HESI RN
Leadership and Management HESI Questions
Question 1 of 9
A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?
Correct Answer: C
Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.
Question 2 of 9
A client with Cushing's syndrome is being monitored for complications. Which of the following findings should the nurse report to the healthcare provider immediately?
Correct Answer: C
Rationale: The correct answer is C: Low-grade fever. A low-grade fever may indicate an infection, which is a serious concern in clients with Cushing's syndrome due to their immunosuppressed state. Hypertension and hyperglycemia are common manifestations of Cushing's syndrome and may not require immediate reporting unless severe or uncontrolled. Weight gain is also a common symptom in clients with Cushing's syndrome and may not warrant immediate reporting unless it is sudden and significant.
Question 3 of 9
A client with diabetes mellitus is experiencing symptoms of hypoglycemia. Which of the following is the nurse's priority action?
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.
Question 4 of 9
A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?
Correct Answer: B
Rationale: The correct first intervention in the treatment of a client with diabetic ketoacidosis (DKA) is to start an intravenous line and infuse normal saline. This is essential for fluid resuscitation to restore intravascular volume and improve perfusion. Administering intravenous insulin can lead to further potassium depletion without first addressing dehydration and electrolyte imbalances. Monitoring serum potassium levels is important but should follow fluid resuscitation to avoid life-threatening hypokalemia. Obtaining an arterial blood gas (ABG) is necessary to assess the acid-base status but is not the initial priority when managing DKA.
Question 5 of 9
A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?
Correct Answer: A
Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.
Question 6 of 9
A client with Addison's disease is being educated about managing the condition during times of stress. The nurse should instruct the client to:
Correct Answer: A
Rationale: Clients with Addison's disease should be educated to double their corticosteroid dosage during periods of stress. This is crucial to prevent adrenal crisis, as stress can increase the body's demand for cortisol. Skipping doses when feeling well can lead to an adrenal crisis if stress occurs suddenly. Decreasing fluid intake can exacerbate dehydration and electrolyte imbalances, which are already concerns in Addison's disease. Avoiding physical activity during stressful times is not the most appropriate advice; moderate physical activity can be beneficial, as long as the client is adequately managing their corticosteroid regimen.
Question 7 of 9
The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should the healthcare provider report?
Correct Answer: B
Rationale: In Cushing's syndrome, hyperglycemia is a common finding due to increased cortisol levels leading to insulin resistance. This can have serious implications such as diabetes mellitus and should be promptly reported for appropriate management. Hypotension (choice A) is more commonly associated with Addison's disease, not Cushing's syndrome. Weight gain rather than weight loss (choice C) is typically observed in clients with Cushing's syndrome. While hypokalemia (choice D) can occur in Cushing's syndrome due to excess cortisol affecting potassium levels, it is not as critical as hyperglycemia and may not be the priority for immediate reporting.
Question 8 of 9
A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional's response to this situation?
Correct Answer: A
Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient's family.
Question 9 of 9
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:
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.