HESI RN
Leadership and Management HESI
1. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?
- A. Administering insulin intravenously.
- B. Giving the client sips of water.
- C. Monitoring the client's urine output.
- D. Applying a heating pad to the client's abdomen.
Correct answer: A
Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.
2. Which of the following best describes the role of a nurse manager in managing conflict on the unit?
- A. The nurse manager is responsible for identifying the sources of conflict and working with staff members to resolve them in a constructive manner.
- B. The nurse manager is responsible for mediating conflicts between staff members and ensuring that they are resolved in a fair and equitable manner.
- C. The nurse manager is responsible for facilitating communication between staff members and ensuring that conflicts are addressed in a timely manner.
- D. The nurse manager is responsible for providing training and support to staff members to help them develop the skills needed to manage conflict effectively.
Correct answer: A
Rationale: The nurse manager's role in managing conflict involves identifying the sources of conflict and working with staff members to resolve them in a constructive manner. This includes addressing conflicts at their root cause and guiding staff towards effective resolution. Choice B is incorrect as the nurse manager typically does not act as a mediator but rather empowers staff to resolve conflicts themselves. Choice C is incorrect as while facilitating communication is important, it is not the sole responsibility of the nurse manager. Choice D is incorrect as providing training and support for conflict management is part of the role, but the primary responsibility lies in addressing the sources of conflict directly.
3. A client with Addison's disease is being educated on managing the condition. Which of the following statements indicates a need for further teaching?
- A. I should carry an emergency kit with hydrocortisone at all times.
- B. I need to increase my sodium intake during hot weather.
- C. I can skip my medication if I feel well.
- D. I should avoid stress as much as possible.
Correct answer: C
Rationale: The correct answer is C. Clients with Addison's disease should not skip their medication, even if they feel well, as consistent medication is necessary to manage the condition. Choice A is correct as carrying an emergency kit with hydrocortisone is essential for managing potential adrenal crises. Choice B is correct as increasing sodium intake during hot weather helps prevent electrolyte imbalances. Choice D is correct as stress can trigger adrenal crisis in individuals with Addison's disease, so stress management is crucial.
4. A healthcare professional caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the healthcare professional note in a client with this condition?
- A. Lung congestion
- B. Decreased hematocrit
- C. Increased blood pressure
- D. Decreased central venous pressure (CVP)
Correct answer: D
Rationale: Decreased central venous pressure (CVP) is the correct assessment finding in a client with deficient fluid volume. This is because a decrease in CVP indicates reduced blood volume returning to the heart, which is consistent with hypovolemia. Lung congestion (Choice A) would be more indicative of fluid volume excess, not deficiency. Decreased hematocrit (Choice B) may be seen in conditions such as anemia but is not specific to deficient fluid volume. Increased blood pressure (Choice C) is not typically associated with deficient fluid volume; in fact, hypovolemia often leads to decreased blood pressure.
5. What is the nurse manager’s role in improving the quality of care on the unit?
- A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
- B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
- C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
- D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.
Correct answer: A
Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.
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