HESI RN
HESI Leadership and Management
1. Which of the following describes an effective method of communication?
- A. A unit manager meets with a new nurse to discuss what is going well and areas for improvement.
- B. A unit manager meets with a new nurse to explain departmental policies.
- C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing further safety events.
- D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.
Correct answer: A
Rationale: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.
2. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?
- A. Tap water
- B. Sterile water
- C. Sodium chloride
- D. Normal saline
Correct answer: C
Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.
3. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. Be sure to take glipizide 30 minutes before meals.
- B. Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.
- C. You won't need to check your blood glucose level after you start taking glipizide.
- D. Take glipizide after a meal to prevent heartburn.
Correct answer: A
Rationale: Glipizide should be taken 30 minutes before meals to maximize its glucose-lowering effect.
4. A client with hyperthyroidism is being treated with radioactive iodine. The nurse should teach the client to expect which of the following side effects?
- A. Increased heart rate
- B. Hypothyroidism
- C. Hypercalcemia
- D. Weight loss
Correct answer: B
Rationale: When a client with hyperthyroidism undergoes radioactive iodine treatment, it often leads to hypothyroidism due to the destruction of thyroid tissue. This occurs as a desired outcome of the treatment to reduce the overactive thyroid function. Choices A, C, and D are incorrect. Increased heart rate, hypercalcemia, and weight loss are not expected side effects of radioactive iodine treatment for hyperthyroidism. Instead, the goal is to suppress the overactive thyroid, leading to a hypothyroid state.
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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