Leadership HESI

Leadership HESI Related

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An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:

  • A. 2 to 5 g of a simple carbohydrate.
  • B. 10 to 15 g of a simple carbohydrate.
  • C. 18 to 20 g of a simple carbohydrate.
  • D. 25 to 30 g of a simple carbohydrate.
Correct Answer: B

Rationale: The correct answer is B: 10 to 15 g of a simple carbohydrate. In the treatment of hypoglycemia, it is important to administer a specific amount of simple carbohydrates to raise blood glucose levels effectively without causing hyperglycemia. 10 to 15 g of simple carbohydrates, such as glucose tablets, fruit juice, or regular soft drinks, is recommended to rapidly increase blood sugar levels in clients experiencing hypoglycemia. Choices A, C, and D are incorrect as they either provide too little or too much glucose, which may not effectively treat the hypoglycemic episode or may lead to rebound hyperglycemia.

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A client with diabetes insipidus is being treated with desmopressin. The nurse should monitor for which of the following side effects?

  • A. Hyponatremia
  • B. Hypernatremia
  • C. Hypokalemia
  • D. Hypercalcemia
Correct Answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used in diabetes insipidus, can cause water retention by increasing water reabsorption in the kidneys. This excess water retention can lead to dilutional hyponatremia, where sodium levels in the body become too low. Monitoring for hyponatremia is crucial to prevent complications such as neurological symptoms. Choices B, C, and D are incorrect because desmopressin is not known to cause hypernatremia, hypokalemia, or hypercalcemia.

A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?

  • A. Dry skin
  • B. Decreased urinary output
  • C. Hyperactive bowel sounds
  • D. Increased specific gravity of the urine
Correct Answer: C

Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.

A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

  • A. Obtaining a controlled IV infusion pump
  • B. Monitoring urine output during administration
  • C. Diluting an appropriate amount of normal saline
  • D. Preparing the medication for bolus administration
Correct Answer: D

Rationale: The correct answer is preparing the medication for bolus administration (Choice D). Potassium should never be administered as a bolus because it can cause cardiac arrest. It must always be diluted and given slowly. Obtaining a controlled IV infusion pump (Choice A) is essential for accurate delivery, monitoring urine output during administration (Choice B) helps assess the client's response, and diluting an appropriate amount of normal saline (Choice C) is necessary to prevent irritation and ensure safe administration.

The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?

  • A. I should take my medication every day as prescribed.
  • B. I need to avoid foods high in iodine.
  • C. I can skip my medication on days when I feel fine.
  • D. I should monitor my pulse regularly.
Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

The client with type 2 DM is learning to manage blood glucose levels. When should the client monitor blood glucose?

  • A. Only when feeling unwell.
  • B. Only before meals.
  • C. Before meals and at bedtime.
  • D. Only after meals.
Correct Answer: C

Rationale: The correct answer is to monitor blood glucose before meals and at bedtime. This timing allows the client to assess fasting levels and make informed decisions about mealtime insulin or medication doses. Monitoring only when feeling unwell (choice A) is not sufficient for proper glucose management as it may miss important trends. Monitoring only before meals (choice B) is helpful but does not provide a complete picture of the client's glucose control throughout the day. Monitoring only after meals (choice D) is less beneficial than monitoring before meals as it does not capture fasting levels. Therefore, monitoring before meals and at bedtime (choice C) is the most comprehensive approach to maintain good glucose control and prevent complications.

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