HESI RN
HESI Leadership and Management
1. A client with hypothyroidism is prescribed levothyroxine. The nurse should teach the client to take this medication:
- A. With meals
- B. Before bedtime
- C. On an empty stomach in the morning
- D. With a glass of milk
Correct answer: C
Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and efficacy. Taking it with meals (Choice A) may interfere with absorption due to food interactions. Taking it before bedtime (Choice B) can lead to difficulties with absorption and may disrupt the sleep cycle. Consuming levothyroxine with a glass of milk (Choice D) is not recommended as calcium in milk can interfere with its absorption. Therefore, the best practice is to take levothyroxine on an empty stomach in the morning to ensure optimal effectiveness.
2. In a client with hypoparathyroidism, the nurse should expect which laboratory result?
- A. Increased calcium levels
- B. Decreased phosphorus levels
- C. Increased phosphorus levels
- D. Increased potassium levels
Correct answer: C
Rationale: In hypoparathyroidism, there is a deficiency of parathyroid hormone, leading to decreased calcium levels and increased phosphorus levels. Therefore, the correct answer is 'Increased phosphorus levels' (Choice C). Choice A, 'Increased calcium levels,' is incorrect because hypoparathyroidism is associated with low calcium levels. Choice B, 'Decreased phosphorus levels,' is incorrect as phosphorus levels are typically elevated in hypoparathyroidism. Choice D, 'Increased potassium levels,' is not directly related to hypoparathyroidism and is not an expected laboratory result in this condition.
3. Which advice is most beneficial for a new nurse manager?
- A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
- B. Keep in mind that it may take 6 months to feel at ease in a new role.
- C. Begin by mentoring other novice nurse managers.
- D. Participate in substantial personal growth endeavors.
Correct answer: B
Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.
4. The client with newly diagnosed diabetes mellitus is being taught about managing blood glucose levels. Which statement indicates a need for further teaching?
- A. I will rotate my insulin injection sites to avoid tissue damage.
- B. I will monitor my blood glucose levels before each meal.
- C. I can eat unlimited fruit as it is healthy.
- D. I should carry a fast-acting carbohydrate with me at all times.
Correct answer: C
Rationale: Choice C indicates a need for further teaching because stating 'I can eat unlimited fruit as it is healthy' is incorrect. While fruits are healthy, they also contain natural sugars that can affect blood glucose levels. Portion control is crucial to managing blood glucose levels effectively. Choices A, B, and D demonstrate correct understanding. Rotating insulin injection sites helps prevent tissue damage, monitoring blood glucose levels before meals aids in managing diabetes effectively, and carrying a fast-acting carbohydrate is essential to treat hypoglycemia promptly.
5. The client has hyperparathyroidism. Which of the following dietary instructions should the nurse provide?
- A. Increase calcium intake
- B. Limit phosphorus intake
- C. Increase fluid intake
- D. Limit vitamin D intake
Correct answer: C
Rationale: The correct answer is to 'Increase fluid intake.' This is because increasing fluid intake helps prevent kidney stones, a common complication of hyperparathyroidism. While calcium is involved in the condition, increasing calcium intake is not recommended as it can exacerbate hypercalcemia, which is commonly present in hyperparathyroidism. Limiting phosphorus intake is not directly related to managing hyperparathyroidism. Limiting vitamin D intake is also not typically necessary in managing hyperparathyroidism, as it is usually a calcium and PTH-related issue.
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