HESI RN
Leadership HESI
1. During preoperative teaching for a female client undergoing subtotal thyroidectomy, which statement should the nurse include?
- A. The head of your bed must remain flat for 24 hours after surgery.
- B. You should avoid deep breathing and coughing after surgery.
- C. You won't be able to swallow for the first day or two.
- D. You must avoid hyperextending your neck after surgery.
Correct answer: D
Rationale: The correct answer is D. Instructing the client to avoid hyperextending the neck after thyroid surgery is crucial to prevent stress on the surgical site and reduce the risk of complications such as strain on the incision or damage to the healing tissues. Choices A, B, and C are incorrect because: A) Keeping the head of the bed flat for 24 hours is not necessary after a thyroidectomy; elevation of the head of the bed can actually help reduce swelling and improve comfort. B) Encouraging deep breathing and coughing after surgery is essential to prevent respiratory complications such as pneumonia, so this advice is incorrect. C) Difficulty swallowing after thyroid surgery is not a typical outcome, so this statement is inaccurate and should not be included in the preoperative teaching.
2. How often should rotation sites for insulin injection be separated from one another?
- A. Every third day.
- B. Every week.
- C. Every 2-3 weeks.
- D. Every 2-4 weeks.
Correct answer: C
Rationale: Insulin injection sites should be rotated every 2-3 weeks to prevent lipodystrophy and ensure proper insulin absorption. Option A ('Every third day') is too frequent and does not allow enough time for the previous site to heal properly. Option B ('Every week') might not provide adequate time for the tissue to recover. Option D ('Every 2-4 weeks') could potentially lead to overuse of a single injection site, increasing the risk of lipodystrophy and inconsistent insulin absorption. Therefore, the recommended interval of every 2-3 weeks is optimal for insulin injection site rotation.
3. Which of the following is true about nursing ethics?
- A. Nursing ethics focus on the organizational level at the workplace.
- B. Nursing ethics focus on the moral character of nurses.
- C. Nursing ethics focus on the experiences and needs of patients.
- D. Nursing ethics focus on the ethical principles governing healthcare organizations.
Correct answer: B
Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.
4. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. Be sure to take glipizide 30 minutes before meals.
- B. Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.
- C. You won't need to check your blood glucose level after you start taking glipizide.
- D. Take glipizide after a meal to prevent heartburn.
Correct answer: A
Rationale: Glipizide should be taken 30 minutes before meals to maximize its glucose-lowering effect.
5. The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?
- A. I will rotate my injection sites to prevent skin damage.
- B. I can stop taking my medication if my blood sugar is normal.
- C. I should monitor my blood sugar levels regularly.
- D. I should follow a healthy diet and exercise regularly.
Correct answer: B
Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.
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