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. A client with hyperthyroidism is prescribed propranolol. The nurse explains that this medication is used to:
- A. Increase thyroid hormone production
- B. Decrease thyroid hormone production
- C. Relieve symptoms such as tachycardia and anxiety
- D. Prevent weight loss
Correct answer: C
Rationale: Propranolol is a beta-blocker that works by blocking the effects of adrenaline, which helps to reduce symptoms such as tachycardia (fast heart rate) and anxiety in individuals with hyperthyroidism. Choices A and B are incorrect because propranolol does not affect thyroid hormone production; it only addresses symptoms. Choice D is incorrect because propranolol does not prevent weight loss associated with hyperthyroidism.
3. Skillful communication is one behavior of an effective leader. Which of the following describes an effective method of communication?
- A. A unit manager meets with a new nurse to discuss what is going well and what improvements the new nurse can make.
- B. A unit manager meets with a new nurse to explain departmental policy.
- C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent further safety events.
- D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.
Correct answer: A
Rationale: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.
4. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hyponatremia
Correct answer: C
Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.
5. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he's impotent and says he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to:
- A. Encourage the client to ask questions about personal sexuality.
- B. Provide time for privacy.
- C. Provide support for the spouse or significant other.
- D. Suggest referral to a sex counselor or other appropriate professional.
Correct answer: D
Rationale: The most appropriate intervention for a postoperative male client with diabetes mellitus who reports impotence and concerns about its impact on his marriage is to suggest referral to a sex counselor or other appropriate professional. Impotence can have significant emotional and relational effects, and a sex counselor is specifically trained to address such concerns. Encouraging the client to ask questions about personal sexuality (Choice A) may not provide the specialized support needed in this situation. Providing time for privacy (Choice B) is important but may not directly address the client's concerns about impotence. Providing support for the spouse or significant other (Choice C) is valuable but may not be as effective as seeking professional help to address the client's specific issue of impotence.
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