HESI RN
Leadership and Management HESI
1. The client with DM is being taught about foot care. The nurse instructs the client to:
- A. Avoid hot water when bathing the feet.
- B. Apply a moisturizing lotion to the feet, especially between the toes.
- C. Use a heating pad to warm the feet if they feel cold.
- D. Go barefoot at home to allow the feet to air out.
Correct answer: A
Rationale: The correct answer is to avoid hot water when bathing the feet. This instruction is crucial because clients with diabetes may have decreased sensation in their feet, which can put them at risk of burns from hot water. Choice B is incorrect because applying moisturizing lotion between the toes can increase moisture and promote fungal growth. Choice C is incorrect because using a heating pad can also lead to burns due to decreased sensation. Choice D is incorrect as going barefoot can increase the risk of injury and infections in clients with diabetes.
2. A client with type 1 diabetes mellitus is experiencing hypoglycemia. What should the nurse instruct the client to do?
- A. Administer insulin immediately
- B. Consume 15 grams of simple carbohydrates
- C. Drink plenty of water
- D. Avoid eating until symptoms resolve
Correct answer: B
Rationale: When a client with type 1 diabetes mellitus experiences hypoglycemia, the nurse should instruct them to consume 15 grams of simple carbohydrates. This is the recommended initial treatment for hypoglycemia as it helps quickly raise blood sugar levels to alleviate symptoms and prevent complications. Administering insulin immediately (Choice A) would further lower blood sugar levels, worsening the hypoglycemia. Drinking plenty of water (Choice C) and avoiding eating until symptoms resolve (Choice D) are not appropriate actions for treating hypoglycemia as they do not address the immediate need to raise blood sugar levels.
3. A client with hypothyroidism is prescribed levothyroxine. The nurse should teach the client to take this medication:
- A. With meals
- B. Before bedtime
- C. On an empty stomach in the morning
- D. With a glass of milk
Correct answer: C
Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and efficacy. Taking it with meals (Choice A) may interfere with absorption due to food interactions. Taking it before bedtime (Choice B) can lead to difficulties with absorption and may disrupt the sleep cycle. Consuming levothyroxine with a glass of milk (Choice D) is not recommended as calcium in milk can interfere with its absorption. Therefore, the best practice is to take levothyroxine on an empty stomach in the morning to ensure optimal effectiveness.
4. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct answer: B
Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.
5. 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.
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