HESI RN
Leadership and Management HESI
1. Why might an RN need professional liability insurance?
- A. Protection against frivolous lawsuits without incurring expenses.
- B. Immunity from being sued by the institution if guilty of malpractice.
- C. Coverage for charges of libel, slander, assault, and HIPAA violations.
- D. Exclusively doctors face malpractice lawsuits.
Correct answer: C
Rationale: Having professional liability insurance is crucial for Registered Nurses due to various reasons. Choice A is incorrect because there are expenses associated with defending against frivolous lawsuits. Choice B is incorrect as institutions can still sue a nurse found guilty of malpractice. Choice D is incorrect because malpractice lawsuits can be filed against healthcare professionals, including nurses. Therefore, the correct answer is C, as liability policies can provide coverage for charges involving libel, slander, assault, and breaches of patient confidentiality like HIPAA violations, offering essential protection for RNs in their practice.
2. A client with cirrhosis is admitted with jaundice and ascites. Which laboratory value requires immediate intervention?
- A. Serum albumin of 3.0 g/dL
- B. Serum bilirubin of 3.0 mg/dL
- C. Serum ammonia level of 80 mcg/dL
- D. Serum sodium level of 135 mEq/L
Correct answer: C
Rationale: A serum ammonia level of 80 mcg/dL is most concerning in a client with cirrhosis as it may indicate hepatic encephalopathy, requiring immediate intervention. High serum ammonia levels can lead to altered mental status, confusion, and even coma. Serum albumin (choice A) is often decreased in cirrhosis but does not require immediate intervention. Serum bilirubin (choice B) elevation is expected in cirrhosis and may not require immediate intervention unless very high. Serum sodium (choice D) within the given range is generally acceptable and does not require immediate intervention.
3. The client has been managing angina episodes with nitroglycerin. Which of the following indicates the drug is effective?
- A. Decreased chest pain.
- B. Increased blood pressure.
- C. Decreased blood pressure.
- D. Decreased heart rate.
Correct answer: A
Rationale: The correct answer is A: Decreased chest pain. Nitroglycerin is a vasodilator that works by decreasing myocardial oxygen consumption, which helps to reduce chest pain caused by angina. Therefore, a reduction in chest pain is a positive indicator of the drug's effectiveness. Choices B, C, and D are incorrect because nitroglycerin does not typically increase blood pressure or heart rate; instead, it often causes a decrease in blood pressure due to vasodilation and may cause a reflex tachycardia (increased heart rate) as a compensatory response to lowered blood pressure.
4. A client presents at the clinic with blepharitis. What instructions should the nurse provide for home care?
- A. Use bilateral eye patches while sleeping to prevent injury to the eyes.
- B. Wear sunglasses when outdoors to prevent photophobia.
- C. Apply cold compresses to reduce inflammation.
- D. Apply warm moist compresses then gently scrub eyelids with diluted baby shampoo.
Correct answer: D
Rationale: The correct answer is D. Blepharitis is managed with warm moist compresses to help loosen debris and oils on the eyelids, followed by gentle scrubbing with a mild solution like diluted baby shampoo. This helps in controlling the condition. Choice A is incorrect as using eye patches while sleeping is not a standard recommendation for blepharitis. Choice B is incorrect as wearing sunglasses does not directly treat blepharitis but may help with light sensitivity. Choice C is incorrect as cold compresses are not typically used for blepharitis, as warm compresses are more effective in managing the condition.
5. A client with diabetes mellitus is admitted with a blood glucose level of 600 mg/dl and is unresponsive. Which laboratory value is most concerning?
- A. Serum potassium of 3.0 mEq/L
- B. Serum glucose of 200 mg/dl
- C. Serum pH of 7.30
- D. Serum sodium of 135 mEq/L
Correct answer: C
Rationale: In a client with Hyperosmolar Hyperglycemic State (HHS), a serum pH of 7.30 is the most concerning value as it indicates acidosis, a life-threatening condition that requires immediate intervention. Choices A, B, and D are not the most concerning in this scenario. A low serum potassium level (Choice A) may be expected due to cellular shift in hyperglycemia, a serum glucose level of 200 mg/dl (Choice B) is not as concerning compared to the extremely high initial glucose level, and a serum sodium level of 135 mEq/L (Choice D) is within the normal range and not the immediate priority.