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. A client with a history of rheumatoid arthritis is prescribed methotrexate. Which laboratory value should the nurse monitor closely?
- A. Liver function tests
- B. Complete blood count
- C. Serum creatinine
- D. Prothrombin time
Correct answer: C
Rationale: Serum creatinine should be closely monitored in a client receiving methotrexate, as the medication can cause nephrotoxicity. Monitoring serum creatinine levels helps assess kidney function and detect potential nephrotoxic effects of methotrexate. Liver function tests (Choice A) are important to monitor for hepatotoxicity caused by methotrexate. While methotrexate can cause bone marrow suppression, leading to anemia, leukopenia, and thrombocytopenia, monitoring a complete blood count (Choice B) is essential but not the priority in this case. Prothrombin time (Choice D) is not typically affected by methotrexate therapy and is not the primary laboratory value to monitor in this situation.
3. The RN on the evening shift receives a report that a client is scheduled for electroconvulsive treatment (ECT) in the morning. Which intervention should the RN implement the evening before the scheduled ECT?
- A. Hold all bedtime medications.
- B. Keep the client NPO after midnight.
- C. Implement elopement precautions.
- D. Give the client an enema at bedtime.
Correct answer: B
Rationale: Keeping the client NPO after midnight is the appropriate intervention before ECT to prevent complications during the procedure. Withholding food and fluids reduces the risk of aspiration and helps ensure the safety of the client. Option A (Hold all bedtime medications) is incorrect because medications may need to be given as prescribed unless specified otherwise by the healthcare provider. Option C (Implement elopement precautions) is unrelated to preparing a client for ECT and focuses on preventing a client from leaving the treatment area. Option D (Give the client an enema at bedtime) is unnecessary and not a standard pre-ECT preparation, making it an incorrect choice.
4. Which intervention by the community health nurse is an example of a secondary level of prevention?
- A. providing a needle exchange program at a community mental health clinic
- B. developing an educational program for clients with diabetes mellitus
- C. administering influenza vaccines to residents of a nursing home
- D. initiating contact notifications for sexual partners of an HIV client
Correct answer: C
Rationale: Administering influenza vaccines to residents of a nursing home is an example of secondary prevention. Secondary prevention aims to detect and treat a disease or condition in its early stages to prevent complications. In this case, administering influenza vaccines helps prevent the spread of the flu among vulnerable individuals. Choices A, B, and D are not examples of secondary prevention. Providing a needle exchange program (Choice A) is a harm reduction strategy (tertiary prevention). Developing an educational program for clients with diabetes mellitus (Choice B) focuses on health promotion and primary prevention. Initiating contact notifications for sexual partners of an HIV client (Choice D) is a measure to prevent further transmission of the disease but is more aligned with tertiary prevention.
5. After a thyroidectomy, which vital sign is the most important for the nurse to monitor closely?
- A. Monitor respiratory rate and rhythm.
- B. Assess for signs of hypocalcemia.
- C. Monitor for elevated body temperature.
- D. Check blood pressure every 30 minutes.
Correct answer: B
Rationale: The correct answer is B: Assess for signs of hypocalcemia. After a thyroidectomy, monitoring for hypocalcemia is crucial because damage to the parathyroid glands during surgery can result in low calcium levels, which may cause life-threatening complications. Monitoring respiratory rate and rhythm (choice A) is important but not the most critical in this situation. Monitoring for elevated body temperature (choice C) is less of a priority post-thyroidectomy. Checking blood pressure every 30 minutes (choice D) is not as vital as monitoring for hypocalcemia in this context.