HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. Which of the following ethical principles is involved when protecting a patient's privacy and confidentiality?
- A. Fidelity
- B. Beneficence
- C. Confidentiality
- D. Justice
Correct answer: C
Rationale: Confidentiality is the ethical principle involved in protecting a patient's privacy and ensuring that personal information is not shared inappropriately. Fidelity refers to being faithful to commitments and keeping promises, not directly related to privacy and confidentiality. Beneficence involves doing good for the patient, and justice pertains to fairness and equal treatment, but they are not directly related to protecting privacy and confidentiality.
2. The client with type 1 DM asks why it is necessary to rotate injection sites when managing insulin therapy. The nurse's best response is:
- A. It helps prevent skin irritation.
- B. It helps prevent scar tissue buildup.
- C. It ensures more consistent insulin absorption.
- D. It makes the injections less painful.
Correct answer: C
Rationale: Rotating injection sites is necessary to ensure more consistent insulin absorption. This practice helps maintain stable blood glucose levels by preventing the formation of lipohypertrophy (fatty lumps under the skin) at injection sites. Choices A and B are incorrect as the primary purpose of rotating injection sites is not focused on preventing skin irritation or scar tissue buildup. While rotating injection sites may contribute to reducing pain over time, the primary benefit is the consistency in insulin absorption to support glycemic control, making choice D less relevant.
3. The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?
- A. Weight loss
- B. Flat neck and hand veins
- C. An increase in blood pressure
- D. A decreased central venous pressure (CVP)
Correct answer: C
Rationale: An increase in blood pressure is a common sign of fluid volume excess in clients with congestive heart failure due to the increased amount of fluid in the vascular system. Weight loss (Choice A) is not typically associated with fluid volume excess. Flat neck and hand veins (Choice B) are signs of fluid volume deficit, not excess. A decreased central venous pressure (CVP) (Choice D) is not expected in a client with fluid volume excess.
4. Nurse Wayne is aware that a positive Chvostek's sign indicates:
- A. Hypocalcemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypermagnesemia
Correct answer: A
Rationale: A positive Chvostek's sign indicates hypocalcemia. This sign is elicited by tapping the facial nerve anterior to the ear, resulting in facial muscle twitching due to increased neuromuscular irritability from low calcium levels. Hyponatremia (Choice B) is characterized by low sodium levels, but it does not present with Chvostek's sign. Hypokalemia (Choice C) is low potassium levels, and hypermagnesemia (Choice D) is high magnesium levels, neither of which are associated with Chvostek's sign.
5. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to:
- A. Administer a sedative
- B. Make sure the client knows all the correct medical terms to understand what is happening.
- C. Ignore the signs and symptoms of anxiety so that they will soon disappear.
- D. Convey empathy, trust, and respect toward the client.
Correct answer: D
Rationale: Conveying empathy, trust, and respect can help reduce the client's anxiety and improve their overall experience during treatment. This approach creates a supportive environment and fosters a sense of safety and understanding for the client. Administering a sedative (Choice A) should not be the initial intervention for anxiety, as it does not address the underlying emotional needs of the client. Making sure the client knows all the correct medical terms (Choice B) may increase anxiety by overwhelming the client with technical information. Ignoring signs and symptoms of anxiety (Choice C) can lead to worsening distress and potential complications in the client's care.
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