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. Nurse Wayne is aware that a positive Chvostek's sign indicates:
- A. Hypocalcemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypermagnesemia
Correct answer: A
Rationale: A positive Chvostek's sign indicates hypocalcemia. This sign is elicited by tapping the facial nerve anterior to the ear, resulting in facial muscle twitching due to increased neuromuscular irritability from low calcium levels. Hyponatremia (Choice B) is characterized by low sodium levels, but it does not present with Chvostek's sign. Hypokalemia (Choice C) is low potassium levels, and hypermagnesemia (Choice D) is high magnesium levels, neither of which are associated with Chvostek's sign.
3. A client with diabetes insipidus is receiving desmopressin therapy. The nurse should monitor for which of the following potential side effects?
- A. Hyponatremia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used to treat diabetes insipidus, can cause the retention of water without sodium, leading to dilutional hyponatremia. This occurs because desmopressin increases water reabsorption in the kidneys without affecting sodium levels. Hypernatremia (choice B) is unlikely because desmopressin does not cause excessive sodium retention. Hypokalemia (choice C) and hypercalcemia (choice D) are not typically associated with desmopressin therapy for diabetes insipidus.
4. In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Pancreas
- C. Adrenal medulla
- D. Parathyroid
Correct answer: A
Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.
5. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should the healthcare provider report?
- A. Hypotension
- B. Hyperglycemia
- C. Weight loss
- D. Hypokalemia
Correct answer: B
Rationale: In Cushing's syndrome, hyperglycemia is a common finding due to increased cortisol levels leading to insulin resistance. This can have serious implications such as diabetes mellitus and should be promptly reported for appropriate management. Hypotension (choice A) is more commonly associated with Addison's disease, not Cushing's syndrome. Weight gain rather than weight loss (choice C) is typically observed in clients with Cushing's syndrome. While hypokalemia (choice D) can occur in Cushing's syndrome due to excess cortisol affecting potassium levels, it is not as critical as hyperglycemia and may not be the priority for immediate reporting.
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