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. During a physical assessment of a client with type 2 DM, a nurse notes the following findings: fasting blood glucose of 120 mg/dl, temperature of 101°F, pulse 88 bpm, respirations 22/min, and BP 140/84 mmHg. Which finding should concern the nurse the most?
- A. Pulse
- B. BP
- C. Respiration
- D. Temperature
Correct answer: D
Rationale: The correct answer is 'Temperature.' A temperature of 101°F indicates a fever, which can be a sign of infection. In individuals with diabetes, infections can lead to significant complications and affect blood glucose control. Monitoring and addressing infections promptly are crucial in individuals with diabetes to prevent worsening of their condition. Choice A, 'Pulse,' is within the normal range (60-100 bpm) and does not indicate an immediate concern. Choice B, 'BP,' while slightly elevated, is not as acutely concerning as an elevated temperature in this scenario. Choice C, 'Respiration,' falls within the normal range (12-20 breaths/min) and is not the most concerning finding among the options provided.
3. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which of the following complications?
- A. Hypernatremia
- B. Hyponatremia
- C. Hyperkalemia
- D. Hypercalcemia
Correct answer: B
Rationale: The correct answer is B: Hyponatremia. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention in the body. This causes dilutional hyponatremia, where the sodium levels in the blood become abnormally low. Option A, Hypernatremia, is incorrect because SIADH does not cause elevated sodium levels. Option C, Hyperkalemia, is incorrect as SIADH does not directly affect potassium levels. Option D, Hypercalcemia, is also incorrect as SIADH does not impact calcium levels.
4. What is the nurse manager’s role in improving the quality of care on the unit?
- A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
- B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
- C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
- D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.
Correct answer: A
Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.
5. A client with type 1 DM is experiencing hypoglycemia. Which symptom should the nurse expect to observe?
- A. Tachycardia
- B. Polyuria
- C. Flushed skin
- D. Dry mouth
Correct answer: A
Rationale: The correct answer is A: Tachycardia. In hypoglycemia, the body releases adrenaline in response to low blood glucose levels, leading to symptoms such as tachycardia (rapid heart rate). Choice B, polyuria, refers to excessive urination and is not a typical symptom of hypoglycemia. Choice C, flushed skin, is not a common symptom of hypoglycemia; instead, pale skin and sweating are more characteristic. Choice D, dry mouth, is not directly associated with hypoglycemia; rather, it can be a symptom of hyperglycemia or dehydration.
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