NCLEX PN ARCHER REVIEW 2026 ACTUAL EXAM latest
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED
A+ 2025\2026
The nurse is caring for a client exhibiting signs of poor muscle coordination, stooped posture, and slow
movements. Which medication is most likely to cause these symptoms?
- correct answer Haloperidol
Rationale:
Haloperidol is a typical antipsychotic that may adversely cause extrapyramidal side effects (EPS). These
effects include akathisia, dystonia, pseudo-parkinsonism, and/or tardive dyskinesia. Tardive dyskinesia is
an adverse effect that occurs with antipsychotics and has an onset of months to years while on the
medication.
While reviewing the morning labs of your client, you see the following results from their thyroid panel.
What diagnosis does the nurse suspect?
TSH: 7 mU/L
T4: 1.0 mcg/dL
T3: 2.0 ng/dL
- correct answer Hypothyroidism
Rationale:
Hypothyroidism would be manifested with an increased thyroid-stimulating hormone level and
decreased T4 and T3, as shown in these labs. Because of the increased TSH level, the thyroid gland is
tricked into thinking that there is enough thyroid hormone already in the body and does not secrete
more. The decreased T3 and T4 levels cause hypothyroidism symptoms, such as weight gain and fatigue.
The nurse reinforces teaching to a client with hypertension about the newly prescribed furosemide.
Which of the following should the nurse include in the teaching?
- correct answer Take this medication in the early part of the day
,Rationale:
Furosemide is a loop diuretic and may be indicated for conditions such as heart failure or hypertension.
The client should be instructed to take this medication in the earlier part of the day to avoid nocturia.
The nurse is assessing a 7-month-old infant. At this age, which of the following reflexes would the nurse
expect to no longer be present? Select all that apply.
- correct answer Rooting
Moro
Palmar
Tonic neck
Rationale:
The Rooting reflex should disappear by 3-4 months of age. It occurs when the infants turn their face
toward stimulation (such as stroking their cheek) and make sucking (rooting) motions with the mouth.
This reflex helps to ensure successful feeding.
The Moro reflex should disappear by 5-6 months of age. This reflex is a response to a sudden loss of
support. When support is removed, the infant spreads out the arms and cries.
The Palmar reflex should disappear by 2-3 months of age. When an object is placed in an infant's hand,
and the palm is stroked, the fingers will close reflexively.
The tonic neck reflex disappears around 4 months of age. This reflex is elicited by turning the infant's
head to one side and is considered positive if the infant extends the extremities on the side that the
head is turned toward, and flexes the extremities on the opposite side.
The nurse is caring for a client with diabetes mellitus. Which of the following laboratory data requires
follow-up? Select all that apply.
- correct answer Hemoglobin A1C 8.5% [< 5.7%]
Creatinine 1.9 mg/dL [0.6-1.2 mg/dL]
BUN 25 mg/dL [10-20 mg/dL]
Proteinuria
,Rationale:
The client's hemoglobin A1C is elevated as the therapeutic goal for a client with diabetes is to attain less
than 7%. This elevated level is causing the client to experience an insult to the kidneys, which is evident
by the increased BUN (normal 10-20 mg/dL) and creatinine (normal 0.6-1.2 mg/dL). Finally, proteinuria
is further evidence that this client is experiencing diabetic nephropathy.
The nurse is caring for the following assigned clients. Which client should the nurse follow up with first?
- correct answer A client requesting diphenhydramine after starting an intravenous antibiotic.
Rationale:
A client requesting diphenhydramine following the initiation of an antibiotic requires immediate follow-
up because the client could be experiencing an allergic reaction ranging from mild to severe. Thus, the
nurse should quickly follow-up with this client.
The nurse is assessing a 6-year-old client with asthma. Which of the following findings is of highest
concern?
- correct answer Silent chest
Rationale:
Silent chest is the assessment finding of most concern. This refers to the inability to auscultate any lung
sounds. There is complete obstruction of the client's airway, and therefore the inability to move air.
When complete obstruction occurs, this is a medical emergency. This assessment finding is of most
concern because the client has lost their airway.
The nurse is caring for a client with newly prescribed zolpidem. The nurse understands that this
medication is indicated for which condition?
- correct answer Insomnia
Rationale:
Zolpidem is a non-benzodiazepine indicated in the treatment of insomnia.
*NGN* The nurse is caring for a 47-year-old male in the outpatient clinic
, Orders
Discharge home
Schedule a follow-up appointment in four weeks
Sertraline 50 mg PO Daily
Clonidine 0.1 mg PO Daily
Zolpidem 5 mg PO, PRN insomnia
The nurse reviews the orders and formulates a teaching plan for the newly prescribed medications
For each medication, select the appropriate option for drug classification and client teaching that should
be reinforced
- correct answer Clonidine - alpha2-adrenergic agonist
This medication may cause you to become dizzy or tired.
Sertraline - selective serotonin reuptake inhibitor
Diarrhea is a common side effect of this medication.
Zolpidem - Hypnotic
Do not take this medication with alcohol
Rationale:
Clonidine is indicated in the treatment of hypertension. The medication may be administered as a pill or
transdermal patch for seven days. It should not be abruptly discontinued because of the risk of rebound
hypertension due to a catecholamine surge. Clonidine has a sedative effect, and the client should not
take this medication with alcohol or while driving/performing tasks requiring a high degree of
concentration.
Sertraline is a potent, selective serotonin reuptake inhibitor. Sertraline is indicated in treating anxiety,
obsessive-compulsive, and depressive disorders. SSRIs typically cause gastrointestinal distress once they
are started and may be lessened by taking the medication with food.
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED
A+ 2025\2026
The nurse is caring for a client exhibiting signs of poor muscle coordination, stooped posture, and slow
movements. Which medication is most likely to cause these symptoms?
- correct answer Haloperidol
Rationale:
Haloperidol is a typical antipsychotic that may adversely cause extrapyramidal side effects (EPS). These
effects include akathisia, dystonia, pseudo-parkinsonism, and/or tardive dyskinesia. Tardive dyskinesia is
an adverse effect that occurs with antipsychotics and has an onset of months to years while on the
medication.
While reviewing the morning labs of your client, you see the following results from their thyroid panel.
What diagnosis does the nurse suspect?
TSH: 7 mU/L
T4: 1.0 mcg/dL
T3: 2.0 ng/dL
- correct answer Hypothyroidism
Rationale:
Hypothyroidism would be manifested with an increased thyroid-stimulating hormone level and
decreased T4 and T3, as shown in these labs. Because of the increased TSH level, the thyroid gland is
tricked into thinking that there is enough thyroid hormone already in the body and does not secrete
more. The decreased T3 and T4 levels cause hypothyroidism symptoms, such as weight gain and fatigue.
The nurse reinforces teaching to a client with hypertension about the newly prescribed furosemide.
Which of the following should the nurse include in the teaching?
- correct answer Take this medication in the early part of the day
,Rationale:
Furosemide is a loop diuretic and may be indicated for conditions such as heart failure or hypertension.
The client should be instructed to take this medication in the earlier part of the day to avoid nocturia.
The nurse is assessing a 7-month-old infant. At this age, which of the following reflexes would the nurse
expect to no longer be present? Select all that apply.
- correct answer Rooting
Moro
Palmar
Tonic neck
Rationale:
The Rooting reflex should disappear by 3-4 months of age. It occurs when the infants turn their face
toward stimulation (such as stroking their cheek) and make sucking (rooting) motions with the mouth.
This reflex helps to ensure successful feeding.
The Moro reflex should disappear by 5-6 months of age. This reflex is a response to a sudden loss of
support. When support is removed, the infant spreads out the arms and cries.
The Palmar reflex should disappear by 2-3 months of age. When an object is placed in an infant's hand,
and the palm is stroked, the fingers will close reflexively.
The tonic neck reflex disappears around 4 months of age. This reflex is elicited by turning the infant's
head to one side and is considered positive if the infant extends the extremities on the side that the
head is turned toward, and flexes the extremities on the opposite side.
The nurse is caring for a client with diabetes mellitus. Which of the following laboratory data requires
follow-up? Select all that apply.
- correct answer Hemoglobin A1C 8.5% [< 5.7%]
Creatinine 1.9 mg/dL [0.6-1.2 mg/dL]
BUN 25 mg/dL [10-20 mg/dL]
Proteinuria
,Rationale:
The client's hemoglobin A1C is elevated as the therapeutic goal for a client with diabetes is to attain less
than 7%. This elevated level is causing the client to experience an insult to the kidneys, which is evident
by the increased BUN (normal 10-20 mg/dL) and creatinine (normal 0.6-1.2 mg/dL). Finally, proteinuria
is further evidence that this client is experiencing diabetic nephropathy.
The nurse is caring for the following assigned clients. Which client should the nurse follow up with first?
- correct answer A client requesting diphenhydramine after starting an intravenous antibiotic.
Rationale:
A client requesting diphenhydramine following the initiation of an antibiotic requires immediate follow-
up because the client could be experiencing an allergic reaction ranging from mild to severe. Thus, the
nurse should quickly follow-up with this client.
The nurse is assessing a 6-year-old client with asthma. Which of the following findings is of highest
concern?
- correct answer Silent chest
Rationale:
Silent chest is the assessment finding of most concern. This refers to the inability to auscultate any lung
sounds. There is complete obstruction of the client's airway, and therefore the inability to move air.
When complete obstruction occurs, this is a medical emergency. This assessment finding is of most
concern because the client has lost their airway.
The nurse is caring for a client with newly prescribed zolpidem. The nurse understands that this
medication is indicated for which condition?
- correct answer Insomnia
Rationale:
Zolpidem is a non-benzodiazepine indicated in the treatment of insomnia.
*NGN* The nurse is caring for a 47-year-old male in the outpatient clinic
, Orders
Discharge home
Schedule a follow-up appointment in four weeks
Sertraline 50 mg PO Daily
Clonidine 0.1 mg PO Daily
Zolpidem 5 mg PO, PRN insomnia
The nurse reviews the orders and formulates a teaching plan for the newly prescribed medications
For each medication, select the appropriate option for drug classification and client teaching that should
be reinforced
- correct answer Clonidine - alpha2-adrenergic agonist
This medication may cause you to become dizzy or tired.
Sertraline - selective serotonin reuptake inhibitor
Diarrhea is a common side effect of this medication.
Zolpidem - Hypnotic
Do not take this medication with alcohol
Rationale:
Clonidine is indicated in the treatment of hypertension. The medication may be administered as a pill or
transdermal patch for seven days. It should not be abruptly discontinued because of the risk of rebound
hypertension due to a catecholamine surge. Clonidine has a sedative effect, and the client should not
take this medication with alcohol or while driving/performing tasks requiring a high degree of
concentration.
Sertraline is a potent, selective serotonin reuptake inhibitor. Sertraline is indicated in treating anxiety,
obsessive-compulsive, and depressive disorders. SSRIs typically cause gastrointestinal distress once they
are started and may be lessened by taking the medication with food.
