HESI RN
HESI RN Nursing Leadership and Management Exam 5
1. Which of the following symptoms would be most concerning in a client with diabetes insipidus?
- A. Polydipsia
- B. Polyuria
- C. Nocturia
- D. Hypertension
Correct answer: D
Rationale: In a client with diabetes insipidus, excessive thirst (polydipsia) and excessive urination (polyuria) are expected symptoms due to the inability to concentrate urine, leading to dilute urine production. Nocturia, waking up at night to urinate, is also common. However, hypertension is not a typical symptom of diabetes insipidus. The correct answer is D because hypertension may indicate a complication such as dehydration or electrolyte imbalances, which would require further assessment in a client with diabetes insipidus.
2. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?
- A. Take the medication with meals.
- B. Take the medication on an empty stomach.
- C. Avoid taking the medication if you miss a meal.
- D. Take the medication before bedtime.
Correct answer: A
Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.
3. A male client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder?
- A. Serum potassium level
- B. Serum sodium level
- C. Arterial blood gas (ABG) values
- D. Serum osmolarity
Correct answer: D
Rationale: Serum osmolarity is the most important laboratory test for confirming hyperosmolar hyperglycemic nonketotic syndrome (HHNS). HHNS is characterized by severe hyperglycemia and dehydration without ketoacidosis. Elevated serum osmolarity indicates increased solute concentration in the blood, which is a hallmark of HHNS. Serum potassium level (Choice A) is important in conditions like diabetic ketoacidosis rather than HHNS. Serum sodium level (Choice B) may be affected in HHNS but is not the primary test for confirming the disorder. Arterial blood gas (ABG) values (Choice C) are more useful in assessing acid-base status, which is not the primary concern in HHNS.
4. A nurse manager works hard to keep employee morale high with the thought that this will lead to effective employees doing the best work they can. Which of the following theories does this best describe?
- A. Theory X
- B. Theory Y
- C. Servant leadership
- D. Scientific management
Correct answer: B
Rationale: Theory Y, as proposed by Douglas McGregor, emphasizes that employees are intrinsically motivated and seek responsibility. It suggests that high morale leads to high productivity, aligning with the nurse manager's actions. Theory X, on the other hand, assumes employees are inherently lazy and need to be closely monitored and controlled. Servant leadership focuses on serving others first and prioritizing their needs, which is not directly related to the scenario described. Scientific management, developed by Frederick Taylor, emphasizes efficiency and standardization through systematic study and organizational control, which is not the primary focus of the nurse manager's approach to boosting employee morale.
5. A healthcare provider is educating a client with DM on recognizing symptoms of hypoglycemia. Which symptom should the healthcare provider mention?
- A. Increased thirst
- B. Frequent urination
- C. Sweating
- D. Weight loss
Correct answer: C
Rationale: The correct symptom to mention when educating a client with diabetes mellitus (DM) on hypoglycemia is sweating. Sweating is a common symptom of hypoglycemia as it occurs due to the activation of the sympathetic nervous system in response to low blood sugar levels. Increased thirst (Choice A) and frequent urination (Choice B) are more indicative of hyperglycemia (high blood sugar) rather than hypoglycemia. Weight loss (Choice D) is not a typical symptom associated with hypoglycemia.
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