HESI RN
HESI Leadership and Management
1. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor the client for which of the following potential side effects?
- A. Hypoglycemia
- B. Hypertension
- C. Weight loss
- D. Hyperkalemia
Correct answer: B
Rationale: When a client with Addison's disease is receiving corticosteroid therapy, the nurse should monitor for hypertension as a potential side effect. Corticosteroids can lead to hypertension by causing fluid retention and increased blood volume. Hypoglycemia (Choice A) is not a common side effect of corticosteroid therapy; instead, hyperglycemia is more likely. Weight loss (Choice C) is not a typical side effect of corticosteroid therapy; in fact, weight gain is more common due to fluid retention and increased appetite. Hyperkalemia (Choice D) is a potential side effect of Addison's disease itself due to adrenal insufficiency, but it is not directly caused by corticosteroid therapy.
2. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager’s actions?
- A. Resource allocation
- B. Monitoring
- C. Job analysis and redesign
- D. Planning for the future
Correct answer: D
Rationale: The correct answer is D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.
3. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?
- A. Obtaining a controlled IV infusion pump
- B. Monitoring urine output during administration
- C. Diluting an appropriate amount of normal saline
- D. Preparing the medication for bolus administration
Correct answer: D
Rationale: The correct answer is preparing the medication for bolus administration (Choice D). Potassium should never be administered as a bolus because it can cause cardiac arrest. It must always be diluted and given slowly. Obtaining a controlled IV infusion pump (Choice A) is essential for accurate delivery, monitoring urine output during administration (Choice B) helps assess the client's response, and diluting an appropriate amount of normal saline (Choice C) is necessary to prevent irritation and ensure safe administration.
4. The nurse is caring for a client with hypothyroidism. Which of the following clinical findings should the nurse expect?
- A. Tachycardia
- B. Weight loss
- C. Cold intolerance
- D. Diaphoresis
Correct answer: C
Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a decreased ability to regulate body temperature. This results in a feeling of being cold most of the time. Tachycardia (Choice A) is more commonly associated with hyperthyroidism, not hypothyroidism. Weight loss (Choice B) and diaphoresis (Choice D) are also more characteristic of hyperthyroidism, where there is an increased metabolic rate and excess heat production.
5. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
- A. Increasing saturated fat intake and fasting in the afternoon
- B. Increasing intake of vitamins B and D and taking iron supplements
- C. Eating a candy bar if lightheadedness occurs
- D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting
Correct answer: D
Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.
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