HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. The client with hyperthyroidism is receiving propylthiouracil (PTU). The nurse should monitor for which of the following potential side effects?
- A. Leukopenia
- B. Hyperglycemia
- C. Hypertension
- D. Weight gain
Correct answer: A
Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.
2. Why is glucose an important molecule in a cell?
- A. Extraction of energy
- B. Synthesis of protein
- C. Building of genetic material
- D. Formation of cell membranes
Correct answer: A
Rationale: Glucose is a crucial molecule in cells because it serves as the primary source of energy through cellular respiration. Choice B, the synthesis of protein, is incorrect because proteins are typically synthesized from amino acids, not glucose. Choice C, the building of genetic material, is incorrect because genetic material, such as DNA and RNA, is not directly built from glucose. Choice D, the formation of cell membranes, is also incorrect as cell membranes are primarily composed of lipids and proteins, not glucose.
3. In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Pancreas
- C. Adrenal medulla
- D. Parathyroid
Correct answer: A
Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.
4. A nurse is preparing to administer insulin to a client with DM. The nurse understands that the peak time for rapid-acting insulin, such as lispro (Humalog), is:
- A. 30 minutes to 1 hour after administration.
- B. 1 to 2 hours after administration.
- C. 2 to 4 hours after administration.
- D. 3 to 5 hours after administration.
Correct answer: A
Rationale: The correct answer is A: 30 minutes to 1 hour after administration. Rapid-acting insulins like lispro, such as Humalog, peak quickly within 30 minutes to 1 hour after administration. This peak time is crucial to monitor for potential hypoglycemia, which is most likely to occur during this period. Choice B is incorrect as it suggests a longer peak time for rapid-acting insulin, which is inaccurate. Choices C and D are also incorrect because they indicate even longer peak times, which do not align with the rapid onset and peak action of lispro insulin.
5. A client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN's teaching to the client?
- A. When a heart ceases to beat, the client is pronounced clinically dead.
- B. Physicians must write do not resuscitate (DNR) orders.
- C. A DNR order can be written after the healthcare provider has discussed it with the client and family.
- D. A DNR requires a court decision.
Correct answer: C
Rationale: A DNR order is typically written after the healthcare provider has discussed the implications with the patient and their family. This ensures that the patient and family are fully informed before making such a critical decision. Choice A is incorrect because pronouncing clinical death is a medical determination, not directly related to DNR orders. Choice B is incorrect because while physicians commonly write DNR orders, the discussion with the patient and family is crucial. Choice D is incorrect because a DNR order does not require a court decision; it is a decision made in collaboration with the healthcare team and the patient or family.
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