Flushed skin
- D. Dry mouth
Correct answer: A
Rationale: In a client experiencing hypoglycemia, tachycardia is a common symptom. This occurs due to the release of adrenaline in response to low blood glucose levels, which stimulates the heart to beat faster. Polyuria, the increased production of urine, flushed skin, and dry mouth are not typical symptoms of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes insipidus or uncontrolled diabetes mellitus. Flushed skin and dry mouth are not direct physiological responses to low blood sugar levels.
4. 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.
5. A client with hyperthyroidism is receiving radioactive iodine therapy. The nurse should monitor for which of the following side effects?
- A. Hypothyroidism
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hypothyroidism. Radioactive iodine therapy is used to treat hyperthyroidism by destroying thyroid tissue and reducing hormone production. This can lead to an underactive thyroid, resulting in hypothyroidism. Hyperkalemia (choice B) is an elevated potassium level, usually not associated with radioactive iodine therapy. Hyponatremia (choice C) is a low sodium level, which is also not a common side effect of this therapy. Hypercalcemia (choice D) is an elevated calcium level, unrelated to radioactive iodine therapy for hyperthyroidism.
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