HURST READINESS EXAM 4 ACTUAL TEST
QUESTIONS AND CORRECT ANSWERS
BUNDLED STUDY MATERIAL COMPLETE
GUIDE
●● 3. Correct: Anxiety, restlessness, or a sense of apprehension is often
the first sign/symptoms of acute pulmonary edema.1. Incorrect: Blood
pressure is normal. The number one concern right now is the anxiety: an
early sign of pulmonary edema.
2. Incorrect: Although we would want to help the client having nausea,
the anxiety is of upmost importance, as it might indicate acute
pulmonary edema.
4. Incorrect: The client is dehydrated. A urinary output of 50 mL/hr,
although low, is not at a critical level. Signs of pulmonary edema will
take priority..
Answer: A nurse is caring for a 65 year-old client diagnosed with
dehydration. The client has been receiving intravenous normal saline at
150 mL/hour for the past 4 hours. Which finding would the nurse need
to notify the primary healthcare provider?
1. Blood pressure 136/842.
Report of nausea
3. Anxiety
4. Urinary output at 50 mL/hour
,●● 4. Correct: Insulin syringes and needles should be stored at room
temperature. The potential benefits or risks of refrigerating the syringe
are unknown.1. Incorrect: Insulin injection sites are rotated, but within a
chosen site e.g., the abdomen. Once all the sites in that area are used,
then another area of the body is selected e.g., the arm.
2. Incorrect: As a rule, remember clear before cloudy; that is, draw up
the regular (clear) insulin first, and then draw up the long acting insulin,
isophane suspension (cloudy).
3. Incorrect: Gently blot any blood with a gauze pad. Do not massage the
site. Massaging or rubbing the site will alter the rate of absorption of the
medication..
Answer: What instruction is most important to include when teaching a
child how to self administer a combined dose of isophane suspension
and regular insulin subcutaneously?
1. Alternate the injection sites from one body area to another with each
dose.
2. Draw up the isophane suspension insulin first and then regular insulin
into the same insulin syringe.
3. Massage the injection site after the medication is injected.
4. Insulin syringes should be stored at room temperature.
●● 2. & 4. Correct: Not removing the hair at all is preferred, but if this is
not an option the use of clippers or a depilatory cream may be used to
prevent trauma to the skin before surgery.1. Incorrect: Using a razor for
hair removal is not recommended because it causes micro-abrasions of
, the skin. Bacteria multiply in the micro-abrasions, increasing the risk of
infection. This is not appropriate for a client going to surgery..
Answer: The nurse is preparing a client for surgery. Which methods are
appropriate for the nurse to use in removing excessive body hair?
1. Shaving the hair with a razor.
2. Removing the hair with clippers.
3. Lathering the skin with soap and water prior to shaving with a razor.
4. Using a depilatory cream.
5. Always use a new, sharp razor.
●● 3., & 4. Correct: The frontal lobe is responsible for motor control,
ability to speak words, concentration, memory, and judgment..
Answer: What impaired functions does the nurse expect to observe in
the client admitted with an injury to the frontal lobe of the brain?1.
Decreased sensation to touch.2. Impaired vision.3. Impaired speech.4.
Decreased concentration.5. Decreased hearing.
●● 1, & 2. Correct: AV shunts should have the presence of a bruit and a
thrill which indicates patency..
Answer: The nurse is caring for a client with chronic renal failure who
receives dialysis treatment. Which findings would indicate to the nurse
that the client's AV shunt is patent? SATA.
1. A bruit is heard with a stethoscope.
2. A thrill is felt on palpation.
QUESTIONS AND CORRECT ANSWERS
BUNDLED STUDY MATERIAL COMPLETE
GUIDE
●● 3. Correct: Anxiety, restlessness, or a sense of apprehension is often
the first sign/symptoms of acute pulmonary edema.1. Incorrect: Blood
pressure is normal. The number one concern right now is the anxiety: an
early sign of pulmonary edema.
2. Incorrect: Although we would want to help the client having nausea,
the anxiety is of upmost importance, as it might indicate acute
pulmonary edema.
4. Incorrect: The client is dehydrated. A urinary output of 50 mL/hr,
although low, is not at a critical level. Signs of pulmonary edema will
take priority..
Answer: A nurse is caring for a 65 year-old client diagnosed with
dehydration. The client has been receiving intravenous normal saline at
150 mL/hour for the past 4 hours. Which finding would the nurse need
to notify the primary healthcare provider?
1. Blood pressure 136/842.
Report of nausea
3. Anxiety
4. Urinary output at 50 mL/hour
,●● 4. Correct: Insulin syringes and needles should be stored at room
temperature. The potential benefits or risks of refrigerating the syringe
are unknown.1. Incorrect: Insulin injection sites are rotated, but within a
chosen site e.g., the abdomen. Once all the sites in that area are used,
then another area of the body is selected e.g., the arm.
2. Incorrect: As a rule, remember clear before cloudy; that is, draw up
the regular (clear) insulin first, and then draw up the long acting insulin,
isophane suspension (cloudy).
3. Incorrect: Gently blot any blood with a gauze pad. Do not massage the
site. Massaging or rubbing the site will alter the rate of absorption of the
medication..
Answer: What instruction is most important to include when teaching a
child how to self administer a combined dose of isophane suspension
and regular insulin subcutaneously?
1. Alternate the injection sites from one body area to another with each
dose.
2. Draw up the isophane suspension insulin first and then regular insulin
into the same insulin syringe.
3. Massage the injection site after the medication is injected.
4. Insulin syringes should be stored at room temperature.
●● 2. & 4. Correct: Not removing the hair at all is preferred, but if this is
not an option the use of clippers or a depilatory cream may be used to
prevent trauma to the skin before surgery.1. Incorrect: Using a razor for
hair removal is not recommended because it causes micro-abrasions of
, the skin. Bacteria multiply in the micro-abrasions, increasing the risk of
infection. This is not appropriate for a client going to surgery..
Answer: The nurse is preparing a client for surgery. Which methods are
appropriate for the nurse to use in removing excessive body hair?
1. Shaving the hair with a razor.
2. Removing the hair with clippers.
3. Lathering the skin with soap and water prior to shaving with a razor.
4. Using a depilatory cream.
5. Always use a new, sharp razor.
●● 3., & 4. Correct: The frontal lobe is responsible for motor control,
ability to speak words, concentration, memory, and judgment..
Answer: What impaired functions does the nurse expect to observe in
the client admitted with an injury to the frontal lobe of the brain?1.
Decreased sensation to touch.2. Impaired vision.3. Impaired speech.4.
Decreased concentration.5. Decreased hearing.
●● 1, & 2. Correct: AV shunts should have the presence of a bruit and a
thrill which indicates patency..
Answer: The nurse is caring for a client with chronic renal failure who
receives dialysis treatment. Which findings would indicate to the nurse
that the client's AV shunt is patent? SATA.
1. A bruit is heard with a stethoscope.
2. A thrill is felt on palpation.
