HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. Which instruction about insulin administration should Nurse Kate give to a client?
- A. Always follow the same order when drawing up different insulins into the syringe.
- B. Shake the vials before withdrawing the insulin.
- C. Store unopened vials of insulin in the refrigerator at recommended temperatures.
- D. Discard the intermediate-acting insulin if it appears cloudy.
Correct answer: A
Rationale: The correct answer is A. Consistently following the same order when drawing up different insulins helps to prevent medication errors. Option B is incorrect because shaking insulin vials could cause bubbles to form, leading to inaccurate dosing. Option C is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness. Option D is incorrect because cloudy appearance in intermediate-acting insulin may indicate the presence of insulin crystals, which can affect its potency, but this does not necessarily mean it should be discarded without consulting a healthcare provider.
2. Which of the following ethical principles is involved when protecting a patient's privacy and confidentiality?
- A. Fidelity
- B. Beneficence
- C. Confidentiality
- D. Justice
Correct answer: C
Rationale: Confidentiality is the ethical principle involved in protecting a patient's privacy and ensuring that personal information is not shared inappropriately. Fidelity refers to being faithful to commitments and keeping promises, not directly related to privacy and confidentiality. Beneficence involves doing good for the patient, and justice pertains to fairness and equal treatment, but they are not directly related to protecting privacy and confidentiality.
3. The healthcare provider is caring for a client with Cushing's syndrome. Which of the following nursing interventions is appropriate?
- A. Monitor blood glucose levels
- B. Restrict fluid intake
- C. Administer potassium supplements
- D. Encourage a high-protein diet
Correct answer: A
Rationale: Clients with Cushing's syndrome are at risk for hyperglycemia due to the effects of cortisol on glucose metabolism. Monitoring blood glucose levels is crucial to detect and manage hyperglycemia promptly. Restricting fluid intake (choice B) is not necessary unless specifically indicated for another condition, as clients with Cushing's syndrome are prone to fluid imbalances. Administering potassium supplements (choice C) is not appropriate as clients with Cushing's syndrome often have elevated potassium levels due to the effects of cortisol. Encouraging a high-protein diet (choice D) is not recommended as clients with Cushing's syndrome should focus on a balanced diet to manage their condition effectively.
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 client with DM is being taught by the nurse about the importance of monitoring blood glucose levels. The nurse should instruct the client to:
- A. Check blood glucose only when feeling unwell.
- B. Check blood glucose before meals and at bedtime.
- C. Check blood glucose only after meals.
- D. Check blood glucose only in the morning.
Correct answer: B
Rationale: The correct answer is to check blood glucose before meals and at bedtime. Monitoring blood glucose levels before meals allows the client to adjust their insulin or oral antidiabetic medications based on their current levels. Checking at bedtime helps in ensuring blood glucose levels are at a safe range throughout the night. Option A is incorrect because blood glucose should be monitored regularly as part of diabetes management, not just when feeling unwell. Option C is incorrect because checking only after meals does not provide a complete picture of blood glucose control throughout the day. Option D is incorrect as checking only in the morning does not cover the full spectrum of blood glucose variations that can occur during the day.
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