HESI RN
Leadership and Management HESI
1. 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.
2. Which of the following is true about nursing ethics?
- A. Nursing ethics focus on the organizational level at the workplace.
- B. Nursing ethics focus on the moral character of nurses.
- C. Nursing ethics focus on the experiences and needs of patients.
- D. Nursing ethics focus on the ethical principles governing healthcare organizations.
Correct answer: B
Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.
3. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.
- A. Place the solution on an IV pump at the prescribed rate.
- B. Monitor blood glucose every twelve (12) hours.
- C. Weigh the client weekly, first thing in the morning.
- D. Change the IV tubing every three (3) days.
Correct answer: D
Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.
4. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?
- A. Weight gain
- B. Hypoglycemia
- C. Hyperglycemia
- D. Bradycardia
Correct answer: B
Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.
5. A client with DM is being taught about the importance of foot care by a nurse. Which instruction should the nurse include?
- A. Use a heating pad to warm your feet.
- B. Avoid walking barefoot.
- C. Soak your feet in hot water every night.
- D. Wear tight shoes to protect your feet.
Correct answer: B
Rationale: The correct instruction for the nurse to include is to advise the client to avoid walking barefoot. This recommendation is crucial for clients with diabetes to prevent foot injuries and infections. Walking barefoot can lead to unnoticed wounds or ulcers due to reduced sensation in the feet (neuropathy) common in diabetes. Choice A is incorrect as heating pads can cause burns and should be avoided. Choice C is incorrect because soaking feet in hot water can also lead to burns and skin damage. Choice D is incorrect as tight shoes can increase the risk of pressure sores and restrict blood flow, which is detrimental for individuals with diabetes.
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