Hurst Readiness Exam 1 Latest 2023 with complete solution
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Hurst Readiness Exam 1 Latest 2023 with complete solution
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. Foll...
hurst readiness exam 1 latest 2023 with complete solution the nurse is teaching a group of pregnant women about hormonal changes during pregnancy the nurse recognizes that teaching was successful wh
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Hurst Readiness Exam 1 Latest 2023 with complete
solution
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. Gloves
are needed when coming into contact with body fluids. 3. Incorrect: This is a correct
statement. Standard precautions is part of the first line of defense against the spread of
infection.
The nurse is preparing to discharge a client who has been placed on tranylcypromine.
The nurse teaches the client about food to avoid while taking this medication. What food
choice by the client confirms appropriate understanding of the teaching?
1. Cottage cheese 2. Salami 3. Baked chicken 4. Potatoes
Rationale
2. Correct: The client taking a monoamine oxidase inhibitor (MAOI) such as
tranylcypromine should avoid foods rich in tyramine or tryptophan. These include: cured
foods, those that have been aged, pickled, fermented, or smoked. These can precipitate
a hypertensive crisis. 1. Incorrect: Clients taking MAOIs can eat cottage cheese in
reasonable amounts. 3. Incorrect: Clients taking MAOIs can eat baked chicken. 4.
Incorrect: Clients taking MAOIs can eat potatoes.
Which nurse is providing cost effective care to a client?
1. Providing palliative care to a terminally ill client. 2. Beginning discharge planning on
admit. 3. Counseling clients on cigarette smoking cessation. 4. Educating a group of
parents on the importance of childhood immunizations. 5. Performing a postop wound
dressing change using clean gloves.
Rationale
1., 2., 3., & 4. Correct. Palliative care is considered cost effective when caring for the
terminally ill client. There was a 60% drop reported in the healthcare costs since
palliative care was introduced. In comparison to conventional care, palliative care is
considered as cost effective in reducing unnecessary utilization of resources. Palliative
care has focused on the efficient and the effective care that is centered on the clients.
The nurse who begins discharge planning on admit is providing cost effective care. The
client may not be able to learn all that is needed if waiting until the day of discharge.
Also, supplies and equipment may be needed. If waiting until the day of discharge to
determine client needs, then discharge can be delayed. This is costly. Counseling to
quit cigarette smoking, colonoscopies, giving beta-blockers to clients after heart attacks
are well-established interventions that are effective and also are cost-effective. Two
additional preventive interventions were found to be cost-saving: childhood
immunization and counseling adults on the use of low dose aspirin. 5. Incorrect. A
postop surgical wound dressing change is a sterile procedure: Sterile gloves are
necessary and failure to use them could lead to infection, which would then increase the
cost of care to a client.
A client is admitted for observation following an unrestrained motor vehicle accident. A
bystander stated that the client lost consciousness for 1-2 minutes. On admission, the
client reports a headache and had a Glasgow coma scale (GCS) of 14. The GCS is now
12. What is the priority nursing intervention for this client?
1. Continue to assess every 15 minutes. 2. Stimulate the client with a sternal rub. 3.
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