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. The client with type 1 DM asks why it is necessary to rotate injection sites when managing insulin therapy. The nurse's best response is:
- A. It helps prevent skin irritation.
- B. It helps prevent scar tissue buildup.
- C. It ensures more consistent insulin absorption.
- D. It makes the injections less painful.
Correct answer: C
Rationale: Rotating injection sites is necessary to ensure more consistent insulin absorption. This practice helps maintain stable blood glucose levels by preventing the formation of lipohypertrophy (fatty lumps under the skin) at injection sites. Choices A and B are incorrect as the primary purpose of rotating injection sites is not focused on preventing skin irritation or scar tissue buildup. While rotating injection sites may contribute to reducing pain over time, the primary benefit is the consistency in insulin absorption to support glycemic control, making choice D less relevant.
3. Which of the following ethical principles is involved when protecting a patient's privacy and confidentiality?
- A. Fidelity
- B. Beneficence
- C. Confidentiality
- D. Justice
Correct answer: C
Rationale: Confidentiality is the ethical principle involved in protecting a patient's privacy and ensuring that personal information is not shared inappropriately. Fidelity refers to being faithful to commitments and keeping promises, not directly related to privacy and confidentiality. Beneficence involves doing good for the patient, and justice pertains to fairness and equal treatment, but they are not directly related to protecting privacy and confidentiality.
4. A client with diabetes insipidus is receiving desmopressin therapy. The nurse should monitor for which of the following potential side effects?
- A. Hyponatremia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used to treat diabetes insipidus, can cause the retention of water without sodium, leading to dilutional hyponatremia. This occurs because desmopressin increases water reabsorption in the kidneys without affecting sodium levels. Hypernatremia (choice B) is unlikely because desmopressin does not cause excessive sodium retention. Hypokalemia (choice C) and hypercalcemia (choice D) are not typically associated with desmopressin therapy for diabetes insipidus.
5. When implementing a new policy on the unit, what process should a nurse manager follow?
- A. The nurse manager should involve staff members in the decision-making process, gather input, and communicate the reasons for the policy change to ensure buy-in from the team.
- B. The nurse manager should implement the policy change immediately and monitor staff compliance to ensure that the new policy is being followed.
- C. The nurse manager should delegate the implementation of the policy change to a staff member and provide support as needed to ensure that the change is successful.
- D. The nurse manager should communicate the policy change to staff members, provide training as needed, and monitor the implementation process to ensure that the change is effective.
Correct answer: A
Rationale: When introducing a new policy on the unit, it is essential for the nurse manager to involve staff members in the decision-making process. This approach helps in gathering input and insights from the team, fostering a sense of ownership and commitment. By communicating the reasons behind the policy change, the nurse manager ensures transparency and promotes understanding among the staff, leading to buy-in and acceptance of the new policy. Choice B is incorrect because implementing a policy change without involving staff and explaining the rationale may lead to resistance or lack of understanding. Choice C is not ideal as delegation without active involvement and communication with the team may result in misunderstandings or incomplete implementation. Choice D lacks the crucial step of involving staff in the decision-making process, which is important for successful policy implementation and team engagement.
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