HESI RN
HESI Leadership and Management
1. What is the nurse's responsibility when dealing with an impaired colleague?
- A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
- B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
- C. Nonmaleficence
- D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.
Correct answer: A
Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.
2. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamines, Nurse April is most likely to detect:
- A. A blood pressure of 130/70 mm Hg
- B. A blood glucose level of 130 mg/dl
- C. Bradycardia
- D. A blood pressure of 176/88 mm Hg
Correct answer: D
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive catecholamines, leading to symptoms such as hypertension. The normal blood pressure range is around 120/80 mm Hg, so a blood pressure reading of 176/88 mm Hg is most likely to be detected in a client with pheochromocytoma. Choices A, B, and C are incorrect because pheochromocytoma typically presents with hypertension, not a normal or low blood pressure (choice A), not related to blood glucose levels (choice B), and not bradycardia (choice C).
3. Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client's need for additional teaching when the client states:
- A. If I have hypoglycemia, I should eat some sugar, not dextrose.
- B. The drug makes my pancreas release more insulin.
- C. I should never take insulin while I'm taking this drug.
- D. It's best if I take the drug with the first bite of a meal.
Correct answer: B
Rationale: The correct answer is B. Acarbose (Precose) is an alpha-glucosidase inhibitor that works by slowing carbohydrate absorption in the intestine, not by stimulating insulin release. Therefore, the client would need additional teaching if they state that the drug makes their pancreas release more insulin (Choice B). Choices A, C, and D are incorrect. Choice A is incorrect because during hypoglycemia, it is recommended to consume glucose or dextrose to rapidly raise blood sugar levels. Choice C is incorrect because insulin therapy may still be needed in some cases, even when taking acarbose. Choice D is incorrect because acarbose should be taken at the start of a meal to help reduce postprandial blood glucose levels.
4. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. Which of the following is the nurse's priority action?
- A. Administer glucagon
- B. Check the client's blood glucose level
- C. Give the client a snack
- D. Notify the healthcare provider
Correct answer: B
Rationale: The correct answer is to check the client's blood glucose level. This is the priority action to confirm hypoglycemia before implementing further interventions. Administering glucagon (Choice A) may be necessary in severe cases of hypoglycemia, but confirming the low blood glucose level is crucial before administering any treatment. Giving the client a snack (Choice C) can help raise blood sugar levels but should come after confirming the hypoglycemia. Notifying the healthcare provider (Choice D) is important, but the immediate priority is to assess and address the hypoglycemia.
5. A nurse is preparing to administer insulin to a client with DM. The nurse understands that the peak time for rapid-acting insulin, such as lispro (Humalog), is:
- A. 30 minutes to 1 hour after administration.
- B. 1 to 2 hours after administration.
- C. 2 to 4 hours after administration.
- D. 3 to 5 hours after administration.
Correct answer: A
Rationale: The correct answer is A: 30 minutes to 1 hour after administration. Rapid-acting insulins like lispro, such as Humalog, peak quickly within 30 minutes to 1 hour after administration. This peak time is crucial to monitor for potential hypoglycemia, which is most likely to occur during this period. Choice B is incorrect as it suggests a longer peak time for rapid-acting insulin, which is inaccurate. Choices C and D are also incorrect because they indicate even longer peak times, which do not align with the rapid onset and peak action of lispro insulin.
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