HESI MILESTONE #2 LATEST 2024 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |AGRADE

HESI MILESTONE #2 LATEST 2024 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |AGRADE HESI MILESTONE #2 LATEST 2024 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |AGRADE The nurse is performing an assessment on a client with a diagnosis of left-sided heart failure. Which assessment component would elicit specific information regarding the client's left-sided heart function? 1. Listening to lung sounds 2. Palpating for organomegaly 3. Assessing for jugular vein distention 4. Assessing for peripheral and sacral edema - CORRECT ANSWER - Listening to lung sounds. The client with heart failure may present with different symptoms, depending on whether the right or the left side of the heart is failing. Peripheral and sacral edema, jugular vein distention, and organomegaly all are manifestations of problems with right-sided heart function. Lung sounds constitute an accurate indicator of left- sided heart function. The registered nurse (RN) is educating a new RN about the use of oxygen for clients with angina pectoris. Which statement by the new nurse indicates that the teaching has been effective? 1. "Oxygen has a calming effect." 2. "Oxygen will prevent the development of any thrombus." 3. "The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells." 4. "Oxygen dilates the blood vessels so that they can supply more nutrients to the heart muscle." - CORRECT ANSWER - "The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells." The pain associated with angina results from ischemia of myocardial cells. The pain often is precipitated by activity that places more oxygen demand on heart muscle. Supplemental oxygen will help meet the added demands on the heart muscle. Oxygen does not dilate blood vessels or prevent thrombus formation and does not directly calm the client. The nurse has provided dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions? 1. "I'll need to become a strict vegetarian." 2. "I should use polyunsaturated oils in my diet." 3. "I need to substitute eggs and whole milk for meat." 4. "I should eliminate all cholesterol and fat from my diet." - CORRECT ANSWER - "I should use polyunsaturated oils in my diet." The client with coronary artery disease needs to avoid foods high in saturated fat and cholesterol such as eggs, whole milk, and red meat. These foods contribute to increases in low-density lipoproteins. The use of polyunsaturated oils is recommended to control hypercholesterolemia. It is not necessary to eliminate all cholesterol and fat from the diet. It is not necessary to become a strict vegetarian. The home care nurse has taught a client with heart failure and a problem of inadequate cardiac output about helpful lifestyle adaptations to promote health. Which statement by the client best demonstrates an understanding of the information provided? 1. "I will try to exercise vigorously to strengthen my heart muscle." 2. "I will eat enough daily fiber to prevent straining during bowel movement." 3. "I will drink 3000 to 3500 mL of fluid daily to promote good kidney function." 4. "Drinking 2 to 3 oz of liquor each night will promote blood flow by enlarging blood vessels." - CORRECT ANSWER - "I will eat enough daily fiber to prevent straining during bowel movement." Standard home care instructions for a client with this problem include, among others, lifestyle changes such as avoiding alcohol intake, avoiding activities that increase the demands on the heart, instituting a bowel regimen to prevent straining and constipation, and maintaining fluid and electrolyte balance. Consuming 3000 to 3500 mL of fluid and exercising vigorously will increase the cardiac workload. A client with heart failure has been experiencing difficulty with completion of daily activities, as evidenced by exertional fatigue and increased blood pressure. Which observation by the nurse best indicates client progress in meeting goals for this problem? 1. Ambulates 10 feet (3 meters) farther each day 2. Verbalizes the benefits of increasing activity 3. Chooses a healthy diet that meets caloric needs 4. Sleeps without awakening throughout the night - CORRECT ANSWER - Chooses a healthy diet that meets caloric needs Each of the options indicates a positive outcome on the part of the client. Both option 2 and the correct one relate to the client problem of difficulty with completion of daily activities. However, the question asks about progress. The correct option is more action-oriented and therefore is the better choice. Option 3 would most likely indicate progress if the client had a problem of inadequate nutritional intake. Option 4 would be a satisfactory outcome for a client experiencing difficulty sleeping. A client with coronary artery disease is scheduled to have a diagnostic exercise stress test. Which instruction would the nurse plan to provide to the client about this procedure? 1. Eat breakfast just before the procedure. 2. Wear firm, rigid shoes, such as work boots. 3. Wear loose clothing with a shirt that buttons in front. 4. Avoid cigarettes for 30 minutes before the procedure. - CORRECT ANSWER - Wear loose clothing with a shirt that buttons in front. The client needs to wear loose, comfortable clothing for the procedure. Electrocardiogram (ECG) lead placement is enhanced if the client wears a shirt that buttons in the front. The client needs to receive nothing by mouth after bedtime or for a minimum of 2 hours before the test. The client would wear rubber-soled, supportive shoes, such as athletic training shoes. The client needs to avoid smoking, alcohol, and caffeine on the day of the test. Inadequate or incorrect preparation can interfere with the test, with the potential for a false-positive result. A client recovering from pulmonary edema is preparing for discharge. What would the nurse plan to teach the client to do to manage or prevent recurrent symptoms after discharge? 1. Weigh self on a daily basis.