HURST READINESS EXAM (PRACTICE) QUESTIONS AND ANSWERS | COMPLETE
HURST NCLEX READINESS PRACTICE STUDY GUIDE 2026/2027
A 40 year old client reports a diminished ability to visually focus on close objects and has also noticed a
need for a well lit environment to enhance vision. To what would the nurse attribute these changes?
a. normal changes associated with aging
b. a cataract is forming
c. symptoms of a brain tumor
d. precipitated by diabetic retinopathy - correct answer ✔✔a. normal changes associated with aging
Rationale: aging results in stiffening of the lens, thus lessening the ability to focus. The retina is less
sensitive to light, making accurate vision in low-light situations more difficult. Pupillary response
diminishes, affecting the ability to adjust to changing light levels
The nurse is assessing pain after surgery in a 3 year old client with a known developmental delay. Which
pain scale should the nurse use to assess this client's pain level?
a. CRIES scale
b. numeric scale
c. FLACC scale
d. FACES scale - correct answer ✔✔c. FLACC scale
Rationale: The FLACC scale can be used for pediatric clients from age 2 months to 7 years and is
appropriate when clients cannot communicate their pain
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?
a. "I should wrap the needle in a paper towel and place in the trash."
b. "I should use a hospital issued biohazard container for all needles."
c. "I may use any hard plastic container with a screw-on cap."
d. "I should take my needles to the nearest hospital for disposal." - correct answer ✔✔c. "I may use any
hard plastic container with a screw-on cap."
Rationale: At home, an FDA approved sharps container is not needed, however, needles, syringes, and
sharps may be disposed of in a hard plastic container. Clients should follow their community guidelines
for sharps container disposal. This protects the sanitation engineers from injury by the sharps.
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?
a. don sterile gloves
b. place the client on reverse isolation
,c. wear a particulate respirator
d. obtain a consent form
e. initiate airborne precautions - correct answer ✔✔c. wear a particulate respirator
e. initiate airborne precautions
Rationale: A disposable particulate respirator that fits snugly around the face is needed. The client needs
to be on acid-fast bacilli (AFB) isolation precautions, not reverse isolation. Airborne precautions include a
private room with negative pressure and a minimum of 6 air exchanges per hour. Ultraviolet lamps and
high efficiency particulate air filters are also needed.
A hysterical college student arrives in the emergency department in bloody soiled clothing. The nursing
assessment reveals facial bruising and multiple contusions consistent with the client's report of being
raped. Which initial nursing intervention takes priority at this time?
a. notify police of the alleged rape
b. allow the client privacy to wash self
c. remove clothing and bag for evidence
d. encourage client to express fears and anxiety - correct answer ✔✔d. encourage client to express fears
and anxiety
Rationale: Although there are specific protocols that must be followed when dealing with rape clients, it
is important to remember that this client had all control taken away during the attack. The emotional
effects of rape are as traumatizing as the physical injuries. Allowing the client to first express emotions,
such as fear or anxiety, returns a small amount of control to a situation in which the client has little or
none.
The nurse is caring for an adolescent client diagnosed with depression. The client is prescribed
fluoxetine. What is the best response by the nurse when the client says, "What will this medicine do to
me?"
a. it will increase the level of serotonin in the brain
b. it will decrease the production of noradrenaline
c. it will lower your level of the brain hormone norepinephrine
d. it will balance blood glucose and dopamine levels in your head - correct answer ✔✔a. it will increase
the level of serotonin in the brain
Rationale: The action of fluoxetine is to increase the level of serotonin in the central nervous system.
There is a correlation between a low level of serotonin and depression. The action of the drug should be
explained to the adolescent in a manner that will be understood.
A new mother brings her infant to the clinic for a well-baby checkup. While at the clinic, the mother asks
the nurse if there are any reasons why her infant should not have the MMR vaccine. The nurse's
response is based on evidence that the MMR vaccine is contraindicated under which condition?
a. a known allergy to gelatin
b. a family history of autism
c. in infants with diarrhea
d. a known allergy to sulfonamides - correct answer ✔✔a. a known allergy to gelatin
, Rationale: The MMR vaccine is grown using chicken embryos and manufactured with the use of gelatin.
Known allergies to gelatin would be a contraindication for administration.
A client, post laparoscopic cholecystectomy, develops pain in their right shoulder. Vital signs, laboratory
studies, and an electrocardiogram are within normal limits. What does the nurse recognize as a
contributing cause of the pain?
a. surgical cannulation of the bile duct is causing spasm and pain
b. carbon dioxide used intraperitoneally is irritating the phrenic nerve
c. large abdominal retractors used in the procedure compressed a nerve
d. side lying position in the operating room generated pressure damage - correct answer ✔✔b. carbon
dioxide used intraperitoneally is irritating the phrenic nerve
Rationale: Phrenic nerve irritation can result in referred pain to the right shoulder. Carbon dioxide is used
to inflate the abdominal/chest wall during the procedure for better visualization of the internal organs. If
the CO2 irritates the phrenic nerve, it radiates to the shoulder.
Post cataract removal a client reports nausea and severe pain in the operative eye. Which nursing
intervention takes priority?
a. administer morphine and ondansetron
b. reposition client to non-operative side
c. massage the canthus to unblock the lacrimal duct
d. notify the primary healthcare provider - correct answer ✔✔d. notify the primary healthcare provider
Rationale: Severe pain with nausea indicates an increase in intraocular pressure and needs to be
reported at once. Eye damage can result if not resolved quickly. The primary healthcare provider may
prescribe medications or take the client back to surgery.
A client who has developed hypovolemic shock is receiving albumin. What assessment finding by the
nurse indicates that the albumin has been effective?
a. swelling in the legs
b. increase in urinary output
c. proteinuria
d. increase in waist measurement - correct answer ✔✔b. increase in urinary output
Rationale: The action of albumin is to increase the serum albumin level. When the albumin level
increases, there is a shift of fluid from extracellular to intracellular. This action will result in an increase in
urinary output.
Which tasks would be appropriate for the nurse to assign to an LPN/VN?
a. changing a colostomy bag
b. administer antibiotic via IVPB
c. teach insulin self administration to a diabetic client
d. administer IV pain medication to a 2 day post op client
HURST NCLEX READINESS PRACTICE STUDY GUIDE 2026/2027
A 40 year old client reports a diminished ability to visually focus on close objects and has also noticed a
need for a well lit environment to enhance vision. To what would the nurse attribute these changes?
a. normal changes associated with aging
b. a cataract is forming
c. symptoms of a brain tumor
d. precipitated by diabetic retinopathy - correct answer ✔✔a. normal changes associated with aging
Rationale: aging results in stiffening of the lens, thus lessening the ability to focus. The retina is less
sensitive to light, making accurate vision in low-light situations more difficult. Pupillary response
diminishes, affecting the ability to adjust to changing light levels
The nurse is assessing pain after surgery in a 3 year old client with a known developmental delay. Which
pain scale should the nurse use to assess this client's pain level?
a. CRIES scale
b. numeric scale
c. FLACC scale
d. FACES scale - correct answer ✔✔c. FLACC scale
Rationale: The FLACC scale can be used for pediatric clients from age 2 months to 7 years and is
appropriate when clients cannot communicate their pain
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?
a. "I should wrap the needle in a paper towel and place in the trash."
b. "I should use a hospital issued biohazard container for all needles."
c. "I may use any hard plastic container with a screw-on cap."
d. "I should take my needles to the nearest hospital for disposal." - correct answer ✔✔c. "I may use any
hard plastic container with a screw-on cap."
Rationale: At home, an FDA approved sharps container is not needed, however, needles, syringes, and
sharps may be disposed of in a hard plastic container. Clients should follow their community guidelines
for sharps container disposal. This protects the sanitation engineers from injury by the sharps.
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?
a. don sterile gloves
b. place the client on reverse isolation
,c. wear a particulate respirator
d. obtain a consent form
e. initiate airborne precautions - correct answer ✔✔c. wear a particulate respirator
e. initiate airborne precautions
Rationale: A disposable particulate respirator that fits snugly around the face is needed. The client needs
to be on acid-fast bacilli (AFB) isolation precautions, not reverse isolation. Airborne precautions include a
private room with negative pressure and a minimum of 6 air exchanges per hour. Ultraviolet lamps and
high efficiency particulate air filters are also needed.
A hysterical college student arrives in the emergency department in bloody soiled clothing. The nursing
assessment reveals facial bruising and multiple contusions consistent with the client's report of being
raped. Which initial nursing intervention takes priority at this time?
a. notify police of the alleged rape
b. allow the client privacy to wash self
c. remove clothing and bag for evidence
d. encourage client to express fears and anxiety - correct answer ✔✔d. encourage client to express fears
and anxiety
Rationale: Although there are specific protocols that must be followed when dealing with rape clients, it
is important to remember that this client had all control taken away during the attack. The emotional
effects of rape are as traumatizing as the physical injuries. Allowing the client to first express emotions,
such as fear or anxiety, returns a small amount of control to a situation in which the client has little or
none.
The nurse is caring for an adolescent client diagnosed with depression. The client is prescribed
fluoxetine. What is the best response by the nurse when the client says, "What will this medicine do to
me?"
a. it will increase the level of serotonin in the brain
b. it will decrease the production of noradrenaline
c. it will lower your level of the brain hormone norepinephrine
d. it will balance blood glucose and dopamine levels in your head - correct answer ✔✔a. it will increase
the level of serotonin in the brain
Rationale: The action of fluoxetine is to increase the level of serotonin in the central nervous system.
There is a correlation between a low level of serotonin and depression. The action of the drug should be
explained to the adolescent in a manner that will be understood.
A new mother brings her infant to the clinic for a well-baby checkup. While at the clinic, the mother asks
the nurse if there are any reasons why her infant should not have the MMR vaccine. The nurse's
response is based on evidence that the MMR vaccine is contraindicated under which condition?
a. a known allergy to gelatin
b. a family history of autism
c. in infants with diarrhea
d. a known allergy to sulfonamides - correct answer ✔✔a. a known allergy to gelatin
, Rationale: The MMR vaccine is grown using chicken embryos and manufactured with the use of gelatin.
Known allergies to gelatin would be a contraindication for administration.
A client, post laparoscopic cholecystectomy, develops pain in their right shoulder. Vital signs, laboratory
studies, and an electrocardiogram are within normal limits. What does the nurse recognize as a
contributing cause of the pain?
a. surgical cannulation of the bile duct is causing spasm and pain
b. carbon dioxide used intraperitoneally is irritating the phrenic nerve
c. large abdominal retractors used in the procedure compressed a nerve
d. side lying position in the operating room generated pressure damage - correct answer ✔✔b. carbon
dioxide used intraperitoneally is irritating the phrenic nerve
Rationale: Phrenic nerve irritation can result in referred pain to the right shoulder. Carbon dioxide is used
to inflate the abdominal/chest wall during the procedure for better visualization of the internal organs. If
the CO2 irritates the phrenic nerve, it radiates to the shoulder.
Post cataract removal a client reports nausea and severe pain in the operative eye. Which nursing
intervention takes priority?
a. administer morphine and ondansetron
b. reposition client to non-operative side
c. massage the canthus to unblock the lacrimal duct
d. notify the primary healthcare provider - correct answer ✔✔d. notify the primary healthcare provider
Rationale: Severe pain with nausea indicates an increase in intraocular pressure and needs to be
reported at once. Eye damage can result if not resolved quickly. The primary healthcare provider may
prescribe medications or take the client back to surgery.
A client who has developed hypovolemic shock is receiving albumin. What assessment finding by the
nurse indicates that the albumin has been effective?
a. swelling in the legs
b. increase in urinary output
c. proteinuria
d. increase in waist measurement - correct answer ✔✔b. increase in urinary output
Rationale: The action of albumin is to increase the serum albumin level. When the albumin level
increases, there is a shift of fluid from extracellular to intracellular. This action will result in an increase in
urinary output.
Which tasks would be appropriate for the nurse to assign to an LPN/VN?
a. changing a colostomy bag
b. administer antibiotic via IVPB
c. teach insulin self administration to a diabetic client
d. administer IV pain medication to a 2 day post op client
