HURST REVIEW NCLEX-RN READINESS EXAM 1 QUESTIONS AND ANSWERS |
COMPLETE HURST READINESS EXAM 1 STUDY GUIDE 2026/2027
2. Correct: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or
50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min
(or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes. Giving this
dose over only one minute could lead to these or other potential harmful effects.
3. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min
(or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can s - ANS ✔✔The primary healthcare provider has prescribed
phenytoin 100 mg intravenous push (IVP) stat for an adult client. What is the least amount of time that
the nurse can safely administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes
2. Correct: In clients with pancreatitis, the pancreatic enzymes cannot exit the pancreas. These enzymes,
when activated, begin to digest the pancreas itself. The enzymes become activated in the pancreas when
fluid or food accumulates in the stomach. The goal in treating this client is to stop the activation of the
pancreatic enzymes. Treatment is focused on keeping the stomach empty and dry. This allows the
pancreas time to rest and heal. Note: Autodigestion (pancreas digesting itself) is painful for the client
and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep the stomach empty and dry to
decrease pancreatic enzyme production, not to relieve nausea.
3. Incorrect: Because gastric contents are removed, the NG tube to suction may lead to fluid and
electrolyte disturbances rather than helping to control them.
4. Incorrect: Although the food in the - ANS ✔✔A client, hospitalized with possible acute pancreatitis
secondary to chronic cholecystitis, has severe abdominal pain and nausea. The client is kept NPO, an NG
tube is inserted, and IV fluids are being administered. What is the rationale for the client being NPO with
an NG tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants
1., 2., 3. & 5. Correct: Everyone should be aware of safe zones within the school. Personnel should be
given this information and signs posted in safe zones. There must be systems in place to accurately
,determine the number of people in the building at any given time. There also must be a system in place
to alert personnel and students of tornado warnings. Regular practice prepares everyone for an actual
event.
4. Incorrect: Gymnasiums are not considered safe places due to wide expanse of roof. Safe zones should
be on interior walls, no windows, and a strong concrete floor if possible. - ANS ✔✔The nurse is working
with a committee at the local school to develop an emergency preparedness plan for tornados. What
should be included in the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols.
1., 2., 4., & 5. Correct: Protective isolation is needed for this client because of the presence of a low
white blood cell count. We are protecting the client from acquiring an infection. So any visitors will need
to have meticulous hand washing prior to entering. The visitor should not enter if he or she has any type
of infection. To decrease the risk of infection, small children should not visit. Even the mildest symptom
of infection could be detrimental to the client. Flowers have bacteria and should not be brought into the
room.
3. Incorrect: A mask must be worn by the visitor, not the client. The mask is worn by visitors to prevent a
possible spread of an airborne infection to the immunocompromised client. - ANS ✔✔What should a
nurse teach family members prior to them entering the room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room.
2. Correct: Myoclonus, high body temperature, shaking, chills, and mental confusion are some of the
symptoms of serotonin syndrome. This client may be having symptoms of this adverse reaction which, if
severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective serotonin reuptake inhibitors
(SSRIs) may cause insomnia; however, there is a more pertinent question needed for assessment of this
client. You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the client is exhibiting significant
symptoms of an adverse reaction which would take priority.
4. Incorrect: The response to the SSRI medications is important; however, there is a more significant
issue in this case. The possible serotonin syndrome is a serious situation that would be the priority for
the nurse to address. - ANS ✔✔A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the mental health center, the nurse
discusses the medication and response with the client. The nurse's assessment reveals that the client is
confused about the date and about the prescribed dosage of the medication. Which question would be
most important for the nurse to ask to further assess the situation?
,1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving?
1., 2. & 5. Correct: Serotonin syndrome is a group of symptoms that can result from the use of certain
serotonin reuptake inhibitors. These symptoms can range from mild to severe and include high body
temperature, agitation, increased reflexes, diaphoresis, tremors, dilated pupils and diarrhea. The client is
likely to experience shivering with fever. Increased heart rate and blood pressure are also commonly
experienced. More severe symptoms, including muscle rigidity and seizures, can occur. If not treated,
serotonin syndrome can be fatal.
3. Incorrect: Increased body temperature is expected as is increased diaphoresis.
4. Incorrect: Diarrhea, not constipation, is a symptom of serotonin syndrome. - ANS ✔✔A client
diagnosed with serotonin syndrome is admitted to the unit. The nurse is familiar with this adverse
reaction to the serotonin reuptake inhibitors. Which symptoms can the nurse expect on assessment?
1. Fever and shivering
2. Agitation
3. Decreased body temperature
4. Constipation
5. Increased heart rate
1. Correct: These ABGs are indicative of metabolic alkalosis. The pH is high, the pCO2 is within normal
limits and the bicarb is high (alkalosis). So, the excess Tums (calcium carbonate) could have caused
metabolic alkalosis.
2. Incorrect: The client is not hypoventilating and would not be in metabolic acidosis because he ate 3
rolls of Tums which is a base. These ABGs are indicative of acidosis. The pH is low (acidosis), the pCO2 is
high (acidosis) and the bicarb is low (acidosis).
3. Incorrect: The client is not a long-term COPD client as these ABGs might suggest. These ABGs are
indicative of fully compensated respiratory acidosis. The pH is normal. The pCO2 is high (as with chronic
retention) and the bicarb is high to help compensate.
4. Incorrect: These ABGs are the result of an acute ventilation problem. They are indicative of respiratory
acidosis. The pH is low, the pCO2 is high, and the bicarb is normal. No - ANS ✔✔The emergency
department nurse is assessing a client who presents with severe epigastric pain. The client reports that
three rolls of calcium carbonate were consumed in the past eight hours to treat the indigestion. Which
blood gas report does the nurse associate with this situation?
1. pH - 7.49, pCO2 - 40, HCO3 - 30
2. pH - 7.32, pCO2 - 48, HCO3 - 20
3. pH - 7.38, pCO2 - 52, HCO3 - 32
4. pH - 7.29, pCO2 - 54, HCO3 - 26
1., 2. & 3. Correct: According to the current standards of Standard Precautions per the CDC, the client
with shingles should be placed on airborne precautions which require the use of a private room with
negative pressure airflow and a N-95 respirator mask.
, 4. Incorrect: A face shield is used when there is risk of splashing or spraying of blood or body fluids. This
is not required for airborne precautions.
5. Incorrect: Negative pressure is required in order to prevent the airborne infection from spreading
outside of the room. Positive pressure is used only in protective environments such as when
immunocompromised clients require protection from potential infectious agents outside of the room. -
ANS ✔✔Which prescriptions would the nurse recognize as being appropriate for the client with
shingles?
1. Private room
2. Negative pressure airflow
3. Respirator mask
4. Face Shield
5. Positive pressure room
Remember Maslow's hierarchy of needs will guide your assessment. First, Assess newborn's airway and
breathing. The most critical change that a newborn must make physiologically is the initiation of
breathing. The nurse should assess the newborn's crying. If the cry is weak, it may indicate a respiratory
disturbance. Other signs of respiratory compromise may include: stridor, grunting, retractions, apnea or
diminished breath sounds. Normal respiration are 30 - 60 breaths a minute.
Second, Bulb suction excessive mucus. It is important to assure that the throat and nose are kept clean
of secretions to prevent respiratory distress.
Third, Assess newborn's heart rate. If there is no respiratory distress, the nurse continues the assessment
by checking the heart rate and other vital signs.
Fourth, Place identification bands on newborn and mom. These are critical for ensuring babies and
moms will be appropriately matche - ANS ✔✔A healthy newborn has just been delivered and placed in
the care of the nurse. What nursing actions should the nurse initiate?
Place in the correct priority order.
Assess newborn's airway and breathing.
Bulb suction excessive mucus.
Assess newborn's heart rate.
Place identification bands on newborn and mom.
Administer sterile ophthalmic ointment containing 0.5% erythromycin.
1., 2., & 3. Correct: These are correct statements about buccal administration of medication. Buccal
administration involves the medication being placed between the gums and cheek, where it dissolves
and becomes absorbed into the bloodstream. The cheek area has many capillaries that allow the
medication to be absorbed quickly without having to pass through the digestive system. The degree of
stinging experienced depends on the medication being administered. Some effects of certain
medications can be lessened by digestive processes.
COMPLETE HURST READINESS EXAM 1 STUDY GUIDE 2026/2027
2. Correct: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or
50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min
(or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes. Giving this
dose over only one minute could lead to these or other potential harmful effects.
3. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min
(or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and
cardiac arrhythmias. So 100 mg can s - ANS ✔✔The primary healthcare provider has prescribed
phenytoin 100 mg intravenous push (IVP) stat for an adult client. What is the least amount of time that
the nurse can safely administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes
2. Correct: In clients with pancreatitis, the pancreatic enzymes cannot exit the pancreas. These enzymes,
when activated, begin to digest the pancreas itself. The enzymes become activated in the pancreas when
fluid or food accumulates in the stomach. The goal in treating this client is to stop the activation of the
pancreatic enzymes. Treatment is focused on keeping the stomach empty and dry. This allows the
pancreas time to rest and heal. Note: Autodigestion (pancreas digesting itself) is painful for the client
and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep the stomach empty and dry to
decrease pancreatic enzyme production, not to relieve nausea.
3. Incorrect: Because gastric contents are removed, the NG tube to suction may lead to fluid and
electrolyte disturbances rather than helping to control them.
4. Incorrect: Although the food in the - ANS ✔✔A client, hospitalized with possible acute pancreatitis
secondary to chronic cholecystitis, has severe abdominal pain and nausea. The client is kept NPO, an NG
tube is inserted, and IV fluids are being administered. What is the rationale for the client being NPO with
an NG tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants
1., 2., 3. & 5. Correct: Everyone should be aware of safe zones within the school. Personnel should be
given this information and signs posted in safe zones. There must be systems in place to accurately
,determine the number of people in the building at any given time. There also must be a system in place
to alert personnel and students of tornado warnings. Regular practice prepares everyone for an actual
event.
4. Incorrect: Gymnasiums are not considered safe places due to wide expanse of roof. Safe zones should
be on interior walls, no windows, and a strong concrete floor if possible. - ANS ✔✔The nurse is working
with a committee at the local school to develop an emergency preparedness plan for tornados. What
should be included in the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols.
1., 2., 4., & 5. Correct: Protective isolation is needed for this client because of the presence of a low
white blood cell count. We are protecting the client from acquiring an infection. So any visitors will need
to have meticulous hand washing prior to entering. The visitor should not enter if he or she has any type
of infection. To decrease the risk of infection, small children should not visit. Even the mildest symptom
of infection could be detrimental to the client. Flowers have bacteria and should not be brought into the
room.
3. Incorrect: A mask must be worn by the visitor, not the client. The mask is worn by visitors to prevent a
possible spread of an airborne infection to the immunocompromised client. - ANS ✔✔What should a
nurse teach family members prior to them entering the room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room.
2. Correct: Myoclonus, high body temperature, shaking, chills, and mental confusion are some of the
symptoms of serotonin syndrome. This client may be having symptoms of this adverse reaction which, if
severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective serotonin reuptake inhibitors
(SSRIs) may cause insomnia; however, there is a more pertinent question needed for assessment of this
client. You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the client is exhibiting significant
symptoms of an adverse reaction which would take priority.
4. Incorrect: The response to the SSRI medications is important; however, there is a more significant
issue in this case. The possible serotonin syndrome is a serious situation that would be the priority for
the nurse to address. - ANS ✔✔A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the mental health center, the nurse
discusses the medication and response with the client. The nurse's assessment reveals that the client is
confused about the date and about the prescribed dosage of the medication. Which question would be
most important for the nurse to ask to further assess the situation?
,1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving?
1., 2. & 5. Correct: Serotonin syndrome is a group of symptoms that can result from the use of certain
serotonin reuptake inhibitors. These symptoms can range from mild to severe and include high body
temperature, agitation, increased reflexes, diaphoresis, tremors, dilated pupils and diarrhea. The client is
likely to experience shivering with fever. Increased heart rate and blood pressure are also commonly
experienced. More severe symptoms, including muscle rigidity and seizures, can occur. If not treated,
serotonin syndrome can be fatal.
3. Incorrect: Increased body temperature is expected as is increased diaphoresis.
4. Incorrect: Diarrhea, not constipation, is a symptom of serotonin syndrome. - ANS ✔✔A client
diagnosed with serotonin syndrome is admitted to the unit. The nurse is familiar with this adverse
reaction to the serotonin reuptake inhibitors. Which symptoms can the nurse expect on assessment?
1. Fever and shivering
2. Agitation
3. Decreased body temperature
4. Constipation
5. Increased heart rate
1. Correct: These ABGs are indicative of metabolic alkalosis. The pH is high, the pCO2 is within normal
limits and the bicarb is high (alkalosis). So, the excess Tums (calcium carbonate) could have caused
metabolic alkalosis.
2. Incorrect: The client is not hypoventilating and would not be in metabolic acidosis because he ate 3
rolls of Tums which is a base. These ABGs are indicative of acidosis. The pH is low (acidosis), the pCO2 is
high (acidosis) and the bicarb is low (acidosis).
3. Incorrect: The client is not a long-term COPD client as these ABGs might suggest. These ABGs are
indicative of fully compensated respiratory acidosis. The pH is normal. The pCO2 is high (as with chronic
retention) and the bicarb is high to help compensate.
4. Incorrect: These ABGs are the result of an acute ventilation problem. They are indicative of respiratory
acidosis. The pH is low, the pCO2 is high, and the bicarb is normal. No - ANS ✔✔The emergency
department nurse is assessing a client who presents with severe epigastric pain. The client reports that
three rolls of calcium carbonate were consumed in the past eight hours to treat the indigestion. Which
blood gas report does the nurse associate with this situation?
1. pH - 7.49, pCO2 - 40, HCO3 - 30
2. pH - 7.32, pCO2 - 48, HCO3 - 20
3. pH - 7.38, pCO2 - 52, HCO3 - 32
4. pH - 7.29, pCO2 - 54, HCO3 - 26
1., 2. & 3. Correct: According to the current standards of Standard Precautions per the CDC, the client
with shingles should be placed on airborne precautions which require the use of a private room with
negative pressure airflow and a N-95 respirator mask.
, 4. Incorrect: A face shield is used when there is risk of splashing or spraying of blood or body fluids. This
is not required for airborne precautions.
5. Incorrect: Negative pressure is required in order to prevent the airborne infection from spreading
outside of the room. Positive pressure is used only in protective environments such as when
immunocompromised clients require protection from potential infectious agents outside of the room. -
ANS ✔✔Which prescriptions would the nurse recognize as being appropriate for the client with
shingles?
1. Private room
2. Negative pressure airflow
3. Respirator mask
4. Face Shield
5. Positive pressure room
Remember Maslow's hierarchy of needs will guide your assessment. First, Assess newborn's airway and
breathing. The most critical change that a newborn must make physiologically is the initiation of
breathing. The nurse should assess the newborn's crying. If the cry is weak, it may indicate a respiratory
disturbance. Other signs of respiratory compromise may include: stridor, grunting, retractions, apnea or
diminished breath sounds. Normal respiration are 30 - 60 breaths a minute.
Second, Bulb suction excessive mucus. It is important to assure that the throat and nose are kept clean
of secretions to prevent respiratory distress.
Third, Assess newborn's heart rate. If there is no respiratory distress, the nurse continues the assessment
by checking the heart rate and other vital signs.
Fourth, Place identification bands on newborn and mom. These are critical for ensuring babies and
moms will be appropriately matche - ANS ✔✔A healthy newborn has just been delivered and placed in
the care of the nurse. What nursing actions should the nurse initiate?
Place in the correct priority order.
Assess newborn's airway and breathing.
Bulb suction excessive mucus.
Assess newborn's heart rate.
Place identification bands on newborn and mom.
Administer sterile ophthalmic ointment containing 0.5% erythromycin.
1., 2., & 3. Correct: These are correct statements about buccal administration of medication. Buccal
administration involves the medication being placed between the gums and cheek, where it dissolves
and becomes absorbed into the bloodstream. The cheek area has many capillaries that allow the
medication to be absorbed quickly without having to pass through the digestive system. The degree of
stinging experienced depends on the medication being administered. Some effects of certain
medications can be lessened by digestive processes.
