HESI RN
Leadership HESI Questions
Question 1 of 5
In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?
Correct Answer: A
Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.
Question 2 of 5
Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:
Correct Answer: C
Rationale: For a conscious client with hypoglycemia, the initial treatment should involve administering 15 to 20 g of a fast-acting carbohydrate, such as orange juice. This helps rapidly raise the client's blood glucose levels. Choices A and D are incorrect as administering glucagon or fast-acting insulin is not the first-line treatment for hypoglycemia in a conscious client. Choice B, an I.V. bolus of dextrose 50%, is a more invasive and aggressive intervention that is not typically indicated for a conscious client with hypoglycemia.
Question 3 of 5
What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?
Correct Answer: B
Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.
Question 4 of 5
A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is:
Correct Answer: B
Rationale: The correct answer is B: 6-14 hours after administration. NPH insulin has an onset of action within 1-2 hours, a peak action at 6-14 hours, and a duration of action of 16-24 hours. The peak action period, which is when the risk of hypoglycemia is highest, falls between 6-14 hours after administration. Choices A, C, and D are incorrect because they do not align with the typical action profile of NPH insulin.
Question 5 of 5
During a physical assessment of a client with type 2 DM, a nurse notes the following findings: fasting blood glucose of 120 mg/dl, temperature of 101°F, pulse 88 bpm, respirations 22/min, and BP 140/84 mmHg. Which finding should concern the nurse the most?
Correct Answer: D
Rationale: The correct answer is 'Temperature.' A temperature of 101°F indicates a fever, which can be a sign of infection. In individuals with diabetes, infections can lead to significant complications and affect blood glucose control. Monitoring and addressing infections promptly are crucial in individuals with diabetes to prevent worsening of their condition. Choice A, 'Pulse,' is within the normal range (60-100 bpm) and does not indicate an immediate concern. Choice B, 'BP,' while slightly elevated, is not as acutely concerning as an elevated temperature in this scenario. Choice C, 'Respiration,' falls within the normal range (12-20 breaths/min) and is not the most concerning finding among the options provided.