Hurst Readiness Exam 1: Questions

Hurst Readiness Exam 1: Questions &

Answers

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?

• Progesterone
• Estrogen
• Follicle-stimulating hormone (FSH) 4. Human chorionic

gonadotropin (hCG) (Ans -

• 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?

• Mediastinal shift
• Tension pneumothorax
• Flail chest
• Pulmonary contusion

(Ans -

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. 1 / 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?

• Client admitted with possible tuberculosis (TB) awaiting skin test

results.

• Client diagnosed with seizure disorder.
• 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.(Ans -

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?

• Check shoes for rough spots in the lining.
• File toenails straight across.
• Cover feet and between toes with creams to moisten the skin.
• Break in new shoes gradually.
• Use pumice stones to treat calluses.

(Ans - 2 / 4

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?

• Satisfying and supporting the next generation.
• Reflecting on life accomplishments.
• Developing meaningful and intimate relationships.
• 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.(Ans

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.

• / 4

What symptoms does the nurse expect to see in a client with bulimia nervosa?

• Amenorrhea
• Feelings of self-worth unduly influenced by weight
• Recurrent episodes of binge eating
• Recurrent inappropriate compensatory behavior to prevent weight

gain

• Lack of exercise

(Ans -

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?

• Surgical cannulation of the bile duct is causing spasm and pain.
• Carbon dioxide used intraperitoneally is irritating the phrenic nerve.
• Large abdominal retractors used in the procedure compressed a

nerve.

• Side lying position in the operating room generated pressure

damage.(Ans - 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

• / 4