HESI LPN
Leadership and Management HESI Quizlet
1. A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?
- A. Kussmaul's respirations and a fruity odor on the breath
- B. Shallow respirations and severe abdominal pain
- C. Decreased respirations and increased urine output
- D. Cheyne-Stokes respirations and foul-smelling urine
Correct answer: A
Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.
2. A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?
- A. A visitor experiences a minor burn after spilling coffee
- B. A client receives an operation on the wrong side of her body
- C. A parent wants her 14-year-old adolescent to receive radiation treatment against his will
- D. A nurse witnesses another nurse administer an incorrect medication
Correct answer: C
Rationale: An ethical dilemma involves a situation where moral principles conflict, such as in the case of a parent wanting their adolescent to receive treatment against their will. In option A, a minor burn from spilled coffee does not present a conflict of moral principles. Option B describes a medical error, not necessarily a conflict of moral principles. Option D involves an issue of professional practice and patient safety but does not inherently pose a conflict of moral principles.
3. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?
- A. Is the client's family present so the AP can show them how to turn the client?
- B. Has data been collected about specific client needs related to turning?
- C. Does the AP have time to change the client's central IV line dressing after turning her?
- D. Has the AP checked the client's pain level prior to turning her?
Correct answer: B
Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.
4. Which of the following is the best way for a nurse to improve quality of care?
- A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
- B. Work with patients and families to improve healthcare.
- C. Collaborate with other health-care professionals, patients, and their families.
- D. Recognize that physicians are among the numerous professionals in health care.
Correct answer: C
Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.
5. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:
- A. Call the physician
- B. Encourage the intake of fluids
- C. Administer the insulin as ordered
- D. Give the client ½ cup of orange juice
Correct answer: C
Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.
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