HESI LPN
Leadership and Management HESI Test Bank
1. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.
- A. It stimulates the pancreas to produce more insulin.
- B. It must be taken after meals.
- C. It decreases sugar production in the liver.
- D. It inhibits absorption of carbohydrates.
Correct answer: A
Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.
2. A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?
- A. Transport the client to the operating room without verifying informed consent
- B. Ask the anesthesiologist to sign the consent
- C. Obtain telephone consent from the facility administrator before the surgery
- D. Delay the surgery until the nurse can obtain informed consent
Correct answer: A
Rationale: In emergency situations where a client is unconscious and requires immediate surgery, implied consent applies. Implied consent allows healthcare providers, including nurses, to proceed with necessary treatment or surgery without formally verifying informed consent. Choice A is correct because the priority in this scenario is to ensure the client receives timely medical intervention to address life-threatening conditions. Choices B, C, and D are incorrect because in emergencies, waiting to obtain formal consent can delay critical treatment, risking the client's health and well-being.
3. What is the most common cause of HHNS?
- A. Insulin overdose
- B. Removal of the adrenal gland
- C. Undiagnosed, untreated hyperpituitarism
- D. Undiagnosed, untreated diabetes mellitus
Correct answer: D
Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.
4. What is the main purpose of quality improvement in healthcare?
- A. To increase healthcare costs
- B. To improve patient outcomes
- C. To decrease patient satisfaction
- D. To increase hospital stays
Correct answer: B
Rationale: The main purpose of quality improvement in healthcare is to improve patient outcomes by enhancing the quality and safety of healthcare services. Choice A is incorrect because the goal is not to increase healthcare costs but to optimize resources and provide cost-effective care. Choice C is incorrect as the aim is to increase patient satisfaction through better outcomes. Choice D is incorrect as the objective is to reduce hospital stays by improving care efficiency and effectiveness.
5. Select the stage of shock that is accurately paired with its characteristic.
- A. The initial stage of shock: Hyperventilation occurs and the blood pH rises.
- B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
- C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
- D. The refractory stage of shock: Potassium ions leak out; sodium ions build up, and metabolic acidosis increases.
Correct answer: C
Rationale: The progressive stage of shock is accurately described as the stage where histamine is released, leading to fluid and proteins leaking into surrounding tissues and the blood thickening. In this stage, the body's compensatory mechanisms are overwhelmed, resulting in a cascade of events that worsen the shock state. Choice A is incorrect as hyperventilation and a rise in blood pH are more characteristic of the compensatory stage. Choice B is incorrect as hypoxia and a rise in lactic acid are more typical of the progressive stage. Choice D is incorrect as the described electrolyte imbalances and metabolic acidosis are more aligned with the refractory stage of shock.
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