HESI RN
Leadership and Management HESI
1. When should a new nurse graduate consider applying for a position as a nurse manager?
- A. When she is comfortable in her current position
- B. When she begins mentoring other new nurses
- C. As soon as a position opens
- D. When she has developed leadership and clinical expertise
Correct answer: D
Rationale: A new nurse graduate should consider applying for a position as a nurse manager when she has developed leadership and clinical expertise. Option A, 'When she is comfortable in her current position,' is incorrect as comfort in the current position may not necessarily align with the skills required for a managerial role. Option B, 'When she begins mentoring other new nurses,' is not a definitive indicator of readiness for a managerial position. Option C, 'As soon as a position opens,' does not take into account the necessary skills and experience required for a nurse manager role. Therefore, the best time to consider applying for a nurse manager position is after developing the required leadership and clinical expertise.
2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which 'related-to' phrase should the nurse add?
- A. Related to bone demineralization resulting in pathologic fractures
- B. Related to exhaustion secondary to an accelerated metabolic rate
- C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
- D. Related to tetany secondary to a decreased serum calcium level
Correct answer: A
Rationale: The correct answer is A: 'Related to bone demineralization resulting in pathologic fractures.' In chronic hyperparathyroidism, bone demineralization occurs due to the excessive release of parathyroid hormone, leading to increased calcium resorption from bones. This process weakens the bones, making the client prone to pathologic fractures. Choices B, C, and D are incorrect because they do not directly relate to the increased risk of injury associated with chronic hyperparathyroidism. Exhaustion, edema, dry skin, and tetany are not the primary risks for injury in this client population.
3. Nurse Noemi administers glucagon to her diabetic client and then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
- A. Oral anticoagulants
- B. Anabolic steroids
- C. Beta-adrenergic blockers
- D. Thiazide diuretics
Correct answer: A
Rationale: The correct answer is A: Oral anticoagulants. Glucagon may enhance the anticoagulant effect of oral anticoagulants, increasing the risk of bleeding. This interaction can be dangerous for the patient, leading to serious complications. Choices B, C, and D are incorrect because anabolic steroids, beta-adrenergic blockers, and thiazide diuretics do not typically interact adversely with glucagon. It is crucial for healthcare providers to be aware of potential drug interactions to ensure patient safety and optimal outcomes.
4. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which of the following complications?
- A. Hypernatremia
- B. Hyponatremia
- C. Hyperkalemia
- D. Hypercalcemia
Correct answer: B
Rationale: The correct answer is B: Hyponatremia. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention in the body. This causes dilutional hyponatremia, where the sodium levels in the blood become abnormally low. Option A, Hypernatremia, is incorrect because SIADH does not cause elevated sodium levels. Option C, Hyperkalemia, is incorrect as SIADH does not directly affect potassium levels. Option D, Hypercalcemia, is also incorrect as SIADH does not impact calcium levels.
5. A client with hyperthyroidism is prescribed propranolol. The nurse explains that this medication is used to:
- A. Increase thyroid hormone production
- B. Decrease thyroid hormone production
- C. Relieve symptoms such as tachycardia and anxiety
- D. Prevent weight loss
Correct answer: C
Rationale: Propranolol is a beta-blocker that works by blocking the effects of adrenaline, which helps to reduce symptoms such as tachycardia (fast heart rate) and anxiety in individuals with hyperthyroidism. Choices A and B are incorrect because propranolol does not affect thyroid hormone production; it only addresses symptoms. Choice D is incorrect because propranolol does not prevent weight loss associated with hyperthyroidism.
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