HESI RN
HESI Leadership and Management
1. The client with DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:
- A. Increased risk of heart disease and stroke.
- B. Improved wound healing.
- C. Reduced need for medication.
- D. Decreased risk of infection.
Correct answer: A
Rationale: The correct answer is A: Increased risk of heart disease and stroke. Uncontrolled blood glucose levels in clients with diabetes mellitus (DM) can lead to cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, increasing the risk of atherosclerosis and cardiovascular events. Choices B, C, and D are incorrect because uncontrolled blood glucose levels do not improve wound healing, reduce the need for medication, or decrease the risk of infection. In fact, uncontrolled blood glucose levels can impair wound healing, require more medications to manage symptoms, and increase the risk of infections due to compromised immune function.
2. A client with type 2 DM is being taught about the importance of foot care. Which instruction should the nurse include?
- A. Wear comfortable shoes that allow air circulation.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Soak your feet in hot water every night.
Correct answer: A
Rationale: The correct instruction for a client with type 2 diabetes mellitus (DM) regarding foot care is to wear comfortable shoes that allow air circulation. This recommendation helps prevent foot injuries and infections, which are common concerns for individuals with diabetes. Choice B, walking barefoot, can increase the risk of injuries and wounds due to reduced sensation in the feet often seen in diabetes. Choice C, using a heating pad, can lead to burns or skin damage if the temperature is not carefully monitored, making it an unsafe practice. Choice D, soaking feet in hot water every night, can also be harmful as it can cause burns and dry out the skin, leading to further complications for individuals with diabetes. Therefore, the most appropriate and safe advice is to wear comfortable shoes that promote air circulation to maintain foot health and prevent complications.
3. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperkalemia
Correct answer: A
Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.
4. A new nurse is working on becoming a better follower. Which of the following recommendations should she implement?
- A. When you disagree with the manager, seek to determine the manager’s rationale.
- B. Share what you have learned only with newer nurses.
- C. Listen and reflect on your manager’s feedback.
- D. Seek to find a balance and manage your time and energy as you seek to learn about your specialty.
Correct answer: C
Rationale: Listening and reflecting on the manager’s feedback is crucial for a new nurse aiming to become a better follower. It allows the nurse to understand expectations, identify areas for improvement, and show respect for the manager's guidance. Choice A is incorrect as it focuses on resolving disagreements rather than improving followership skills. Choice B is incorrect as knowledge sharing should not be limited to specific groups. Choice D is incorrect as it addresses time management and learning about the specialty, which are important but not directly related to followership development.
5. The nurse is caring for a client with a history of adrenal insufficiency. The nurse should monitor for which of the following signs of an Addisonian crisis?
- A. Hypertension
- B. Hyperglycemia
- C. Severe hypotension
- D. Tachycardia
Correct answer: C
Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.
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