HESI RN
Leadership and Management HESI
1. The client with type 2 diabetes mellitus is being educated about lifestyle modifications. Which of the following recommendations is appropriate?
- A. Avoiding all forms of physical exercise
- B. Limiting carbohydrate intake to less than 30 grams per day
- C. Increasing physical activity to help control blood glucose levels
- D. Consuming a high-protein, low-fat diet
Correct answer: C
Rationale: The correct answer is to increase physical activity to help control blood glucose levels. Physical activity is essential in managing type 2 diabetes mellitus as it helps improve insulin sensitivity, control weight, and regulate blood sugar levels. Avoiding all forms of physical exercise (Choice A) is incorrect as exercise plays a crucial role in diabetes management. While limiting carbohydrate intake (Choice B) can be beneficial, setting a strict limit of less than 30 grams per day is too restrictive and may not be suitable for everyone. Consuming a high-protein, low-fat diet (Choice D) is generally a healthy choice, but it is not the primary lifestyle modification recommended for managing type 2 diabetes mellitus.
2. A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:
- A. Apples
- B. Carrots
- C. Spinach
- D. Avocado
Correct answer: A
Rationale: The correct answer is 'Apples.' Apples are the lowest in potassium among the given options. Carrots, spinach, and avocados are all higher in potassium content compared to apples. Carrots and spinach are vegetables known to have a moderate amount of potassium. Avocados, on the other hand, are a high-potassium fruit and would not be the lowest in potassium among the choices provided.
3. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia indicated by which of the following signs?
- A. Muscle weakness
- B. Tremors
- C. Diaphoresis
- D. Constipation
Correct answer: A
Rationale: Muscle weakness is a classic manifestation of hyperkalemia, an elevated level of potassium in the blood. After an adrenalectomy, where one adrenal gland is removed, there may be a risk of hyperkalemia due to altered hormone regulation. Tremors (Choice B) are not typically associated with hyperkalemia but may be seen in conditions like hypocalcemia. Diaphoresis (Choice C) and constipation (Choice D) are not specific indicators of hyperkalemia. Diaphoresis is excessive sweating and constipation is a common gastrointestinal issue, neither directly related to potassium imbalances.
4. The client with type 2 DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:
- A. Increased risk of heart disease and stroke.
- B. Improved wound healing.
- C. Reduced need for medication.
- D. Decreased risk of infection.
Correct answer: A
Rationale: Uncontrolled blood glucose levels are associated with an increased risk of cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, leading to atherosclerosis, which can increase the likelihood of heart disease and stroke. Improved wound healing (choice B) is not a consequence of uncontrolled blood glucose levels; in fact, high blood sugar levels can impair wound healing. Reduced need for medication (choice C) is inaccurate because uncontrolled blood glucose usually necessitates more medication to manage the condition. Decreased risk of infection (choice D) is also misleading as high blood glucose levels can compromise the immune system, making individuals more susceptible to infections.
5. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?
- A. Administer insulin
- B. Encourage increased fluid intake
- C. Monitor for signs of dehydration
- D. Check blood glucose levels
Correct answer: D
Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.
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