HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. The client with DM is being taught about the signs of hyperglycemia. Which symptom should the nurse include?
- A. Excessive thirst
- B. Sweating
- C. Shaking
- D. Hunger
Correct answer: A
Rationale: Excessive thirst, also known as polydipsia, is a hallmark symptom of hyperglycemia. When blood glucose levels are high, the body tries to eliminate the excess glucose through urine, leading to increased urination and subsequent thirst. Sweating, shaking, and hunger are more commonly associated with hypoglycemia, not hyperglycemia. Sweating can occur when blood sugar levels drop too low, shaking is a sign of hypoglycemia, and hunger is often a result of low blood sugar levels triggering the body to seek fuel.
2. A client with type 2 diabetes mellitus is being educated on foot care. Which of the following instructions should the nurse provide?
- A. Soak your feet in warm water daily.
- B. Avoid going barefoot to protect your feet.
- C. Inspect your feet daily for any cuts or sores.
- D. Avoid using a heating pad to warm your feet if they are cold.
Correct answer: C
Rationale: The correct instruction for a client with type 2 diabetes mellitus regarding foot care is to inspect their feet daily for any cuts or sores. This practice helps in early detection of potential issues like cuts, sores, or infections, which can be challenging to heal due to poor circulation in diabetes. Choice A is incorrect because soaking feet in hot water can lead to burns or skin damage, especially for individuals with diabetes who may have reduced sensation. Choice B is incorrect because going barefoot increases the risk of injuries and infections for individuals with diabetes. Choice D is incorrect because using a heating pad can also impair sensation, increasing the risk of burns or injuries for diabetic individuals.
3. A nurse manager is focusing on improving communication on the unit. Which of the following best describes the importance of this focus?
- A. The nurse manager's focus on communication is essential to ensure that all staff members are informed, understand their roles, and can work together effectively to provide quality care.
- B. The nurse manager's focus on communication is important to ensure that information is shared effectively and that there is a clear understanding of roles and responsibilities on the unit.
- C. The nurse manager's focus on communication is crucial to ensuring that all staff members are working together effectively and that there is a shared understanding of the unit's goals and priorities.
- D. The nurse manager's focus on communication is vital to creating an open and transparent environment where staff members feel comfortable sharing information and concerns.
Correct answer: A
Rationale: The correct answer is A. Effective communication is essential for ensuring that all staff members are informed, understand their roles, and can collaborate effectively to provide quality care. Choice B focuses more on information sharing and understanding roles but lacks emphasis on effective teamwork and quality care provision. Choice C mentions staff working together effectively and understanding unit goals, but it does not explicitly highlight the importance of staff being informed and understanding their roles. Choice D emphasizes creating an open environment for sharing information and concerns, which is important but does not encompass the broader aspects of effective communication as described in choice A.
4. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?
- A. The client with colitis
- B. The client with Cushing's syndrome
- C. The client who has been overusing laxatives
- D. The client who has sustained a traumatic burn
Correct answer: D
Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.
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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