HESI RN
Leadership HESI
1. Which of the following actions could be considered a breach of patient confidentiality?
- A. Discussing patient information with other healthcare providers in a private setting.
- B. Sharing patient information with family members without the patient's consent.
- C. Discussing patient information in public areas where others may overhear.
- D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.
Correct answer: C
Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.
2. The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?
- A. I will rotate my injection sites to prevent skin damage.
- B. I can stop taking my medication if my blood sugar is normal.
- C. I should monitor my blood sugar levels regularly.
- D. I should follow a healthy diet and exercise regularly.
Correct answer: B
Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.
3. A client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN's teaching to the client?
- A. When a heart ceases to beat, the client is pronounced clinically dead.
- B. Physicians must write do not resuscitate (DNR) orders.
- C. A DNR order can be written after the healthcare provider has discussed it with the client and family.
- D. A DNR requires a court decision.
Correct answer: C
Rationale: A DNR order is typically written after the healthcare provider has discussed the implications with the patient and their family. This ensures that the patient and family are fully informed before making such a critical decision. Choice A is incorrect because pronouncing clinical death is a medical determination, not directly related to DNR orders. Choice B is incorrect because while physicians commonly write DNR orders, the discussion with the patient and family is crucial. Choice D is incorrect because a DNR order does not require a court decision; it is a decision made in collaboration with the healthcare team and the patient or family.
4. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. The nurse should instruct the client to do which of the following?
- A. Eat a high-protein snack
- B. Consume 15 grams of simple carbohydrates
- C. Drink a glass of water
- D. Administer an extra dose of insulin
Correct answer: B
Rationale: Consuming 15 grams of simple carbohydrates is the recommended treatment for mild hypoglycemia to quickly raise blood sugar levels. Simple carbohydrates are rapidly absorbed and provide a quick source of glucose to combat low blood sugar. Eating a high-protein snack (Choice A) would delay the rise in blood sugar as proteins take longer to be broken down. Drinking water (Choice C) does not directly address the low blood sugar levels associated with hypoglycemia. Administering an extra dose of insulin (Choice D) would further lower blood sugar levels, worsening the hypoglycemic state.
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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