HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?
- A. Tetanic contractions
- B. Neck vein distention
- C. Weight loss
- D. Polyuria
Correct answer: B
Rationale: Neck vein distention is a sign of fluid overload, a complication of SIADH due to water retention. Tetanic contractions (Choice A) are not typically associated with SIADH. Weight loss (Choice C) is not a common complication of SIADH, as patients often experience fluid retention and weight gain. Polyuria (Choice D) is also not a typical sign of SIADH, as the condition is characterized by water retention and decreased urine output.
2. A client with Addison's disease is being educated on managing the condition. Which of the following statements indicates a need for further teaching?
- A. I should carry an emergency kit with hydrocortisone at all times.
- B. I need to increase my sodium intake during hot weather.
- C. I can skip my medication if I feel well.
- D. I should avoid stress as much as possible.
Correct answer: C
Rationale: The correct answer is C. Clients with Addison's disease should not skip their medication, even if they feel well, as consistent medication is necessary to manage the condition. Choice A is correct as carrying an emergency kit with hydrocortisone is essential for managing potential adrenal crises. Choice B is correct as increasing sodium intake during hot weather helps prevent electrolyte imbalances. Choice D is correct as stress can trigger adrenal crisis in individuals with Addison's disease, so stress management is crucial.
3. A client with type 1 DM is taught to take NPH and regular insulin every morning. The nurse should provide which instructions to the client?
- A. Take the NPH insulin first, then the regular insulin.
- B. Take the regular insulin first, then the NPH insulin.
- C. It does not matter which insulin is drawn up first.
- D. Contact the healthcare provider if the order for insulin is unclear.
Correct answer: B
Rationale: The correct answer is to take the regular insulin first, then the NPH insulin. Regular insulin should be drawn up before NPH insulin to prevent contamination of the regular insulin vial with the longer-acting insulin. Choice A is incorrect as it suggests taking the NPH insulin first, which is not the recommended practice. Choice C is incorrect because the order of drawing up insulin does matter to prevent contamination. Choice D is not the most appropriate action in this scenario, as the nurse should provide clear instructions to the client based on best practices.
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. What is the approximate duration of action for intermediate-acting insulins like NPH?
- A. 6-8 hours.
- B. 10-14 hours.
- C. 16-20 hours.
- D. 24-28 hours.
Correct answer: C
Rationale: The correct answer is C: '16-20 hours.' Intermediate-acting insulins like NPH typically have a duration of action of approximately 16-20 hours. This prolonged action makes them effective in managing blood glucose levels over an extended period. Choices A, B, and D are incorrect because they do not align with the typical duration of action for intermediate-acting insulins. Choice A (6-8 hours) is too short, choice B (10-14 hours) is also shorter than the typical duration, and choice D (24-28 hours) is too long for intermediate-acting insulins like NPH.
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