HESI RN
Leadership and Management HESI
1. Which of the following is a priority nursing diagnosis for a client with Addison's disease?
- A. Fluid volume deficit
- B. Risk for infection
- C. Imbalanced nutrition: Less than body requirements
- D. Disturbed body image
Correct answer: A
Rationale: The priority nursing diagnosis for a client with Addison's disease is 'Fluid volume deficit.' Addison's disease is characterized by adrenal insufficiency, resulting in decreased aldosterone production. Aldosterone plays a key role in sodium and water retention in the body. With its deficiency, there is an increased risk of dehydration and electrolyte imbalance, leading to fluid volume deficit. While infection risk, nutrition issues, and body image disturbances are also important considerations for holistic care, addressing the fluid volume deficit takes precedence due to the immediate physiological impact on the client's health and well-being.
2. The client with hypothyroidism is being educated by the healthcare provider about taking levothyroxine. Which of the following instructions should be included?
- A. Take the medication with meals
- B. Take the medication at bedtime
- C. Take the medication on an empty stomach in the morning
- D. Take the medication with a glass of milk
Correct answer: C
Rationale: The correct answer is to take levothyroxine on an empty stomach in the morning. This instruction is essential to enhance absorption and efficacy of the medication. Taking levothyroxine with meals, at bedtime, or with a glass of milk can interfere with its absorption and effectiveness, leading to suboptimal treatment outcomes.
3. 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.
4. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?
- A. Hyperglycemia
- B. Hypotension
- C. Hypokalemia
- D. Hyponatremia
Correct answer: B
Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.
5. Which of the following best describes the nurse's role in patient education?
- A. The nurse is responsible for providing patients with information they need to make informed decisions about their care.
- B. The nurse provides education to the patient and their family to help them understand the care plan and make informed decisions.
- C. The nurse is responsible for providing patients with written materials to help them understand their condition and treatment options.
- D. The nurse provides patients with verbal and written instructions on how to manage their care at home.
Correct answer: A
Rationale: The correct answer is A. The nurse's role in patient education involves providing patients with the necessary information to make informed decisions about their care. This includes explaining treatment options, potential risks and benefits, and answering any questions the patient may have. Choice B is incorrect because while nurses do educate patients and families, the primary focus is on empowering patients to make informed decisions. Choice C is incorrect as providing written materials is a part of patient education but not the sole responsibility of the nurse. Choice D is incorrect because while nurses do provide instructions on managing care at home, patient education goes beyond just the home care aspect to encompass a broader understanding of the patient's condition and treatment.
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