HURST READINESS EXAM #3 & #4 QUESTIONS AND ANSWERS | COMPLETE
HURST NCLEX READINESS STUDY GUIDE 2026/2027
A charge nurse is planning care for several clients on the unit. Which activities can the nurse safely
delegate to an unlicensed assistive personnel (UAP) member?
1. Administer a nebulizer treatment to a client diagnosed with pneumonia.
2. Obtain vital signs on a postoperative client who required naloxone 5 minutes ago.
3. Report a urinary output (UOP) less than 50 ml/hr on a post-op client.
4. Assist a client with obtaining a clean catch urine sample.
5. Remove an indwelling urinary catheter from a client. - ANS ✔✔3,4
What should the nurse teach a pregnant client who comes to the clinic reporting hemorrhoids and
constipation?
1. Increased rectal pressure from the gravid uterus may result in hemorrhoids.
2. Hormones decrease maternal GI motility, resulting in constipation.
3. The client needs more fiber in the diet.
4. A mild laxative is recommended to alleviate constipation.
5. The client needs to increase fluid intake.
Rationale - ANS ✔✔1,2,3,5
What statements by a new nurse would indicate to the charge nurse an understanding of how to
maintain skin integrity for a client on bedrest?
1. "Clients on bedrest should be placed on therapeutic mattresses."
2. "I will assess for the skin every 4 hours."
3. "I will assess the skin using the Braden scale."
4. "A pillow will be placed between the knees when client is side lying."
5. "The incontinent client will be kept clean and dry." - ANS ✔✔1,3,4,5
The primary healthcare provider suspects the client has tuberculosis (TB) and prescribes a Mantoux test.
What precautions should the nurse take when administering the Mantoux test?
1. Don sterile gloves.
2. Place the client on reverse isolation.
3. Wear a particulate respirator
4. Obtain a consent form.
5. Initiate airborne precautions. - ANS ✔✔3,5
Which finding should a nurse expect when assessing a healthy 65 year old client?
1. Anomia
2. Presbyopia
3. BP 156/88
,4. Apraxia - ANS ✔✔2
The charge nurse is evaluating knowledge of tracheostomy suctioning of a new nurse prior to that
procedure being performed. Which statement by the new nurse would indicate to the charge nurse that
additional education is needed?
1. "Prior to suctioning, I will hyper-oxygenate the client."
2. "I will instill normal saline bullets to liquefy secretions."
3. "I will allow at least 20 seconds between suctioning passes."
4. "Suctioning will be limited to a maximum of three catheter passes." - ANS ✔✔2
The nurse observes a client at a follow-up appointment using correct cane walking technique but losing
balance each time the quad cane is lifted off of the floor. The client reports a history of recent falls. What
is the best action for the nurse to take?
1. Inform the primary healthcare provider of the observations made regarding quad cane use, and
imbalance assessment.
2. Inform client that there are only a few assistive devices available to help with ambulation.
3. Instruct the client on proper quad cane use.
4. Notify the primary healthcare provider after consulting with the neighbor. - ANS ✔✔1
The nurse is caring for a newly diagnosed diabetic in diabetic hyperosmolar hyperglycemic nonketotic
(HHNK) state. What does the nurse anticipate the immediate treatment plan for this client will include?
1. NPH insulin.
2. Potassium 40 mEq (40 mmol/L) slow intravenous push.
3. Intravenous administration of isotonic saline.
4. Intravenous sodium bicarbonate. - ANS ✔✔3
What is most important for the nurse to do prior to initiating peritoneal dialysis?
1. Aspirate for placement.
2. Have the client void.
3. Irrigate the catheter for patency.
4. Warm the dialysate fluid. - ANS ✔✔4
The nurse in the outpatient clinic performs an assessment on a client who takes propranolol for
management of palpitations associated with mitral valve prolapse. Which statement by the client should
be reported immediately to the primary healthcare provider?
1. "My resting pulse was 60 this morning."
2. "I feel a little short of breath when walking."
3. "I have lost 5 pounds in the last 2 weeks."
4. "My blood pressure (BP) was lower this visit than last time." - ANS ✔✔2
Blood and urine samples are sent to the laboratory for a client who has had a spinal cord injury. After
reviewing these results, the nurse would expect which finding?
,Exhibit
1. Gross hematuria
2. Septicemia
3. Urinary tract infection
4. Anemia - ANS ✔✔3
The nurse is instructing a client on achieving relaxation using deep breathing exercises. Which statement
by the client indicates to the nurse that further teaching is necessary?
1. "I can perform deep breathing exercises anywhere and at any time that I feel tension and anxiety."
2. "I should sit or lie in a comfortable position, making sure my back is straight."
3. "I will inhale slowly and deeply through my mouth focusing on my chest expansion."
4. "When I have inhaled in as much as possible, I will hold my breath for a few seconds before exhaling."
- ANS ✔✔3
A client diagnosed with pancreatitis becomes increasingly restless, confused and has pulled out the NG
tube and IV catheter. HR-128/min, BP 96/62. Oxygen saturation = 90%. Skin is cool and clammy to touch.
Prioritize the actions that the nurse should take.
Initiate oxygen.
Insert another IV line.
Obtain blood sugar level.
Insert NG tube.
Repeat vital sign checks - ANS ✔✔This is the correct order
A teenage client is placed on life-support as a result of a motor vehicle accident (MVA). Following an
electroencephalogram (EEG), the client has been declared brain dead. Which action by the nurse would
take priority?
1. Call the respiratory department to have the ventilator removed.
2. Notify the facility's pastoral personnel.
3. Contact the regional organ procurement team.
4. Ask the family to select a funeral home. - ANS ✔✔3
A child was diagnosed with attention-deficit/hyperactivity disorder (ADHD) in the clinic one week ago.
Today the child's mother calls the clinic to tell the nurse, "My child has not been able to sleep since being
put on methyphenidate." What is the best response for the nurse to make?
1. "I will discuss this with the primary healthcare provider. A different medication may be prescribed."
2. "The insomnia will get better over time. Just wait it out."
3. "To prevent insomnia, give your child the last daily dose at least 6 hours before bedtime."
4. "Your child may have overdosed on the medication. Go to the emergency department now." - ANS
✔✔3
A client has been admitted to the medical unit and placed on airborne precautions for suspected
pulmonary tuberculosis (TB). The nurse will assess for which signs and symptoms?
1. Weight gain
, 2. Fatigue
3. Hemoptysis
4. Diaphoresis during sleep
5. Anorexia - ANS ✔✔2,3,4,5
A primary healthcare provider has prescribed the insertion of a nasogastric (NG) tube. In what order
should the nurse perform this procedure?
Place actions in the correct order.
Elevate head of bed to fowler's position.
Measure distal NG tube from nose tip to earlobe to xiphoid process.
Lubricate 2-3 inches of distal NG tube.
Insert NG tube into unobstructed naris.
Advance NG tube upward and backward until resistance is met.
Rotate catheter and advance into nasopharynx.
Have client swallow ice as NG tube advances into stomach.
Secure NG tube. - ANS ✔✔This is the correct order
A nurse from the neonatal unit is transferred to the adult medical-surgical unit. Which client should the
charge nurse assign to the neonatal nurse?
1. Undergoing surgery for placement of a central venous catheter.
2. Diagnosed with leukemia, hospitalized for induction of high-dose chemotherapy.
3. Receiving IV heparin for left leg thrombosis.
4. Admitted with a cerebrovascular accident. - ANS ✔✔1
A client arrives at the emergency department after sustaining partial and full-thickness burns over the
anterior neck, chest, and right arm. Which interventions will the nurse initiate?
1. Administer oxygen
2. Start two intravenous lines
3. Remove necklace
4. Elevate right arm
5. Debride wounds - ANS ✔✔1,2,3,4
A client recently diagnosed with diabetes is sent home with a prescription for subcutaneous insulin.
What statement made by the client indicates that teaching has been effective regarding safe needle
disposal?
1. "I should wrap the needle in a paper towel and place in the trash."
2. "I should use a hospital issued biohazard container for all needles."
3. "I may use any hard plastic container with a screw-on cap."
4. "I should take my needles to the nearest hospital for disposal. " - ANS ✔✔3
Which interventions should the nurse initiate to lessen acid reflux in a client diagnosed with
gastroesophagel reflux disease (GERD)?
1. Provide small, frequent meals.
HURST NCLEX READINESS STUDY GUIDE 2026/2027
A charge nurse is planning care for several clients on the unit. Which activities can the nurse safely
delegate to an unlicensed assistive personnel (UAP) member?
1. Administer a nebulizer treatment to a client diagnosed with pneumonia.
2. Obtain vital signs on a postoperative client who required naloxone 5 minutes ago.
3. Report a urinary output (UOP) less than 50 ml/hr on a post-op client.
4. Assist a client with obtaining a clean catch urine sample.
5. Remove an indwelling urinary catheter from a client. - ANS ✔✔3,4
What should the nurse teach a pregnant client who comes to the clinic reporting hemorrhoids and
constipation?
1. Increased rectal pressure from the gravid uterus may result in hemorrhoids.
2. Hormones decrease maternal GI motility, resulting in constipation.
3. The client needs more fiber in the diet.
4. A mild laxative is recommended to alleviate constipation.
5. The client needs to increase fluid intake.
Rationale - ANS ✔✔1,2,3,5
What statements by a new nurse would indicate to the charge nurse an understanding of how to
maintain skin integrity for a client on bedrest?
1. "Clients on bedrest should be placed on therapeutic mattresses."
2. "I will assess for the skin every 4 hours."
3. "I will assess the skin using the Braden scale."
4. "A pillow will be placed between the knees when client is side lying."
5. "The incontinent client will be kept clean and dry." - ANS ✔✔1,3,4,5
The primary healthcare provider suspects the client has tuberculosis (TB) and prescribes a Mantoux test.
What precautions should the nurse take when administering the Mantoux test?
1. Don sterile gloves.
2. Place the client on reverse isolation.
3. Wear a particulate respirator
4. Obtain a consent form.
5. Initiate airborne precautions. - ANS ✔✔3,5
Which finding should a nurse expect when assessing a healthy 65 year old client?
1. Anomia
2. Presbyopia
3. BP 156/88
,4. Apraxia - ANS ✔✔2
The charge nurse is evaluating knowledge of tracheostomy suctioning of a new nurse prior to that
procedure being performed. Which statement by the new nurse would indicate to the charge nurse that
additional education is needed?
1. "Prior to suctioning, I will hyper-oxygenate the client."
2. "I will instill normal saline bullets to liquefy secretions."
3. "I will allow at least 20 seconds between suctioning passes."
4. "Suctioning will be limited to a maximum of three catheter passes." - ANS ✔✔2
The nurse observes a client at a follow-up appointment using correct cane walking technique but losing
balance each time the quad cane is lifted off of the floor. The client reports a history of recent falls. What
is the best action for the nurse to take?
1. Inform the primary healthcare provider of the observations made regarding quad cane use, and
imbalance assessment.
2. Inform client that there are only a few assistive devices available to help with ambulation.
3. Instruct the client on proper quad cane use.
4. Notify the primary healthcare provider after consulting with the neighbor. - ANS ✔✔1
The nurse is caring for a newly diagnosed diabetic in diabetic hyperosmolar hyperglycemic nonketotic
(HHNK) state. What does the nurse anticipate the immediate treatment plan for this client will include?
1. NPH insulin.
2. Potassium 40 mEq (40 mmol/L) slow intravenous push.
3. Intravenous administration of isotonic saline.
4. Intravenous sodium bicarbonate. - ANS ✔✔3
What is most important for the nurse to do prior to initiating peritoneal dialysis?
1. Aspirate for placement.
2. Have the client void.
3. Irrigate the catheter for patency.
4. Warm the dialysate fluid. - ANS ✔✔4
The nurse in the outpatient clinic performs an assessment on a client who takes propranolol for
management of palpitations associated with mitral valve prolapse. Which statement by the client should
be reported immediately to the primary healthcare provider?
1. "My resting pulse was 60 this morning."
2. "I feel a little short of breath when walking."
3. "I have lost 5 pounds in the last 2 weeks."
4. "My blood pressure (BP) was lower this visit than last time." - ANS ✔✔2
Blood and urine samples are sent to the laboratory for a client who has had a spinal cord injury. After
reviewing these results, the nurse would expect which finding?
,Exhibit
1. Gross hematuria
2. Septicemia
3. Urinary tract infection
4. Anemia - ANS ✔✔3
The nurse is instructing a client on achieving relaxation using deep breathing exercises. Which statement
by the client indicates to the nurse that further teaching is necessary?
1. "I can perform deep breathing exercises anywhere and at any time that I feel tension and anxiety."
2. "I should sit or lie in a comfortable position, making sure my back is straight."
3. "I will inhale slowly and deeply through my mouth focusing on my chest expansion."
4. "When I have inhaled in as much as possible, I will hold my breath for a few seconds before exhaling."
- ANS ✔✔3
A client diagnosed with pancreatitis becomes increasingly restless, confused and has pulled out the NG
tube and IV catheter. HR-128/min, BP 96/62. Oxygen saturation = 90%. Skin is cool and clammy to touch.
Prioritize the actions that the nurse should take.
Initiate oxygen.
Insert another IV line.
Obtain blood sugar level.
Insert NG tube.
Repeat vital sign checks - ANS ✔✔This is the correct order
A teenage client is placed on life-support as a result of a motor vehicle accident (MVA). Following an
electroencephalogram (EEG), the client has been declared brain dead. Which action by the nurse would
take priority?
1. Call the respiratory department to have the ventilator removed.
2. Notify the facility's pastoral personnel.
3. Contact the regional organ procurement team.
4. Ask the family to select a funeral home. - ANS ✔✔3
A child was diagnosed with attention-deficit/hyperactivity disorder (ADHD) in the clinic one week ago.
Today the child's mother calls the clinic to tell the nurse, "My child has not been able to sleep since being
put on methyphenidate." What is the best response for the nurse to make?
1. "I will discuss this with the primary healthcare provider. A different medication may be prescribed."
2. "The insomnia will get better over time. Just wait it out."
3. "To prevent insomnia, give your child the last daily dose at least 6 hours before bedtime."
4. "Your child may have overdosed on the medication. Go to the emergency department now." - ANS
✔✔3
A client has been admitted to the medical unit and placed on airborne precautions for suspected
pulmonary tuberculosis (TB). The nurse will assess for which signs and symptoms?
1. Weight gain
, 2. Fatigue
3. Hemoptysis
4. Diaphoresis during sleep
5. Anorexia - ANS ✔✔2,3,4,5
A primary healthcare provider has prescribed the insertion of a nasogastric (NG) tube. In what order
should the nurse perform this procedure?
Place actions in the correct order.
Elevate head of bed to fowler's position.
Measure distal NG tube from nose tip to earlobe to xiphoid process.
Lubricate 2-3 inches of distal NG tube.
Insert NG tube into unobstructed naris.
Advance NG tube upward and backward until resistance is met.
Rotate catheter and advance into nasopharynx.
Have client swallow ice as NG tube advances into stomach.
Secure NG tube. - ANS ✔✔This is the correct order
A nurse from the neonatal unit is transferred to the adult medical-surgical unit. Which client should the
charge nurse assign to the neonatal nurse?
1. Undergoing surgery for placement of a central venous catheter.
2. Diagnosed with leukemia, hospitalized for induction of high-dose chemotherapy.
3. Receiving IV heparin for left leg thrombosis.
4. Admitted with a cerebrovascular accident. - ANS ✔✔1
A client arrives at the emergency department after sustaining partial and full-thickness burns over the
anterior neck, chest, and right arm. Which interventions will the nurse initiate?
1. Administer oxygen
2. Start two intravenous lines
3. Remove necklace
4. Elevate right arm
5. Debride wounds - ANS ✔✔1,2,3,4
A client recently diagnosed with diabetes is sent home with a prescription for subcutaneous insulin.
What statement made by the client indicates that teaching has been effective regarding safe needle
disposal?
1. "I should wrap the needle in a paper towel and place in the trash."
2. "I should use a hospital issued biohazard container for all needles."
3. "I may use any hard plastic container with a screw-on cap."
4. "I should take my needles to the nearest hospital for disposal. " - ANS ✔✔3
Which interventions should the nurse initiate to lessen acid reflux in a client diagnosed with
gastroesophagel reflux disease (GERD)?
1. Provide small, frequent meals.
