knowing that gluconeogenesis helps to maintain blood levels a nurse should

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 DM is preparing for a foot care exam. The nurse should advise the client to:

A. Wear loose-fitting shoes to protect the feet.
B. Apply lotion to the tops and bottoms of the feet to keep the skin moist.
C. Avoid using a heating pad to prevent burns on the feet.
D. Avoid using sharp instruments to trim the toenails.

Correct answer: D

Rationale: The correct answer is to advise the client to avoid using sharp instruments to trim the toenails. This is crucial because using sharp instruments can lead to injuries such as cuts or wounds, increasing the risk of infections, especially in clients with diabetes who have decreased sensation in their feet. Choice A is incorrect because tight shoes can restrict circulation and increase the risk of pressure sores. Choice B is incorrect because applying lotion between the toes can create a moist environment, leading to fungal infections. Choice C is incorrect because using a heating pad can lead to burns, which can go unnoticed due to decreased sensation in diabetic feet.

3. Which of the following ethical principles is involved when a healthcare provider allows a patient to refuse treatment?

A. Autonomy
B. Nonmaleficence
C. Beneficence
D. Justice

Correct answer: A

Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make their own decisions, including the right to refuse treatment. This principle acknowledges the patient's self-governance and independence in making choices about their own healthcare. Choice B, Nonmaleficence, refers to the ethical principle of doing no harm and ensuring patient safety. Choice C, Beneficence, involves promoting the patient's well-being and acting in their best interest. Choice D, Justice, pertains to fairness and equitable distribution of healthcare resources.

4. A client with DM is scheduled for surgery. The nurse should plan to:

A. Monitor the client's blood glucose level closely during the perioperative period.
B. Give the client a regular diet as ordered.
C. Have the client stop taking insulin 48 hours before surgery.
D. Hold the client's insulin on the morning of surgery.

Correct answer: A

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.

5. 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 areas for improvement.
B. A unit manager meets with a new nurse to explain departmental policies.
C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing 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: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.