HESI RN
Leadership and Management HESI
1. What is the most common cause of hyperaldosteronism?
- A. Excessive sodium intake
- B. A pituitary adenoma
- C. Deficient potassium intake
- D. An adrenal adenoma
Correct answer: D
Rationale: An adrenal adenoma is the most common cause of primary hyperaldosteronism. Hyperaldosteronism is typically caused by an adrenal adenoma, a benign tumor in the adrenal gland that leads to excessive aldosterone production. Excessive sodium intake (Choice A) does not directly cause hyperaldosteronism. Pituitary adenoma (Choice B) is associated with conditions like Cushing's disease, not hyperaldosteronism. Deficient potassium intake (Choice C) can lead to hypokalemia but is not a common cause of hyperaldosteronism.
2. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?
- A. Hyperglycemia
- B. Hypotension
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.
3. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?
- A. Weight loss
- B. Heat intolerance
- C. Bradycardia
- D. Diarrhea
Correct answer: C
Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.
4. The client with newly diagnosed diabetes mellitus is being taught about managing blood glucose levels. Which statement indicates a need for further teaching?
- A. I will rotate my insulin injection sites to avoid tissue damage.
- B. I will monitor my blood glucose levels before each meal.
- C. I can eat unlimited fruit as it is healthy.
- D. I should carry a fast-acting carbohydrate with me at all times.
Correct answer: C
Rationale: Choice C indicates a need for further teaching because stating 'I can eat unlimited fruit as it is healthy' is incorrect. While fruits are healthy, they also contain natural sugars that can affect blood glucose levels. Portion control is crucial to managing blood glucose levels effectively. Choices A, B, and D demonstrate correct understanding. Rotating insulin injection sites helps prevent tissue damage, monitoring blood glucose levels before meals aids in managing diabetes effectively, and carrying a fast-acting carbohydrate is essential to treat hypoglycemia promptly.
5. A healthcare professional is monitoring a client newly diagnosed with DM for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if blood glucose levels are not adequately managed?
- A. Polyuria
- B. Diaphoresis
- C. Pedal edema
- D. Proteinuria
Correct answer: D
Rationale: Proteinuria is the correct answer because it indicates kidney damage, which is a common complication of uncontrolled diabetes. Elevated blood glucose levels over time can damage the kidneys, leading to proteinuria. Polyuria (excessive urination) is a symptom of diabetes but does not specifically indicate a risk for chronic complications. Diaphoresis (excessive sweating) and pedal edema (swelling of the lower limbs) are not direct indicators of chronic complications related to uncontrolled diabetes.
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