HESI RN
HESI Leadership and Management
1. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?
- A. Vasopressin (Pitressin Synthetic)
- B. Furosemide (Lasix)
- C. Regular insulin
- D. 10% dextrose
Correct answer: A
Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.
2. A client with type 2 DM is being treated with 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. Take the medication before bedtime.
- D. Avoid taking the medication if you miss a meal.
Correct answer: A
Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.
3. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia indicated by which of the following signs?
- A. Muscle weakness
- B. Tremors
- C. Diaphoresis
- D. Constipation
Correct answer: A
Rationale: Muscle weakness is a classic manifestation of hyperkalemia, an elevated level of potassium in the blood. After an adrenalectomy, where one adrenal gland is removed, there may be a risk of hyperkalemia due to altered hormone regulation. Tremors (Choice B) are not typically associated with hyperkalemia but may be seen in conditions like hypocalcemia. Diaphoresis (Choice C) and constipation (Choice D) are not specific indicators of hyperkalemia. Diaphoresis is excessive sweating and constipation is a common gastrointestinal issue, neither directly related to potassium imbalances.
4. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?
- A. Encourage increased fluid intake
- B. Administer hypertonic saline
- C. Monitor for signs of dehydration
- D. Restrict oral fluids
Correct answer: D
Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.
5. The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?
- A. Seafood
- B. Spinach
- C. Bananas
- D. Oatmeal
Correct answer: A
Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.
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