HESI RN
Leadership HESI
1. The client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:
- A. I need to skip meals if my blood glucose level is elevated.
- B. I need to eat a small meal or snack every 2 to 3 hours.
- C. I need to avoid using concentrated sweets in my diet.
- D. I need to eat a high-protein, low-carbohydrate diet.
Correct answer: C
Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.
2. A client with Addison's disease is being educated on managing the condition. Which of the following statements indicates a need for further teaching?
- A. I should carry an emergency kit with hydrocortisone at all times.
- B. I need to increase my sodium intake during hot weather.
- C. I can skip my medication if I feel well.
- D. I should avoid stress as much as possible.
Correct answer: C
Rationale: The correct answer is C. Clients with Addison's disease should not skip their medication, even if they feel well, as consistent medication is necessary to manage the condition. Choice A is correct as carrying an emergency kit with hydrocortisone is essential for managing potential adrenal crises. Choice B is correct as increasing sodium intake during hot weather helps prevent electrolyte imbalances. Choice D is correct as stress can trigger adrenal crisis in individuals with Addison's disease, so stress management is crucial.
3. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?
- A. Administer intravenous fluids
- B. Provide a warming blanket
- C. Administer levothyroxine intravenously
- D. Place the client in Trendelenburg position
Correct answer: C
Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.
4. The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?
- A. Soak your feet in hot water every night.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Wear comfortable shoes that allow air circulation.
Correct answer: D
Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.
5. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?
- A. Take the medication with meals.
- B. Take the medication on an empty stomach.
- C. Avoid taking the medication if you miss a meal.
- D. Take the medication before bedtime.
Correct answer: A
Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.
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