HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. Which of the following symptoms would be most concerning in a client with diabetes insipidus?
- A. Polydipsia
- B. Polyuria
- C. Nocturia
- D. Hypertension
Correct answer: D
Rationale: In a client with diabetes insipidus, excessive thirst (polydipsia) and excessive urination (polyuria) are expected symptoms due to the inability to concentrate urine, leading to dilute urine production. Nocturia, waking up at night to urinate, is also common. However, hypertension is not a typical symptom of diabetes insipidus. The correct answer is D because hypertension may indicate a complication such as dehydration or electrolyte imbalances, which would require further assessment in a client with diabetes insipidus.
2. What is the lowest fasting plasma glucose level suggestive of a diagnosis of DM?
- A. 90 mg/dl.
- B. 115 mg/dl.
- C. 126 mg/dl.
- D. 180 mg/dl.
Correct answer: C
Rationale: A fasting plasma glucose level of 126 mg/dl or higher is diagnostic of diabetes mellitus. Choice A (90 mg/dl) is too low to indicate diabetes. Choice B (115 mg/dl) is also below the diagnostic threshold for diabetes. Choice D (180 mg/dl) is above the diagnostic threshold and would indicate uncontrolled diabetes, not the lowest level suggestive of a diagnosis.
3. Which of the following best defines management?
- A. A manager is someone who ensures that employees complete their work.
- B. A manager controls the work of employees.
- C. A manager organizes and controls a group of employees to get work done.
- D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.
Correct answer: D
Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.
4. A client with type 1 diabetes mellitus presents to the emergency department with symptoms of diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?
- A. Administer intravenous insulin
- B. Start an intravenous line and infuse normal saline
- C. Monitor serum potassium levels
- D. Obtain an arterial blood gas (ABG)
Correct answer: B
Rationale: The correct first intervention in a client with DKA is to start an intravenous line and infuse normal saline for fluid resuscitation. This is crucial to restore intravascular volume and improve perfusion, addressing the dehydration and electrolyte imbalances commonly seen in DKA. Administering insulin without addressing the dehydration can lead to further complications. Monitoring serum potassium levels is important but is not the first priority; potassium levels can shift with fluid resuscitation. Obtaining an arterial blood gas (ABG) is helpful in assessing acid-base status but is not the initial priority compared to fluid resuscitation.
5. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperkalemia
Correct answer: A
Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.
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