HURST REVIEW NCLEX-RN READINESS EXAM
1 UPDATED 2025 2026 WITH ALL NEW
QUESTIONS AND EXACTLY RIGHT ANSWERS |
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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 - ANSWER: 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
safely be delivered over a period of at least 2 minutes. Five minutes would be
longer than required to be able to safely administer the medication.
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4. 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. Ten minutes is much longer
than required to be able to safely administer the medication.
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 - ANSWER: 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.
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4. Incorrect: Although the food in the stomach causes the pancreatic enzymes to
become activated in the pancreas due to the obstruction, the food is not considered
an irritant. Precipitating irritants are not a part of the pathophysiology occurring
with pancreatitis.
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. - ANSWER: 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.
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.
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5. Flowers are not allowed in the room. - ANSWER: 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.
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? - ANSWER: 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