HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. The client with newly diagnosed diabetes mellitus is receiving education from the nurse on managing blood glucose levels. Which statement indicates a need for further teaching?
- A. I will monitor my blood glucose levels regularly.
- B. I can eat whatever I want as long as I take my medication.
- C. I should exercise regularly to help control my blood sugar.
- D. I will rotate my injection sites to avoid tissue damage.
Correct answer: B
Rationale: Choice B indicates a need for further teaching because it suggests that the client can eat whatever they want as long as they take their medication, which is incorrect. Clients with diabetes mellitus need to follow a healthy and balanced diet in addition to taking their medication to effectively manage blood glucose levels. Choices A, C, and D are correct statements for managing diabetes. Monitoring blood glucose levels regularly, engaging in regular exercise to help control blood sugar, and rotating injection sites to avoid tissue damage are all important aspects of diabetes management.
2. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?
- A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
- B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
- C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
- D. It regulates the threshold for water reabsorption in the kidneys.
Correct answer: C
Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.
3. The nurse is preparing to administer NPH insulin to a client. The nurse should administer the insulin at which site for the best absorption?
- A. The deltoid muscle
- B. The anterior thigh
- C. The abdomen
- D. The gluteal muscle
Correct answer: C
Rationale: The abdomen is the preferred site for insulin injection due to its consistent absorption rate. Insulin injected into the abdomen is absorbed more consistently and predictably than in other sites. The deltoid muscle and the anterior thigh are not recommended for insulin injections due to inconsistent absorption rates. The gluteal muscle is avoided for insulin injections due to the risk of hitting the sciatic nerve or causing discomfort to the client.
4. A nurse manager is working to improve patient satisfaction on the unit. Which of the following best describes the nurse manager’s role in this process?
- A. The nurse manager should set clear expectations for patient satisfaction, monitor progress, and provide feedback to staff members to continuously improve patient care.
- B. The nurse manager should gather data on patient satisfaction, identify areas for improvement, and implement strategies to enhance the patient experience.
- C. The nurse manager should develop a patient satisfaction improvement plan, set measurable goals, and track progress over time to ensure continuous improvement.
- D. The nurse manager should involve patients and families in the patient satisfaction improvement process, gather feedback, and use it to make improvements to care delivery.
Correct answer: A
Rationale: The correct answer is A. The nurse manager's role in improving patient satisfaction involves setting clear expectations for patient satisfaction, monitoring progress, and providing feedback to staff members to continuously improve patient care. Choice B is incorrect as gathering data and implementing strategies are typically part of quality improvement initiatives but do not solely define the nurse manager's role. Choice C is incorrect because the nurse manager is responsible for setting expectations and monitoring progress rather than developing the improvement plan. Choice D is incorrect as involving patients and families and gathering feedback are important aspects, but the question specifically asks about the nurse manager's role, which primarily involves setting expectations, monitoring progress, and providing feedback to staff.
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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