HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. 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.
2. A client with hyperparathyroidism is receiving dietary instructions. Which of the following foods should the client avoid?
- A. Milk
- B. Bananas
- C. Spinach
- D. Processed meats
Correct answer: A
Rationale: In hyperparathyroidism, there are already elevated calcium levels in the body. Therefore, clients should avoid high-calcium foods like milk to prevent further increase in calcium levels. Bananas, spinach, and processed meats do not have significant calcium content and do not need to be avoided specifically in hyperparathyroidism.
3. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?
- A. Administering insulin intravenously.
- B. Giving the client sips of water.
- C. Monitoring the client's urine output.
- D. Applying a heating pad to the client's abdomen.
Correct answer: A
Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.
4. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct answer: B
Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.
5. The nurse is caring for a client with hyperparathyroidism. Which of the following clinical manifestations is consistent with this condition?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperphosphatemia
Correct answer: B
Rationale: In hyperparathyroidism, there is an overproduction of parathyroid hormone, leading to increased calcium levels in the blood (hypercalcemia). This occurs as the parathyroid hormone stimulates the release of calcium from the bones and enhances calcium absorption in the intestines and kidneys. Therefore, the correct answer is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not consistent with hyperparathyroidism, as this condition is characterized by high calcium levels. Hypokalemia (Choice C) and hyperphosphatemia (Choice D) are not typically associated with hyperparathyroidism and are not primary manifestations of this condition.
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