HESI RN
Leadership and Management HESI
1. Knowing that gluconeogenesis helps to maintain blood glucose levels, a healthcare provider should:
- A. Document weight changes due to fatty acid mobilization.
- B. Evaluate the patient's sensitivity to low room temperatures due to decreased adipose tissue insulation.
- C. Protect the patient from sources of infection due to decreased cellular protein deposits.
- D. Do all of the above.
Correct answer: D
Rationale: Gluconeogenesis is a process where the body synthesizes glucose from non-carbohydrate sources to maintain blood glucose levels. Documenting weight changes due to fatty acid mobilization is important as it can impact the patient's metabolic status. Evaluating the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation is crucial to prevent hypothermia. Protecting the patient from sources of infection due to decreased cellular protein deposits is essential to prevent complications. Therefore, all the options are relevant considerations in managing a patient undergoing gluconeogenesis, making option D the correct answer.
2. The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?
- A. Decreased blood glucose levels
- B. Decreased urine ketones
- C. Increased serum bicarbonate
- D. Increased anion gap
Correct answer: D
Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.
3. Which of the following best describes the way for a follower to 'manage up'?
- A. Provide feedback to the unit manager when requested.
- B. Assist the manager in capitalizing on their strengths and weaknesses.
- C. If a follower works with a manager displaying poor leadership skills, they should transfer to a different unit.
- D. Demonstrate respect and appreciation for the manager, even when conversing with coworkers.
Correct answer: B
Rationale: The best way for a follower to 'manage up' is to assist the manager in capitalizing on their strengths and weaknesses. This approach involves supporting the manager in leveraging their strengths while helping them address and improve upon their weaknesses. Choice A is not specific enough about the context of providing feedback, which may not always be the best way to manage up. Choice C suggests avoiding the situation rather than actively managing it. Choice D, while important, does not directly address the concept of managing up by helping the manager grow and excel.
4. Which of the following describes the role of the nurse in advocating for a patient?
- A. The nurse ensures that the patient has all the information needed to make an informed decision about their care.
- B. The nurse advocates for the patient by communicating their needs and preferences to the healthcare team.
- C. The nurse advocates for the patient by ensuring that they receive the care they need and by protecting their rights.
- D. The nurse advocates for the patient by helping them navigate the healthcare system and access necessary resources.
Correct answer: C
Rationale: The correct answer is C. Nurses advocate for patients by ensuring that they receive the necessary care and by protecting their rights. This involves speaking up for patients, ensuring they are treated with respect, and helping them access appropriate healthcare services. Option A, providing information for informed decision-making, is an important aspect of nursing care but not the central role of advocacy. Option B, communicating patients' needs to the healthcare team, is essential but more focused on teamwork and collaboration. Option D, helping patients navigate the healthcare system and access resources, is valuable but not the primary definition of advocacy in nursing.
5. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?
- A. Hypernatremia
- B. Hypotension
- C. Decreased urine output
- D. Polyuria
Correct answer: C
Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.
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