HESI RN
Leadership HESI Quizlet
1. The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?
- A. Decreased blood glucose levels
- B. Decreased urine ketones
- C. Increased serum bicarbonate
- D. Increased anion gap
Correct answer: D
Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.
2. Which of the following makes it possible to predict the genotype and phenotype of the offspring of sexual reproduction?
- A. Punnett square
- B. Chi-square
- C. Microscope
- D. None of these
Correct answer: A
Rationale: The correct answer is A, Punnett square. A Punnett square is a tool specifically designed to predict the genotype and phenotype combinations of offspring resulting from a particular cross or breeding experiment. It helps in understanding the probability of different genotypes and phenotypes appearing in the offspring. Choice B, Chi-square, is a statistical test used to determine if there is a significant difference between the expected frequencies and the observed frequencies in a study. Choice C, Microscope, is used for viewing tiny structures and organisms, not for predicting genetic outcomes. Choice D, None of these, is incorrect as Punnett square is a valid tool for predicting genetic outcomes in offspring.
3. The nurse is preparing an orientation class for new employees at an inner-city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?
- A. A lack of transportation is the major impediment for the clinic's clients.
- B. Basic physiological needs are likely to be unmet in this clinic's client population.
- C. Printed material is less effective for this population that has limited reading skills.
- D. A group education class is often poorly attended by non-compliant clients.
Correct answer: A
Rationale: The correct answer is A. Addressing transportation issues is crucial when working with low-income populations as lack of transportation can be a significant barrier to accessing healthcare services. This information is important for new employees to understand the challenges faced by the clinic's clients and to strategize ways to overcome this barrier. Choices B, C, and D are incorrect because while they may be relevant considerations, addressing transportation barriers should be a priority given its impact on accessing care for this specific population.
4. While changing a client's chest tube dressing, the nurse notes a cracking sensation when gentle pressure is applied to the skin at the insertion site. What is the best action for the nurse to take?
- A. Apply a pressure dressing around the chest tube site.
- B. Administer an oral antihistamine.
- C. Assess for allergies to topical cleaning agents.
- D. Measure the area of swelling and crackling.
Correct answer: D
Rationale: When a nurse observes crepitus around a chest tube site, it could indicate subcutaneous emphysema, a potentially serious condition where air gets trapped under the skin. Measuring the area of swelling and crackling is important as it helps monitor the progression of subcutaneous emphysema. Applying a pressure dressing (choice A) might not address the underlying cause and could potentially worsen the condition. Administering an oral antihistamine (choice B) is not indicated for crepitus at a chest tube site. Assessing for allergies to topical cleaning agents (choice C) is important but not the immediate priority when crepitus is observed.
5. The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy?
- A. Sodium 125 mEq/L and potassium 2.5 mEq/L
- B. Sodium 150 mEq/L and potassium 3.6 mEq/L
- C. Sodium 135 mEq/L and potassium 6.9 mEq/L
- D. Sodium 148 mEq/L and potassium 5.5 mEq/L
Correct answer: C
Rationale: Severe hyperkalemia, with a potassium level of 6.9 mEq/L, requires aggressive treatment with Kayexalate and sorbitol to increase the body’s excretion of potassium. The normal range for serum potassium is 3.5 to 5.5 mEq/L, so patients with the other potassium levels would not be treated aggressively or would need potassium supplementation. Therefore, option C (Sodium 135 mEq/L and potassium 6.9 mEq/L) is the correct choice as it indicates severe hyperkalemia warranting the administration of Kayexalate and sorbitol. Options A, B, and D have either potassium levels within normal limits, which would not necessitate this aggressive treatment, or potassium levels that are lower than what would typically prompt the need for Kayexalate and sorbitol.