Look on your start menu and under the Qt folder (or wherever you installed it), there will be a Qt 4.whatever command prompt icon. Starting that will put all of the proper environment variables in place for that session.
There's some specific compilation steps that you'll have to look up (I haven't done it in a while), so grab a good tutorial (like the first edition of C++ GUI Programming with Qt4 available at http://www.qtrac.eu/marksummerfield.html free and legal -- it's getting a little bit outdated but the beginning material in the book should have remained constant over Qt releases).
jonsca
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