HESI LPN
Leadership and Management HESI Test Bank
1. Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?
- A. Subcutaneous
- B. Intramuscular
- C. IV bolus only
- D. IV bolus, followed by continuous infusion
Correct answer: D
Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.
2. Which of the following is an important aspect of healthcare leadership?
- A. Authoritarian decision-making
- B. Collaborative teamwork
- C. Limiting staff input
- D. Focusing only on financial outcomes
Correct answer: B
Rationale: Collaborative teamwork is indeed an important aspect of healthcare leadership. In the healthcare field, effective leadership often involves working collaboratively with a team of diverse professionals to provide the best possible care for patients. This approach encourages communication, shared decision-making, and leveraging the expertise of each team member to achieve optimal outcomes. Choices A, C, and D are not ideal aspects of healthcare leadership. Authoritarian decision-making can hinder team morale and creativity, limiting staff input diminishes the value of diverse perspectives, and focusing only on financial outcomes may compromise patient care and staff well-being.
3. Select the criteria that is accurately paired with its indication of birth weight or gestational age.
- A. Low birth weight: The neonate's weight is less than 1,500 g at the time of delivery.
- B. Appropriate for gestational age: The neonate's weight ranges from the 10th to the 90th percentile.
- C. Large for gestational age: The neonate's weight is above the 99th percentile.
- D. Small for gestational age: The neonate's weight is below the 20th percentile.
Correct answer: B
Rationale: Appropriate for gestational age (AGA) indicates a neonate's weight ranging from the 10th to the 90th percentile. This range signifies that the baby's weight is within the normal range for their gestational age. Choices A, C, and D provide inaccurate information about the criteria and do not correctly correspond to the indicated birth weight or gestational age. Low birth weight typically refers to a weight below 2,500 g, large for gestational age above the 90th percentile, and small for gestational age below the 10th percentile.
4. Which insulin has the most rapid onset of action?
- A. Lente
- B. Lispro
- C. Ultralente
- D. Humulin N
Correct answer: B
Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.
5. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?
- A. Proceed with treatment without obtaining written consent
- B. Contact the client's next of kin to obtain consent for treatment
- C. Have the client sign a consent for treatment
- D. Notify risk management before initiating treatment
Correct answer: A
Rationale: In emergency situations where a client is disoriented and has a cardiac arrhythmia, obtaining written consent may not be possible due to the urgency of the situation. The priority is to provide immediate treatment to ensure patient safety. Contacting the next of kin or having the client sign a consent form would cause unnecessary delays in providing critical care. Notifying risk management before initiating treatment is not the most appropriate action when dealing with a time-sensitive situation like a cardiac arrhythmia.
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