HURST REVIEW NCLEX-RN
Readiness Exam 1
1. A client is admitted with a potassium level of 6.8 mEq/L. Which assessment finding
requires immediate action?
A. Muscle weakness
B. Nausea
C. Tall peaked T waves on ECG
D. Frequent urination
Answer: C. Tall peaked T waves on ECG
Rationale: Peaked T waves indicate hyperkalemia’s effect on cardiac conduction,
which can lead to lethal arrhythmias. Cardiac monitoring is a priority.
2. The nurse is caring for a client post-thyroidectomy. Which assessment is most
important?
A. Bowel sounds
B. Chvostek’s sign
C. Temperature
D. Throat pain
Answer: B. Chvostek’s sign
Rationale: Chvostek’s sign indicates hypocalcemia, which can occur after
thyroidectomy due to accidental removal of parathyroid glands. It can lead to tetany
and airway issues.
,3. Which client should the nurse see first?
A. A client with a blood pressure of 92/58
B. A client with chest pain and ST elevation
C. A client with a urinary tract infection
D. A client complaining of leg cramps
Answer: B. A client with chest pain and ST elevation
Rationale: ST elevation is a sign of myocardial infarction, a priority and life-
threatening issue.
4. The nurse receives a new order to administer digoxin. Which lab value should be
checked first?
A. Potassium
B. Sodium
C. Hemoglobin
D. BUN
Answer: A. Potassium
Rationale: Low potassium increases risk for digoxin toxicity. Always check K+ before
giving digoxin.
5. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse
should:
A. Maintain current oxygen settings
B. Elevate the head of the bed
C. Reduce oxygen to 2 L/min
D. Administer a bronchodilator
Answer: C. Reduce oxygen to 2 L/min
Rationale: COPD clients rely on hypoxic drive to breathe; too much O2 may depress
respiration. NCLEX loves this!
,6. A client with liver failure has a low albumin level. What symptom is expected?
A. Hypertension
B. Edema
C. Hypoglycemia
D. Jaundice
Answer: B. Edema
Rationale: Low albumin reduces oncotic pressure, leading to fluid leakage into
tissues (edema).
7. A client receiving total parenteral nutrition (TPN) suddenly develops shortness of
breath and chest pain. What should the nurse do first?
A. Notify the provider
B. Raise the head of the bed
C. Stop the TPN
D. Turn the client to the left side and lower the head
Answer: D. Turn the client to the left side and lower the head
Rationale: These are signs of an air embolism, which requires Trendelenburg position
on the left side to trap air in the right atrium.
8. A client with Addison’s disease presents with confusion, hypotension, and
hyperkalemia. What should the nurse do first?
A. Administer potassium
B. Give IV hydrocortisone
C. Increase fluid intake
D. Give insulin
Answer: B. Give IV hydrocortisone
Rationale: Addisonian crisis = need for steroids immediately.
9. What is the most important teaching point for a client taking warfarin?
, A. Avoid green leafy vegetables
B. Take with aspirin
C. Use a soft toothbrush
D. Check blood pressure daily
Answer: C. Use a soft toothbrush
Rationale: Warfarin increases bleeding risk. Prevent injury that may cause bleeding
(like brushing gums).
10. Which medication is safe to administer to a client with a penicillin allergy?
A. Ampicillin
B. Cephalexin
C. Erythromycin
D. Amoxicillin
Answer: C. Erythromycin
Rationale: Erythromycin is a macrolide, not related to penicillins or cephalosporins.
11. The nurse is caring for a client with SIADH. Which order should the nurse
question?
A. Fluid restriction
B. Hypertonic saline
C. Vasopressin
D. Seizure precautions
Answer: C. Vasopressin
Rationale: SIADH already has excess ADH. Vasopressin is an ADH analog, so it would
worsen the condition.
12. Which dietary choice is best for a client with iron deficiency anemia?
A. Apple juice and toast
B. Chicken and broccoli
Readiness Exam 1
1. A client is admitted with a potassium level of 6.8 mEq/L. Which assessment finding
requires immediate action?
A. Muscle weakness
B. Nausea
C. Tall peaked T waves on ECG
D. Frequent urination
Answer: C. Tall peaked T waves on ECG
Rationale: Peaked T waves indicate hyperkalemia’s effect on cardiac conduction,
which can lead to lethal arrhythmias. Cardiac monitoring is a priority.
2. The nurse is caring for a client post-thyroidectomy. Which assessment is most
important?
A. Bowel sounds
B. Chvostek’s sign
C. Temperature
D. Throat pain
Answer: B. Chvostek’s sign
Rationale: Chvostek’s sign indicates hypocalcemia, which can occur after
thyroidectomy due to accidental removal of parathyroid glands. It can lead to tetany
and airway issues.
,3. Which client should the nurse see first?
A. A client with a blood pressure of 92/58
B. A client with chest pain and ST elevation
C. A client with a urinary tract infection
D. A client complaining of leg cramps
Answer: B. A client with chest pain and ST elevation
Rationale: ST elevation is a sign of myocardial infarction, a priority and life-
threatening issue.
4. The nurse receives a new order to administer digoxin. Which lab value should be
checked first?
A. Potassium
B. Sodium
C. Hemoglobin
D. BUN
Answer: A. Potassium
Rationale: Low potassium increases risk for digoxin toxicity. Always check K+ before
giving digoxin.
5. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse
should:
A. Maintain current oxygen settings
B. Elevate the head of the bed
C. Reduce oxygen to 2 L/min
D. Administer a bronchodilator
Answer: C. Reduce oxygen to 2 L/min
Rationale: COPD clients rely on hypoxic drive to breathe; too much O2 may depress
respiration. NCLEX loves this!
,6. A client with liver failure has a low albumin level. What symptom is expected?
A. Hypertension
B. Edema
C. Hypoglycemia
D. Jaundice
Answer: B. Edema
Rationale: Low albumin reduces oncotic pressure, leading to fluid leakage into
tissues (edema).
7. A client receiving total parenteral nutrition (TPN) suddenly develops shortness of
breath and chest pain. What should the nurse do first?
A. Notify the provider
B. Raise the head of the bed
C. Stop the TPN
D. Turn the client to the left side and lower the head
Answer: D. Turn the client to the left side and lower the head
Rationale: These are signs of an air embolism, which requires Trendelenburg position
on the left side to trap air in the right atrium.
8. A client with Addison’s disease presents with confusion, hypotension, and
hyperkalemia. What should the nurse do first?
A. Administer potassium
B. Give IV hydrocortisone
C. Increase fluid intake
D. Give insulin
Answer: B. Give IV hydrocortisone
Rationale: Addisonian crisis = need for steroids immediately.
9. What is the most important teaching point for a client taking warfarin?
, A. Avoid green leafy vegetables
B. Take with aspirin
C. Use a soft toothbrush
D. Check blood pressure daily
Answer: C. Use a soft toothbrush
Rationale: Warfarin increases bleeding risk. Prevent injury that may cause bleeding
(like brushing gums).
10. Which medication is safe to administer to a client with a penicillin allergy?
A. Ampicillin
B. Cephalexin
C. Erythromycin
D. Amoxicillin
Answer: C. Erythromycin
Rationale: Erythromycin is a macrolide, not related to penicillins or cephalosporins.
11. The nurse is caring for a client with SIADH. Which order should the nurse
question?
A. Fluid restriction
B. Hypertonic saline
C. Vasopressin
D. Seizure precautions
Answer: C. Vasopressin
Rationale: SIADH already has excess ADH. Vasopressin is an ADH analog, so it would
worsen the condition.
12. Which dietary choice is best for a client with iron deficiency anemia?
A. Apple juice and toast
B. Chicken and broccoli
