HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?
- A. Increase intake of dairy products and green leafy vegetables
- B. Avoid foods high in calcium
- C. Consume a high-sodium diet
- D. Limit fluid intake to prevent fluid overload
Correct answer: A
Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.
2. A female client, who is wearing dirty clothes and has a foul body odor, comes to the clinic reporting feeling scared because she is being stalked. What action is most important for the nurse to take?
- A. Assure the client that she will be seen by a healthcare provider today.
- B. Recommend that the client speaks with a social worker.
- C. Ask the client if she feels comfortable sharing why she is being stalked.
- D. Offer the client a safe place to relax before interviewing her.
Correct answer: D
Rationale: The most important action for the nurse to take in this scenario is to offer the client a safe place to relax before interviewing her. The client's disheveled appearance and foul body odor suggest she may be in distress or facing challenging circumstances. By providing her with a safe and comfortable environment to relax, the nurse can help alleviate some of her distress and establish trust. This approach is crucial as the client is already feeling scared due to being stalked, indicating underlying mental health concerns. Assuring the client that she will be seen by a healthcare provider today (choice A) may not address her immediate need for safety and comfort. Recommending she speaks with a social worker (choice B) may be beneficial later but does not address the immediate need for a safe space. Asking the client if she feels comfortable sharing why she is being stalked (choice C) is not appropriate as the priority is ensuring her safety and comfort first.
3. Which of the following data should not be included in the identification data of gynecological history?
- A. Parity
- B. Lost normal menstrual period
- C. EDD (Expected date of delivery)
- D. Last delivery
Correct answer: C
Rationale: The correct answer is C: EDD (Expected date of delivery). In a gynecological history, EDD is not typically included as it pertains more to obstetric history. Parity, lost normal menstrual period, and last delivery are important components of gynecological history. Parity refers to the number of times a woman has given birth to a fetus past 20 weeks' gestation. Lost normal menstrual period can provide insight into potential gynecological issues, while last delivery details the most recent childbirth experience. Therefore, EDD is the outlier in this context.
4. When asking an unlicensed assistive personnel (UAP) to assist a 69-year-old surgical client to ambulate for the first time, which statement by the nurse is appropriate?
- A. Have the client sit on the side of the bed for at least 2 minutes before helping him stand.
- B. If the client is dizzy on standing, ask him to take some deep breaths.
- C. Assist the client to the bathroom at least twice on this shift.
- D. After you assist him to the chair, let me know how he feels.
Correct answer: A
Rationale: The correct answer is A. Allowing the client to sit on the side of the bed before standing helps prevent dizziness and falls, especially during their first ambulation post-surgery. Choice B is incorrect because asking the client to take deep breaths when feeling dizzy may not address the underlying cause of the dizziness. Choice C is incorrect as it is unrelated to the task of assisting the client to ambulate for the first time. Choice D is incorrect because knowing how the client feels after sitting in the chair does not address the important step of assisting the client to stand up for the first time.
5. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action?
- A. Monitor hemoglobin and hematocrit
- B. Encourage turning and deep breathing
- C. Administer IV antibiotics as prescribed
- D. Auscultate for presence of bowel sounds
Correct answer: C
Rationale: The priority nursing action for a client diagnosed with acute pyelonephritis is to administer IV antibiotics as prescribed. Acute pyelonephritis is a serious kidney infection that requires prompt antibiotic therapy to prevent systemic complications and worsening of the infection. While monitoring hemoglobin and hematocrit (Choice A) is important, it is not the priority in the acute phase of infection. Encouraging turning and deep breathing (Choice B) and auscultating for bowel sounds (Choice D) are relevant aspects of care but do not take precedence over initiating antibiotic treatment to address the infection promptly.