HESI RN
HESI Leadership and Management
1. Which of the following statements should be included in the teaching to a client about a do-not-resuscitate order (DNR)?
- A. When a heart ceases to beat, the client is pronounced clinically dead.
- B. Physicians are required to write DNR orders.
- C. A DNR order can be written after discussion with the client and family.
- D. A court decision is needed for a DNR.
Correct answer: C
Rationale: The correct statement to include in teaching a client about a do-not-resuscitate (DNR) order is that it can be written after discussion with the client and family. This involves ensuring that the client and their family understand the implications and make an informed decision. Choice A is incorrect as pronouncing clinical death is not directly related to discussing a DNR order. Choice B is incorrect as while physicians typically write DNR orders, it is not a strict requirement. Choice D is incorrect as a court decision is not typically required for a DNR order; it is a decision made by the client with input from healthcare providers and family members.
2. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperphosphatemia
Correct answer: B
Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.
3. Which of the following laboratory values should the nurse monitor in a client with Cushing's syndrome?
- A. Blood glucose levels
- B. Serum calcium levels
- C. Serum potassium levels
- D. Serum sodium levels
Correct answer: A
Rationale: The correct answer is A: Blood glucose levels. In Cushing's syndrome, there is excess cortisol in the body which leads to increased blood glucose levels due to its effect on glucose metabolism. Elevated blood glucose levels are a common finding in individuals with Cushing's syndrome. Monitoring blood glucose levels is crucial as it helps in assessing and managing hyperglycemia in these patients. Choice B, serum calcium levels, is not typically a priority in monitoring for Cushing's syndrome. While abnormalities in calcium levels can occur in some endocrine disorders, hypercalcemia is not a hallmark of Cushing's syndrome. Choice C, serum potassium levels, and Choice D, serum sodium levels, are not directly associated with Cushing's syndrome. While electrolyte imbalances can occur in various conditions, they are not specifically linked to Cushing's syndrome as blood glucose levels are.
4. Which of the following is an example of nonmaleficence in nursing practice?
- A. Administering pain medication as prescribed to prevent patient discomfort.
- B. Ensuring that a patient does not receive a treatment that they have refused.
- C. Ensuring that a patient receives appropriate care without causing harm.
- D. Encouraging a patient to express their concerns and fears about a procedure.
Correct answer: B
Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.
5. A client is admitted to the ER with DKA. In the acute phase, the priority nursing action is to prepare to:
- A. Administer regular insulin intravenously
- B. Administer 5% dextrose intravenously
- C. Correct the acidosis
- D. Apply an electrocardiogram monitor
Correct answer: A
Rationale: Administering regular insulin intravenously is the priority nursing action in the acute phase of DKA. Insulin helps to lower blood glucose levels by promoting cellular uptake of glucose and inhibiting ketone production. Administering dextrose would be counterproductive as it can worsen hyperglycemia. Correcting acidosis is important but usually follows insulin administration. Applying an electrocardiogram monitor is not the priority action in the acute management of DKA.
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