HURST COMPREHENSIVE CERTIFICATION
TEST PAPER QUESTIONS AND SOLUTIONS
GRADED A PLUS VERIFIED
●● A client, hospitalized with possible acute pancreatitis secondary to
chronic cholecystitis, has severe abdominal pain and nausea. The client
is kept NPO, an NG tube is inserted, and IV fluids are being
administered. What is the rationale for the client being NPO with an NG
tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants.
Answer: 2. Correct: In clients with pancreatitis, the pancreatic enzymes
cannot exit the pancreas. These enzymes, when activated, begin to digest
the pancreas itself. The enzymes become activated in the pancreas when
fluid or food accumulates in the stomach. The goal in treating this client
is to stop the activation of the pancreatic enzymes. Treatment is focused
on keeping the stomach empty and dry. This allows the pancreas time to
rest and heal. Note: Autodigestion (pancreas digesting itself) is painful
for the client and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep
the stomach empty and dry to decrease pancreatic enzyme production,
not to relieve nausea.
,3. Incorrect: Because gastric contents are removed, the NG tube to
suction may lead to fluid and electrolyte disturbances rather than helping
to control them.
4. Incorrect: Although the food in the stomach causes the pancreatic
enzymes to become activated in the pancreas due to the obstruction, the
food is not considered an irritant. Precipitating irritants are not a part of
the pathophysiology occurring with pancreatitis.
●● The nurse is working with a committee at the local school to develop
an emergency preparedness plan for tornados. What should be included
in the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols..
Answer: 1., 2., 3. & 5. Correct: Everyone should be aware of safe zones
within the school. Personnel should be given this information and signs
posted in safe zones. There must be systems in place to accurately
determine the number of people in the building at any given time. There
also must be a system in place to alert personnel and students of tornado
warnings. Regular practice prepares everyone for an actual event.
,4. Incorrect: Gymnasiums are not considered safe places due to wide
expanse of roof. Safe zones should be on interior walls, no windows, and
a strong concrete floor if possible.
●● What should a nurse teach family members prior to them entering the
room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room..
Answer: 1., 2., 4., & 5. Correct: Protective isolation is needed for this
client because of the presence of a low white blood cell count. We are
protecting the client from acquiring an infection. So any visitors will
need to have meticulous hand washing prior to entering. The visitor
should not enter if he or she has any type of infection. To decrease the
risk of infection, small children should not visit. Even the mildest
symptom of infection could be detrimental to the client. Flowers have
bacteria and should not be brought into the room.
3. Incorrect: A mask must be worn by the visitor, not the client. The
mask is worn by visitors to prevent a possible spread of an airborne
infection to the immunocompromised client.
●● A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the
, mental health center, the nurse discusses the medication and response
with the client. The nurse's assessment reveals that the client is confused
about the date and about the prescribed dosage of the medication. Which
question would be most important for the nurse to ask to further assess
the situation?
1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving?.
Answer: 2. Correct: Myoclonus, high body temperature, shaking, chills,
and mental confusion are some of the symptoms of serotonin syndrome.
This client may be having symptoms of this adverse reaction which, if
severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective
serotonin reuptake inhibitors (SSRIs) may cause insomnia; however,
there is a more pertinent question needed for assessment of this client.
You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the
client is exhibiting significant symptoms of an adverse reaction which
would take priority.
4. Incorrect: The response to the SSRI medications is important;
however, there is a more significant issue in this case. The possible
TEST PAPER QUESTIONS AND SOLUTIONS
GRADED A PLUS VERIFIED
●● A client, hospitalized with possible acute pancreatitis secondary to
chronic cholecystitis, has severe abdominal pain and nausea. The client
is kept NPO, an NG tube is inserted, and IV fluids are being
administered. What is the rationale for the client being NPO with an NG
tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants.
Answer: 2. Correct: In clients with pancreatitis, the pancreatic enzymes
cannot exit the pancreas. These enzymes, when activated, begin to digest
the pancreas itself. The enzymes become activated in the pancreas when
fluid or food accumulates in the stomach. The goal in treating this client
is to stop the activation of the pancreatic enzymes. Treatment is focused
on keeping the stomach empty and dry. This allows the pancreas time to
rest and heal. Note: Autodigestion (pancreas digesting itself) is painful
for the client and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep
the stomach empty and dry to decrease pancreatic enzyme production,
not to relieve nausea.
,3. Incorrect: Because gastric contents are removed, the NG tube to
suction may lead to fluid and electrolyte disturbances rather than helping
to control them.
4. Incorrect: Although the food in the stomach causes the pancreatic
enzymes to become activated in the pancreas due to the obstruction, the
food is not considered an irritant. Precipitating irritants are not a part of
the pathophysiology occurring with pancreatitis.
●● The nurse is working with a committee at the local school to develop
an emergency preparedness plan for tornados. What should be included
in the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols..
Answer: 1., 2., 3. & 5. Correct: Everyone should be aware of safe zones
within the school. Personnel should be given this information and signs
posted in safe zones. There must be systems in place to accurately
determine the number of people in the building at any given time. There
also must be a system in place to alert personnel and students of tornado
warnings. Regular practice prepares everyone for an actual event.
,4. Incorrect: Gymnasiums are not considered safe places due to wide
expanse of roof. Safe zones should be on interior walls, no windows, and
a strong concrete floor if possible.
●● What should a nurse teach family members prior to them entering the
room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room..
Answer: 1., 2., 4., & 5. Correct: Protective isolation is needed for this
client because of the presence of a low white blood cell count. We are
protecting the client from acquiring an infection. So any visitors will
need to have meticulous hand washing prior to entering. The visitor
should not enter if he or she has any type of infection. To decrease the
risk of infection, small children should not visit. Even the mildest
symptom of infection could be detrimental to the client. Flowers have
bacteria and should not be brought into the room.
3. Incorrect: A mask must be worn by the visitor, not the client. The
mask is worn by visitors to prevent a possible spread of an airborne
infection to the immunocompromised client.
●● A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the
, mental health center, the nurse discusses the medication and response
with the client. The nurse's assessment reveals that the client is confused
about the date and about the prescribed dosage of the medication. Which
question would be most important for the nurse to ask to further assess
the situation?
1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving?.
Answer: 2. Correct: Myoclonus, high body temperature, shaking, chills,
and mental confusion are some of the symptoms of serotonin syndrome.
This client may be having symptoms of this adverse reaction which, if
severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective
serotonin reuptake inhibitors (SSRIs) may cause insomnia; however,
there is a more pertinent question needed for assessment of this client.
You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the
client is exhibiting significant symptoms of an adverse reaction which
would take priority.
4. Incorrect: The response to the SSRI medications is important;
however, there is a more significant issue in this case. The possible
