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. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamines, Nurse April is most likely to detect:
- A. A blood pressure of 130/70 mm Hg
- B. A blood glucose level of 130 mg/dl
- C. Bradycardia
- D. A blood pressure of 176/88 mm Hg
Correct answer: D
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive catecholamines, leading to symptoms such as hypertension. The normal blood pressure range is around 120/80 mm Hg, so a blood pressure reading of 176/88 mm Hg is most likely to be detected in a client with pheochromocytoma. Choices A, B, and C are incorrect because pheochromocytoma typically presents with hypertension, not a normal or low blood pressure (choice A), not related to blood glucose levels (choice B), and not bradycardia (choice C).
3. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperkalemia
Correct answer: A
Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.
4. Which of the following charges could be filed if consent was not obtained before the surgery?
- A. False imprisonment
- B. Libel
- C. Battery
- D. Malpractice
Correct answer: C
Rationale: The correct answer is C: Battery. Performing surgery without obtaining consent is considered battery, as it involves intentional harmful or offensive contact without consent. False imprisonment (choice A) involves unlawful restraint or restriction of a person's freedom of movement, which is not applicable in this scenario. Libel (choice B) refers to written defamation that damages a person's reputation, which is not related to lack of consent in surgery. Malpractice (choice D) pertains to professional negligence or failure to meet a standard of care, which is a separate issue from obtaining consent for surgery.
5. 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.
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