HESI RN Nursing Leadership and Management Exam 6

Questions 45

HESI RN

HESI RN Test Bank

HESI RN Nursing Leadership and Management Exam 6 Questions

Question 1 of 5

After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. What would the nurse expect the physician to do?

Correct Answer: A

Rationale: When a client experiences secondary failure to an oral antidiabetic agent like glipizide, the next step is often to initiate insulin therapy. This is because secondary failure indicates that the current oral antidiabetic medication is no longer effective in managing blood glucose levels, and insulin therapy may be required to adequately control blood sugar. Switching to a different oral antidiabetic agent may not be effective if there is already resistance to the current agent. Adding another oral antidiabetic agent may not address the underlying issue of secondary failure. Restricting carbohydrate intake is important for diabetes management but is not the primary intervention indicated in this scenario of secondary failure to glipizide.

Question 2 of 5

How often should rotation sites for insulin injection be separated from one another?

Correct Answer: C

Rationale: Insulin injection sites should be rotated every 2-3 weeks to prevent lipodystrophy and ensure proper insulin absorption. Option A ('Every third day') is too frequent and does not allow enough time for the previous site to heal properly. Option B ('Every week') might not provide adequate time for the tissue to recover. Option D ('Every 2-4 weeks') could potentially lead to overuse of a single injection site, increasing the risk of lipodystrophy and inconsistent insulin absorption. Therefore, the recommended interval of every 2-3 weeks is optimal for insulin injection site rotation.

Question 3 of 5

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

Correct Answer: A

Rationale: Diabetes insipidus is a condition characterized by a deficiency of antidiuretic hormone (ADH). ADH plays a crucial role in regulating water balance by controlling the amount of water reabsorbed by the kidneys. Options B, C, and D are incorrect as they are not associated with diabetes insipidus. TSH (thyroid-stimulating hormone) is responsible for regulating thyroid function, while FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are involved in reproductive functions.

Question 4 of 5

A client with type 1 diabetes mellitus presents to the emergency department with symptoms of diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?

Correct Answer: B

Rationale: The correct first intervention in a client with DKA is to start an intravenous line and infuse normal saline for fluid resuscitation. This is crucial to restore intravascular volume and improve perfusion, addressing the dehydration and electrolyte imbalances commonly seen in DKA. Administering insulin without addressing the dehydration can lead to further complications. Monitoring serum potassium levels is important but is not the first priority; potassium levels can shift with fluid resuscitation. Obtaining an arterial blood gas (ABG) is helpful in assessing acid-base status but is not the initial priority compared to fluid resuscitation.

Question 5 of 5

The nurse is caring for a client with a history of adrenal insufficiency. The nurse should monitor for which of the following signs of an Addisonian crisis?

Correct Answer: C

Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.

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