HURST REVIEW NCLEX-RN READINESS
EXAM 1 fully solved & updated (latest
version verified for accuracy) | Latest
Update!!!
The primary healthcare provider has prescribed phenytoin 100 mg intravenous push
(IVP) stat for an adult client. What is the least amount of time that the nurse can safely
administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes -CORRECTANSWER 2. Correct: The rate of IV administration should not
exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac arrhythmias. So
100 mg can safely be delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Giving this dose over only one minute could lead to
these or other potential harmful effects.
,3. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Five minutes would be longer than required to be
able to safely administer the medication.
4. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Ten minutes is much longer than required to be able
to safely administer the medication.
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 -CORRECTANSWER 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. -CORRECTANSWER 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. -CORRECTANSWER 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
EXAM 1 fully solved & updated (latest
version verified for accuracy) | Latest
Update!!!
The primary healthcare provider has prescribed phenytoin 100 mg intravenous push
(IVP) stat for an adult client. What is the least amount of time that the nurse can safely
administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes -CORRECTANSWER 2. Correct: The rate of IV administration should not
exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac arrhythmias. So
100 mg can safely be delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Giving this dose over only one minute could lead to
these or other potential harmful effects.
,3. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Five minutes would be longer than required to be
able to safely administer the medication.
4. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and
1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the
risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered
over a period of at least 2 minutes. Ten minutes is much longer than required to be able
to safely administer the medication.
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 -CORRECTANSWER 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. -CORRECTANSWER 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. -CORRECTANSWER 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
