Hurst Readiness Exam 1 Questions with
Complete Answers with Rationales
The nurse is teaching a group of pregnant women about hormonal changes during pregnancy. The nurse
recognizes that teaching was successful when the women identify which hormone as causing
amenorrhea?
1. Progesterone 2. Estrogen 3. Follicle-stimulating hormone (FSH) 4. Human chorionic gonadotropin
(hCG)
Rationale
1. Correct: Progesterone causes amenorrhea. 2. Incorrect: Estrogen renders the female genital tract
suitable for fertilization. 3. Incorrect: This stimulates the growth of the graafian follicle in the ovary. 4.
Incorrect: This is the hormone present in urine for pregnancy test
The client is admitted to the hospital following a motor vehicle accident and has sustained a closed chest
wound. The nurse notes paradoxical chest wall movement. Which problem does the nurse suspect?
1. Mediastinal shift 2. Tension pneumothorax 3. Flail chest 4. Pulmonary contusion
Rationale
3. Correct: Hallmark of flail chest is paradoxical chest wall movement. This is often described as a see-
saw effect when observing the rise and fall of the chest. 1. Incorrect: A closed or open tension
pneumothorax results from the lung collapsing and air entering into the pleural cavity. This results in
pressure shifting toward the unaffected pleural cavity. 2. Incorrect: Tension pneumothorax occurs when
there is an accumulation of air in the pleural cavity. The client may exhibit dyspnea, tachycardia, or
hypotension. 4. Incorrect: A pulmonary contusion usually results from blunt trauma. Bruising of lung
would be demonstrated by pain but not paradoxical chest wall movement.
,Which client can a nurse manager safely transfer from the telemetry unit to the obstetrical unit in order
to receive a new admit?
1. Client admitted with possible tuberculosis (TB) awaiting skin test results. 2. Client diagnosed with
seizure disorder. 3. Client with a new pacemaker scheduled to be discharged in the morning. 4. Client
with a history of mild heart failure prescribed one unit of packed red blood cells for anemia.
Rationale
2. Correct: OB nurses would have the appropriate knowledge needed to care for a client with a seizure
disorders, because they care for clients who have eclampsia (seizures). 1. Incorrect: This client might
have tuberculosis (TB) and is not a good choice to move to the OB floor, because of the risk for
transmission of an infectious disease. 3. Incorrect: This client is not the best one to be transferred to the
OB floor, because these nurses do not routinely care for clients with a new pacemaker. The client is also
likely to remain on a cardiac monitor until discharge. 4. Incorrect: This client is at risk for fluid volume
overload since there is a history of heart failure and would require close monitoring while receiving a
blood transfusion.
The nurse is teaching a group of clients who have reduced peripheral circulation how to care for their
feet. What points should the nurse include?
1. Check shoes for rough spots in the lining. 2. File toenails straight across. 3. Cover feet and between
toes with creams to moisten the skin. 4. Break in new shoes gradually. 5. Use pumice stones to treat
calluses.
Rationale
1., 2., & 4. Correct: Rubbing from rough spots in the shoe can lead to corns or calluses. File the toenails
rather than cutting to avoid skin injury. File nails straight across the ends of the toes. If the nails are too
thick or misshapen to file, consult podiatrist. Break in new shoes gradually by increasing the wearing
time 30-60 minutes each day. 3. Incorrect: Cover the feet, except between the toes, with creams or
lotions to moisten the skin. Lotion will also soften calluses. A lotion that reduces dryness effectively is a
mixture of lanolin and mineral oil. 5. Incorrect: Avoid self-treatment of corns or calluses. Pumice stones
and some callus and corn applications are injurious to the skin. Do not cut calluses or corns. Consult a
podiatrist or primary healthcare provider first.
When caring for young adult clients, which developmental tasks would the nurse expect to see?
,1. Satisfying and supporting the next generation. 2. Reflecting on life accomplishments. 3. Developing
meaningful and intimate relationships. 4. Giving and sharing with an individual without asking what will
be given or shared in return. 5. Developing sense of fulfillment by volunteering in the community.
Rationale
3. & 4. Correct: In young adulthood, the developmental tasks involve intimacy versus isolation. Intimacy
relates more to sharing than to sex. Intimacy produces feelings of safety, closeness, and trust. 1.
Incorrect: Parenting is a primary task of middle adulthood. This is the middle adulthood stage of
Generativity versus Stagnation, where each adult must find some way to satisfy and support the next
generation. 2. Incorrect: During late adulthood, there is refection on life accomplishments. This is the
maturity stage of Ego Integrity versus Despair, where there is a reflection of one's life. 5. Incorrect:
During middle age, a sense of fulfillment can be found by volunteering in the community. This is part of
middle age, where the adult is finding ways to support others.
What symptoms does the nurse expect to see in a client with bulimia nervosa?
1. Amenorrhea 2. Feelings of self-worth unduly influenced by weight 3. Recurrent episodes of binge
eating 4. Recurrent inappropriate compensatory behavior to prevent weight gain 5. Lack of exercise
Rationale
2., 3. & 4. Correct: Diagnostic criteria for bulimia nervosa are recurrent episodes of binge eating:
recurrent inappropriate compensatory behavior to prevent weight gain such as laxative, diuretic, or
enema use, induced vomiting, fasting, and excessive exercise; and feeling of self-worth unduly
influenced by weight. Amenorrhea is found in anorexia nervosa. 1. Incorrect: Amenorrhea is found in
anorexia nervosa. 5. Incorrect: Excessive exercise is found in bulimia nervosa as a means to compensate
for the binge eating.
A client who has had a laparoscopic cholecystectomy develops pain in the left shoulder. Vital signs,
laboratory studies, and an electrocardiogram are within normal limits. What does the nurse recognize as
a contributing cause of the pain?
1. Surgical cannulation of the bile duct is causing spasm and pain. 2. Carbon dioxide used
intraperitoneally is irritating the phrenic nerve. 3. Large abdominal retractors used in the procedure
compressed a nerve. 4. Side lying position in the operating room generated pressure damage.
, Rationale
2. Correct: Phrenic nerve irritation can result in referred pain to the left shoulder. Carbon dioxide (CO2)
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. 1. Incorrect: Surgical
cannulation of the bile duct is not performed during a laparoscopic cholecystectomy. 3. Incorrect: Large
abdominal retractors are not used during this procedure. This is done via a small incision to
accommodate a scope. 4. Incorrect: The client is turned in several directions during the procedure to
prevent damage to the abdominal viscera.
A client is admitted to the medical unit with an acute onset of fever, chills and RUQ pain. Vital signs are:
T 99.8°F (37.7°C), P 132, RR 34, B/P 142/82. ABG results are: pH-7.53, PaCO2 30, HCO3 22. The nurse
determines that this client is in what acid/base imbalance?
1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis
Rationale
2. Correct: This client has a severe infection. Hyperventilation due to anxiety, pain, shock, severe
infection, fever, and liver failure can lead to respiratory alkalosis. pH > 7.45, PCO2 < 35, HCO3 normal. 1.
Incorrect: Not acidosis with hyperventilation and pH of 7.53. 3. Incorrect: Not a metabolic related
acid/base imbalance since the HCO3 is in normal range and is not acidosis. 4. Incorrect: Not a metabolic
related acid/base imbalance since the HCO3 is in normal range.
An unlicensed assistive personnel (UAP) has explained how to prevent the spread of infection to the
charge nurse. Which statement by the UAP indicates that further teaching is needed?
1. "Soap and water should be used for hand washing when our hands are visibly soiled." 2. "Gloves do
not have to be worn when taking a client's vital signs or passing out meal trays." 3. "Standard
precautions should be used on all clients." 4. "When caring for a client who has a suppressed immune
response, a N95 mask should be worn."
Rationale
4. Correct: Standard precautions are needed. If there is a risk for coming in contact with client secretions
or excretions, a standard mask may be worn. Routine nursing care does not warrant the use of an N95
mask. This type mask is needed for client's who are placed on Airborne Precautions such as for
tuberculosis (TB). 1. Incorrect: This is a correct statement regarding the prevention of infection. Hand
washing with soap and water is part of standard precautions. 2. Incorrect: This is a correct statement.
Complete Answers with Rationales
The nurse is teaching a group of pregnant women about hormonal changes during pregnancy. The nurse
recognizes that teaching was successful when the women identify which hormone as causing
amenorrhea?
1. Progesterone 2. Estrogen 3. Follicle-stimulating hormone (FSH) 4. Human chorionic gonadotropin
(hCG)
Rationale
1. Correct: Progesterone causes amenorrhea. 2. Incorrect: Estrogen renders the female genital tract
suitable for fertilization. 3. Incorrect: This stimulates the growth of the graafian follicle in the ovary. 4.
Incorrect: This is the hormone present in urine for pregnancy test
The client is admitted to the hospital following a motor vehicle accident and has sustained a closed chest
wound. The nurse notes paradoxical chest wall movement. Which problem does the nurse suspect?
1. Mediastinal shift 2. Tension pneumothorax 3. Flail chest 4. Pulmonary contusion
Rationale
3. Correct: Hallmark of flail chest is paradoxical chest wall movement. This is often described as a see-
saw effect when observing the rise and fall of the chest. 1. Incorrect: A closed or open tension
pneumothorax results from the lung collapsing and air entering into the pleural cavity. This results in
pressure shifting toward the unaffected pleural cavity. 2. Incorrect: Tension pneumothorax occurs when
there is an accumulation of air in the pleural cavity. The client may exhibit dyspnea, tachycardia, or
hypotension. 4. Incorrect: A pulmonary contusion usually results from blunt trauma. Bruising of lung
would be demonstrated by pain but not paradoxical chest wall movement.
,Which client can a nurse manager safely transfer from the telemetry unit to the obstetrical unit in order
to receive a new admit?
1. Client admitted with possible tuberculosis (TB) awaiting skin test results. 2. Client diagnosed with
seizure disorder. 3. Client with a new pacemaker scheduled to be discharged in the morning. 4. Client
with a history of mild heart failure prescribed one unit of packed red blood cells for anemia.
Rationale
2. Correct: OB nurses would have the appropriate knowledge needed to care for a client with a seizure
disorders, because they care for clients who have eclampsia (seizures). 1. Incorrect: This client might
have tuberculosis (TB) and is not a good choice to move to the OB floor, because of the risk for
transmission of an infectious disease. 3. Incorrect: This client is not the best one to be transferred to the
OB floor, because these nurses do not routinely care for clients with a new pacemaker. The client is also
likely to remain on a cardiac monitor until discharge. 4. Incorrect: This client is at risk for fluid volume
overload since there is a history of heart failure and would require close monitoring while receiving a
blood transfusion.
The nurse is teaching a group of clients who have reduced peripheral circulation how to care for their
feet. What points should the nurse include?
1. Check shoes for rough spots in the lining. 2. File toenails straight across. 3. Cover feet and between
toes with creams to moisten the skin. 4. Break in new shoes gradually. 5. Use pumice stones to treat
calluses.
Rationale
1., 2., & 4. Correct: Rubbing from rough spots in the shoe can lead to corns or calluses. File the toenails
rather than cutting to avoid skin injury. File nails straight across the ends of the toes. If the nails are too
thick or misshapen to file, consult podiatrist. Break in new shoes gradually by increasing the wearing
time 30-60 minutes each day. 3. Incorrect: Cover the feet, except between the toes, with creams or
lotions to moisten the skin. Lotion will also soften calluses. A lotion that reduces dryness effectively is a
mixture of lanolin and mineral oil. 5. Incorrect: Avoid self-treatment of corns or calluses. Pumice stones
and some callus and corn applications are injurious to the skin. Do not cut calluses or corns. Consult a
podiatrist or primary healthcare provider first.
When caring for young adult clients, which developmental tasks would the nurse expect to see?
,1. Satisfying and supporting the next generation. 2. Reflecting on life accomplishments. 3. Developing
meaningful and intimate relationships. 4. Giving and sharing with an individual without asking what will
be given or shared in return. 5. Developing sense of fulfillment by volunteering in the community.
Rationale
3. & 4. Correct: In young adulthood, the developmental tasks involve intimacy versus isolation. Intimacy
relates more to sharing than to sex. Intimacy produces feelings of safety, closeness, and trust. 1.
Incorrect: Parenting is a primary task of middle adulthood. This is the middle adulthood stage of
Generativity versus Stagnation, where each adult must find some way to satisfy and support the next
generation. 2. Incorrect: During late adulthood, there is refection on life accomplishments. This is the
maturity stage of Ego Integrity versus Despair, where there is a reflection of one's life. 5. Incorrect:
During middle age, a sense of fulfillment can be found by volunteering in the community. This is part of
middle age, where the adult is finding ways to support others.
What symptoms does the nurse expect to see in a client with bulimia nervosa?
1. Amenorrhea 2. Feelings of self-worth unduly influenced by weight 3. Recurrent episodes of binge
eating 4. Recurrent inappropriate compensatory behavior to prevent weight gain 5. Lack of exercise
Rationale
2., 3. & 4. Correct: Diagnostic criteria for bulimia nervosa are recurrent episodes of binge eating:
recurrent inappropriate compensatory behavior to prevent weight gain such as laxative, diuretic, or
enema use, induced vomiting, fasting, and excessive exercise; and feeling of self-worth unduly
influenced by weight. Amenorrhea is found in anorexia nervosa. 1. Incorrect: Amenorrhea is found in
anorexia nervosa. 5. Incorrect: Excessive exercise is found in bulimia nervosa as a means to compensate
for the binge eating.
A client who has had a laparoscopic cholecystectomy develops pain in the left shoulder. Vital signs,
laboratory studies, and an electrocardiogram are within normal limits. What does the nurse recognize as
a contributing cause of the pain?
1. Surgical cannulation of the bile duct is causing spasm and pain. 2. Carbon dioxide used
intraperitoneally is irritating the phrenic nerve. 3. Large abdominal retractors used in the procedure
compressed a nerve. 4. Side lying position in the operating room generated pressure damage.
, Rationale
2. Correct: Phrenic nerve irritation can result in referred pain to the left shoulder. Carbon dioxide (CO2)
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. 1. Incorrect: Surgical
cannulation of the bile duct is not performed during a laparoscopic cholecystectomy. 3. Incorrect: Large
abdominal retractors are not used during this procedure. This is done via a small incision to
accommodate a scope. 4. Incorrect: The client is turned in several directions during the procedure to
prevent damage to the abdominal viscera.
A client is admitted to the medical unit with an acute onset of fever, chills and RUQ pain. Vital signs are:
T 99.8°F (37.7°C), P 132, RR 34, B/P 142/82. ABG results are: pH-7.53, PaCO2 30, HCO3 22. The nurse
determines that this client is in what acid/base imbalance?
1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis
Rationale
2. Correct: This client has a severe infection. Hyperventilation due to anxiety, pain, shock, severe
infection, fever, and liver failure can lead to respiratory alkalosis. pH > 7.45, PCO2 < 35, HCO3 normal. 1.
Incorrect: Not acidosis with hyperventilation and pH of 7.53. 3. Incorrect: Not a metabolic related
acid/base imbalance since the HCO3 is in normal range and is not acidosis. 4. Incorrect: Not a metabolic
related acid/base imbalance since the HCO3 is in normal range.
An unlicensed assistive personnel (UAP) has explained how to prevent the spread of infection to the
charge nurse. Which statement by the UAP indicates that further teaching is needed?
1. "Soap and water should be used for hand washing when our hands are visibly soiled." 2. "Gloves do
not have to be worn when taking a client's vital signs or passing out meal trays." 3. "Standard
precautions should be used on all clients." 4. "When caring for a client who has a suppressed immune
response, a N95 mask should be worn."
Rationale
4. Correct: Standard precautions are needed. If there is a risk for coming in contact with client secretions
or excretions, a standard mask may be worn. Routine nursing care does not warrant the use of an N95
mask. This type mask is needed for client's who are placed on Airborne Precautions such as for
tuberculosis (TB). 1. Incorrect: This is a correct statement regarding the prevention of infection. Hand
washing with soap and water is part of standard precautions. 2. Incorrect: This is a correct statement.
