HESI RN
HESI Leadership and Management
1. A client with hyperparathyroidism is receiving dietary instructions. Which of the following foods should the client avoid?
- A. Milk
- B. Bananas
- C. Spinach
- D. Processed meats
Correct answer: A
Rationale: In hyperparathyroidism, there are already elevated calcium levels in the body. Therefore, clients should avoid high-calcium foods like milk to prevent further increase in calcium levels. Bananas, spinach, and processed meats do not have significant calcium content and do not need to be avoided specifically in hyperparathyroidism.
2. Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:
- A. I.M. or subcutaneous glucagon.
- B. I.V. bolus of dextrose 50%.
- C. 15 to 20 g of a fast-acting carbohydrate such as orange juice.
- D. 10 U of fast-acting insulin.
Correct answer: C
Rationale: For a conscious client with hypoglycemia, the initial treatment should involve administering 15 to 20 g of a fast-acting carbohydrate, such as orange juice. This helps rapidly raise the client's blood glucose levels. Choices A and D are incorrect as administering glucagon or fast-acting insulin is not the first-line treatment for hypoglycemia in a conscious client. Choice B, an I.V. bolus of dextrose 50%, is a more invasive and aggressive intervention that is not typically indicated for a conscious client with hypoglycemia.
3. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?
- A. Weight loss
- B. Heat intolerance
- C. Bradycardia
- D. Diarrhea
Correct answer: C
Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.
4. During preoperative teaching for a female client undergoing subtotal thyroidectomy, which statement should the nurse include?
- A. The head of your bed must remain flat for 24 hours after surgery.
- B. You should avoid deep breathing and coughing after surgery.
- C. You won't be able to swallow for the first day or two.
- D. You must avoid hyperextending your neck after surgery.
Correct answer: D
Rationale: The correct answer is D. Instructing the client to avoid hyperextending the neck after thyroid surgery is crucial to prevent stress on the surgical site and reduce the risk of complications such as strain on the incision or damage to the healing tissues. Choices A, B, and C are incorrect because: A) Keeping the head of the bed flat for 24 hours is not necessary after a thyroidectomy; elevation of the head of the bed can actually help reduce swelling and improve comfort. B) Encouraging deep breathing and coughing after surgery is essential to prevent respiratory complications such as pneumonia, so this advice is incorrect. C) Difficulty swallowing after thyroid surgery is not a typical outcome, so this statement is inaccurate and should not be included in the preoperative teaching.
5. The client with hyperparathyroidism is being taught about dietary management. Which of the following foods should the client avoid?
- A. Bananas
- B. Spinach
- C. Milk
- D. Processed meats
Correct answer: C
Rationale: Clients with hyperparathyroidism should avoid high-calcium foods like milk because they already have elevated calcium levels. Bananas and spinach are not high in calcium and can be included in the diet. Processed meats are not specifically contraindicated in hyperparathyroidism, so they are not the correct answer.
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