Milestone HESI Retake Questions &
Answers
Levels of Health Promotion - ANSWERSprimary, secondary, tertiary
Application Examples of Levels of Promotion - ANSWERSprimary- weight loss, diet,
smoking cessation
Secondary- papsmears, mammograms, testicular exams
Tertiary- medication therapy, surgical treatment, physical therapy, teaching foot care
education to diabetic care
Primary - ANSWERSpromotes health and preventing development of disease process
or injury
Secondary - ANSWERSscreening for early detection of disease
Tertiary - ANSWERSbegins after illness is diagnosed and treatment. Aims to prevent
long-term consequences of chronic illnesses or disabilities
Nursing Assessments - ANSWERSComprehensive- (Head to Toe) = Can be done
inpatient and through primary care (Physical assessment- annual exam)
Focused- Health and physical hx of specific problem.- ex. Sick visit
Emergency- crisis, life threatening. ex. airway, breathing, injury, disability, exposure,
med reconciliation
Phases of Interview process - ANSWERSPre-interaction, beginning, working (open and
close ended questions), closing
Data sources - ANSWERSPrimary- individual patient
Secondary- chart info, family members
Purposes of Documentation - ANSWERSverbal communication, SBAR, written
document
, Lifespan Nutritional Considerations - Nutrition: Pregnant Women - ANSWERSneed
additional 300-500 cal/day (whole foods
Lifespan Nutritional Considerations - Nutrition: infants/children -
ANSWERSinfants/children: whole milk for ages 2-5 fat intake-brain development
Lifespan Nutritional Considerations - Nutrition: Older - ANSWERSBMR declines,
Vitamin D supplements, Problems: decreased thirst, increase risk for osteoarthritis,
osteoporosis, dementia, obesity, social isolation
General Survey - ANSWERSmental note of overall health (hygiene/appearance).
Assessing pain: documentation, OLDCARTS/OPQRST. Aggravating and alleviating
factors, pain goal and funtional goal
Assessing Pain - Documentation - ANSWERSAcute vs. Chronic-Location
Priority - ANSWERSPriority pain: stones (kidney, gallbladder, calcium and/or struvite),
myocardial infarcation (HA), burns and sickle cell
Heart Rate Elevated - ANSWERSabove 100 beats per minute
Blood Pressure- Normal - ANSWERSabove systolic- 120-129, diastolic- less than 80,
Blood Pressure- elevated - ANSWERSHypertension: Stage 1: 130-139 or 80-89, Stage
Hypertension 2: more than 140, or greater than or equal to 90
When should BP be taken? - ANSWERSafter patient rests for 5 minutues or 30 minutes
after caffeine, smoking
Assessment of the Head and Neck - ANSWERSInspect, palpate, auscultate
Infection - ANSWERSIf nodes are palpable, warm, tender = infection
Assessment of the Ear - Techniques - ANSWERSAdults: up and back
Children: down and back
Assessment of the Ear - Techniques Part 2 - ANSWERSobserve behavioral responses
to speech, inspect ear formation (size, shape & any malformation to the auricle,
condition)
Perform whisper test & Rinne test. Pt plug one ear at a time
Perform weber test (evaluate unilateral hearing loss
Assessing the Chest - ANSWERSinspect, palpate, percuss, auscultate
Answers
Levels of Health Promotion - ANSWERSprimary, secondary, tertiary
Application Examples of Levels of Promotion - ANSWERSprimary- weight loss, diet,
smoking cessation
Secondary- papsmears, mammograms, testicular exams
Tertiary- medication therapy, surgical treatment, physical therapy, teaching foot care
education to diabetic care
Primary - ANSWERSpromotes health and preventing development of disease process
or injury
Secondary - ANSWERSscreening for early detection of disease
Tertiary - ANSWERSbegins after illness is diagnosed and treatment. Aims to prevent
long-term consequences of chronic illnesses or disabilities
Nursing Assessments - ANSWERSComprehensive- (Head to Toe) = Can be done
inpatient and through primary care (Physical assessment- annual exam)
Focused- Health and physical hx of specific problem.- ex. Sick visit
Emergency- crisis, life threatening. ex. airway, breathing, injury, disability, exposure,
med reconciliation
Phases of Interview process - ANSWERSPre-interaction, beginning, working (open and
close ended questions), closing
Data sources - ANSWERSPrimary- individual patient
Secondary- chart info, family members
Purposes of Documentation - ANSWERSverbal communication, SBAR, written
document
, Lifespan Nutritional Considerations - Nutrition: Pregnant Women - ANSWERSneed
additional 300-500 cal/day (whole foods
Lifespan Nutritional Considerations - Nutrition: infants/children -
ANSWERSinfants/children: whole milk for ages 2-5 fat intake-brain development
Lifespan Nutritional Considerations - Nutrition: Older - ANSWERSBMR declines,
Vitamin D supplements, Problems: decreased thirst, increase risk for osteoarthritis,
osteoporosis, dementia, obesity, social isolation
General Survey - ANSWERSmental note of overall health (hygiene/appearance).
Assessing pain: documentation, OLDCARTS/OPQRST. Aggravating and alleviating
factors, pain goal and funtional goal
Assessing Pain - Documentation - ANSWERSAcute vs. Chronic-Location
Priority - ANSWERSPriority pain: stones (kidney, gallbladder, calcium and/or struvite),
myocardial infarcation (HA), burns and sickle cell
Heart Rate Elevated - ANSWERSabove 100 beats per minute
Blood Pressure- Normal - ANSWERSabove systolic- 120-129, diastolic- less than 80,
Blood Pressure- elevated - ANSWERSHypertension: Stage 1: 130-139 or 80-89, Stage
Hypertension 2: more than 140, or greater than or equal to 90
When should BP be taken? - ANSWERSafter patient rests for 5 minutues or 30 minutes
after caffeine, smoking
Assessment of the Head and Neck - ANSWERSInspect, palpate, auscultate
Infection - ANSWERSIf nodes are palpable, warm, tender = infection
Assessment of the Ear - Techniques - ANSWERSAdults: up and back
Children: down and back
Assessment of the Ear - Techniques Part 2 - ANSWERSobserve behavioral responses
to speech, inspect ear formation (size, shape & any malformation to the auricle,
condition)
Perform whisper test & Rinne test. Pt plug one ear at a time
Perform weber test (evaluate unilateral hearing loss
Assessing the Chest - ANSWERSinspect, palpate, percuss, auscultate
