HESI RN
HESI Leadership and Management
1. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?
- A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
- B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
- C. Body image disturbance related to weight gain and edema
- D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Correct answer: D
Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.
2. Why have recent polls placed nursing as one of the most trusted professions?
- A. Nurses engage in lifelong learning.
- B. Nurses abide by a dress code.
- C. Nurses have the skills needed to care for diverse populations.
- D. Nurses must pass the NCLEX in order to obtain a license to practice.
Correct answer: C
Rationale: Recent polls have identified nursing as one of the most trusted professions primarily because nurses possess the essential skills required to provide care to diverse populations. This includes cultural competence, empathy, effective communication, and clinical expertise. Choice A, engaging in lifelong learning, is indeed an important aspect of nursing practice; however, it is not the primary reason for the high level of trust placed in nurses. Choice B, abiding by a dress code, is a professional conduct issue and not directly linked to the trustworthiness of nurses. Choice D, passing the NCLEX exam for licensure, is a regulatory requirement and does not directly contribute to the trust placed in nurses by the public.
3. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?
- A. Serum calcium.
- B. Serum phosphorus.
- C. Serum potassium.
- D. Serum sodium.
Correct answer: C
Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.
4. A client with DM is scheduled to have surgery. The nurse should plan to:
- A. Give the client a regular diet as ordered.
- B. Hold the client's insulin on the morning of surgery.
- C. Monitor the client's blood glucose level closely during the perioperative period.
- D. Have the client stop taking insulin 48 hours before surgery.
Correct answer: C
Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. This is essential to ensure that the client's blood glucose levels remain within the target range and to prevent complications such as hypo- or hyperglycemia. Choices A, B, and D are incorrect because giving a regular diet as ordered, holding insulin on the morning of surgery, or stopping insulin 48 hours before surgery can lead to uncontrolled blood glucose levels, posing risks to the client's safety during the surgical procedure.
5. A client with Cushing's syndrome is being assessed by the nurse. Which of the following clinical manifestations is consistent with this condition?
- A. Moon face
- B. Weight loss
- C. Hyperpigmentation
- D. Hypotension
Correct answer: A
Rationale: The correct clinical manifestation consistent with Cushing's syndrome is a 'moon face.' Cushing's syndrome is characterized by fat redistribution, leading to the round and full appearance of the face known as a moon face. Choice B, weight loss, is not common in Cushing's syndrome as patients often experience weight gain. Choice C, hyperpigmentation, is more indicative of Addison's disease, not Cushing's syndrome. Choice D, hypotension, is not typically associated with Cushing's syndrome which often presents with hypertension due to excess cortisol.
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