HESI RN
HESI RN Nursing Leadership and Management Exam 6
1. What is the nurse manager’s role in improving the quality of care on the unit?
- A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
- B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
- C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
- D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.
Correct answer: A
Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.
2. During the admission assessment of an underweight adolescent with depression on a psychiatric unit, the nurse finds a potassium level of 2.9 mEq/dl. Which finding requires notification to the healthcare provider?
- A. Potassium level of 2.9 mEq/dl.
- B. BP of 110/70 mmHg.
- C. WBC of 10,000 mm³.
- D. Body mass index of 21.
Correct answer: A
Rationale: A potassium level of 2.9 mEq/dl is critically low, indicating hypokalemia, which can lead to serious complications such as cardiac arrhythmias. Prompt notification to the healthcare provider is essential for immediate intervention. Choice B, a blood pressure of 110/70 mmHg, is within the normal range. Choice C, a white blood cell count of 10,000 mm³, is also within normal limits and is not a concerning finding in this context. Choice D, a body mass index of 21, may indicate being underweight but is not as urgent as addressing the critically low potassium level.
3. In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen reservoir bag does not deflate completely during inspiration and the client’s respiratory rate is 14 breaths/minute. What action should the nurse implement?
- A. Remove the mask immediately
- B. Document the assessment data
- C. Increase the oxygen flow
- D. Increase the respiratory rate setting
Correct answer: B
Rationale: The correct answer is to document the assessment data. In a partial rebreather mask, it is normal for the oxygen reservoir bag not to deflate completely during inspiration. Additionally, a respiratory rate of 14 breaths/minute falls within the normal range. Therefore, these findings indicate that the mask is functioning as intended. Removing the mask immediately is unnecessary as there are no signs of distress. Increasing the oxygen flow or adjusting the respiratory rate setting is not warranted based on the assessment findings, as they are within normal parameters.
4. A woman at 36-weeks' gestation who is Rh negative is admitted to labor and delivery reporting abdominal cramping. She is placed on strict bedrest, and the fetal heart rate and contraction pattern are monitored with an external fetal monitor. The nurse notes a large amount of bright red vaginal bleeding. Which nursing intervention has the highest priority?
- A. Perform a sterile vaginal examination to determine dilatation.
- B. Determine fetal position by performing Leopold maneuvers.
- C. Assess the fetal heart rate and client's contraction pattern.
- D. Confirm Rh and Coombs status for Rho(D) immunoglobulin administration.
Correct answer: C
Rationale: The highest priority nursing intervention in this scenario is to assess the fetal heart rate and the client's contraction pattern. The presence of a large amount of bright red vaginal bleeding in a woman at 36-weeks' gestation who is Rh negative raises concerns about the well-being of the fetus. Monitoring the fetal heart rate and contraction pattern will provide crucial information about fetal status and help determine the appropriate course of action to ensure the safety and health of both the mother and the baby.
5. A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
- A. Monitor for renal failure.
- B. Monitor psychosocial status.
- C. Monitor for signs of bleeding.
- D. Have heparin sodium available.
Correct answer: C
Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.