Page 1 of 142
NCLEX ARCHER REVIEW MISSED QUESTIONS
PRACTICE EXAM WITH CORRECT ANSWERS
,RATIONALES AND WHY THE OTHERS ARE NOT
CORRECT NEWEST 2026 EXAM VERIFIED 100 %
You are performing a thorough assessment of a client to determine all
responses to stress. Which of the following are examples of cognitive
responses to stress?
Select all that apply.
A. Difficulty concentrating
B. Poor judgment
C. Depression
D. Forgetfulness
E. Lethargy
F. Aggressiveness
A. Difficulty concentrating
B. Poor judgment
D. Forgetfulness
These are examples of cognitive responses to stress. Psychological responses are
both emotional and cognitive. They include feelings, thoughts, and behaviors.
Emotional responses usually involve anxiety, fear, anger, and depression; whereas,
cognitive responses affect thought processes.
Which of the following are components of the definition of critical thinking?
Select all that apply.
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A. Reasoned thinking
B. Openness to alternatives
C. Adherence to established guidelines
D. Ability to reflect
E. Loyalty to traditional approaches
F. Desire to seek the truth
A. Reasoned thinking
B. Openness to alternatives
D. Ability to reflect
F. Desire to seek the truth
Critical thinking is a combination of reasoned thought, openness to alternatives, the
ability to reflect, and a desire to seek the truth.
There are many definitions of critical thinking. It is a complex concept and people
think about it in different ways. Any situation that requires critical thinking is likely to
have more than one "right" answer. You do not need critical thinking to add 2 + 2 and
come up with the solution. However, you do need critical thinking to problem-solve
essential decisions. A crucial aspect of critical thinking is the process of identifying
and checking your assumption. This is also a necessary part of the research
process. Critical thinking is a combination of reasoned thought, openness to
alternatives, the ability to reflect, and a desire to seek the truth.
The nurse is caring for a client who is receiving prescribed ketorolac. Which of
the following client findings would indicate a therapeutic response? Select all
that apply.
A. Decreased pain
B. Increased urinary output
C. Decreased blood pressure
D. Decreased temperature
E. Increased muscle coordination
A. Decreased pain
D. Decreased temperature
Ketorolac is a medication used to treat pain and pyrexia. A client exhibiting a
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decrease in pain and having a decrease in temperature would be a therapeutic
response.
The nurse is providing education for a diabetic client who is given a
terbinafine prescription for onychomycosis. Which statements by the client
demonstrate a good understanding regarding the treatment with terbinafine?
Select all that apply.
A. "Following a successful course of treatment, my chance of getting cured is
90%."
B. "I will have to take terbinafine for 3 to 6 months."
C. "I will need liver function tests before starting terbinafine."
D. "I will take this on an empty stomach to help improve its absorption."
E. "It may cause taste or vision changes, so I will report vision changes to my
doctor."
F. "Dark urine, pale stools, and persistent nausea may indicate a serious side
effect."
B. "I will have to take terbinafine for 3 to 6 months."
C. "I will need liver function tests before starting terbinafine."
E. "It may cause taste or vision changes, so I will report vision changes to my
doctor."
F. "Dark urine, pale stools, and persistent nausea may indicate a serious side effect."
Onychomycosis, also known as Tinea unguium, is a fungus infection of the nails
(fingernails, toenails) that causes the nails to look thick, discolored, opaque, and
crumbling. Dermatophytes cause 90% of these toenail infections. The remaining
10% are caused by non-dermatophytes (Saprophytes) and yeast (Candida).
Treatment involves topical antifungals and systemic antifungals (Terbinafine,
Lamisil). By inhibiting squalene epoxidase, terbinafine blocks the synthesis of
ergosterol (Ergosterol is a crucial component of the fungal cell membranes). The
nurse should be aware of the interactions and common side effects of terbinafine
because it is one of the commonly prescribed antifungal drugs. Client education
points include:
Even after prolonged treatment, failure and recurrence rate is high (20 to 50%
failure). The cure rate with terbinafine is close to 50% (Choice A is incorrect).
Duration of treatment of toenail onychomycosis is typically much longer (3 to 6
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months) compared to that of fingernails (1 month). Educate the client regarding the
prolonged duration of treatment and instruct them to be compliant (Choice B is
correct).
Educate the client regarding essential side effects and when to contact the
healthcare provider. Common side effects include headache, gastrointestinal side
effects (abdominal pain, nausea, dyspepsia, diarrhea), rash, and taste changes.
To minimize gastrointestinal side effects, terbinafine should be taken with food.
Taking it on an empty stomach may exacerbate gastrointestinal side effe
The nurse is preparing a staff in-service regarding sensorineural hearing loss.
It would be appropriate for the nurse to identify which factors cause this type
of hearing loss? Select all that apply.
A. Presbycusis
B. Ototoxic substance
C. Foreign body
D. Exposure to loud noise
E. Edema
A. Presbycusis
B. Ototoxic substance
D. Exposure to loud noise
These are all risk factors for sensorineural hearing loss. Presbycusis is progressive
and irreversible hearing loss that is often associated with aging. Ototoxic substances
(gentamycin, vancomycin) may also induce sensorineural hearing loss. Exposure to
loud noise is a pointed risk factor because this causes damage to the hair cells of the
cochlea.
The emergency department (ED) nurse is caring for a client with liver cirrhosis
Nurses' Note
57-year-old male reporting increasing dyspnea and abdominal pressure after
missing his previously scheduled paracentesis. The client reports he feels
'uncomfortable.' He is alert and oriented x 4; sclera is yellow along with
jaundice skin appearance. Respirations were labored, tachypnea, and clear
breath sounds. Abdominal distention noted, hypoactive bowel sounds in all
four quadrants. Ascites and dependent edema were noted. Peripheral pulses
NCLEX ARCHER REVIEW MISSED QUESTIONS
PRACTICE EXAM WITH CORRECT ANSWERS
,RATIONALES AND WHY THE OTHERS ARE NOT
CORRECT NEWEST 2026 EXAM VERIFIED 100 %
You are performing a thorough assessment of a client to determine all
responses to stress. Which of the following are examples of cognitive
responses to stress?
Select all that apply.
A. Difficulty concentrating
B. Poor judgment
C. Depression
D. Forgetfulness
E. Lethargy
F. Aggressiveness
A. Difficulty concentrating
B. Poor judgment
D. Forgetfulness
These are examples of cognitive responses to stress. Psychological responses are
both emotional and cognitive. They include feelings, thoughts, and behaviors.
Emotional responses usually involve anxiety, fear, anger, and depression; whereas,
cognitive responses affect thought processes.
Which of the following are components of the definition of critical thinking?
Select all that apply.
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A. Reasoned thinking
B. Openness to alternatives
C. Adherence to established guidelines
D. Ability to reflect
E. Loyalty to traditional approaches
F. Desire to seek the truth
A. Reasoned thinking
B. Openness to alternatives
D. Ability to reflect
F. Desire to seek the truth
Critical thinking is a combination of reasoned thought, openness to alternatives, the
ability to reflect, and a desire to seek the truth.
There are many definitions of critical thinking. It is a complex concept and people
think about it in different ways. Any situation that requires critical thinking is likely to
have more than one "right" answer. You do not need critical thinking to add 2 + 2 and
come up with the solution. However, you do need critical thinking to problem-solve
essential decisions. A crucial aspect of critical thinking is the process of identifying
and checking your assumption. This is also a necessary part of the research
process. Critical thinking is a combination of reasoned thought, openness to
alternatives, the ability to reflect, and a desire to seek the truth.
The nurse is caring for a client who is receiving prescribed ketorolac. Which of
the following client findings would indicate a therapeutic response? Select all
that apply.
A. Decreased pain
B. Increased urinary output
C. Decreased blood pressure
D. Decreased temperature
E. Increased muscle coordination
A. Decreased pain
D. Decreased temperature
Ketorolac is a medication used to treat pain and pyrexia. A client exhibiting a
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decrease in pain and having a decrease in temperature would be a therapeutic
response.
The nurse is providing education for a diabetic client who is given a
terbinafine prescription for onychomycosis. Which statements by the client
demonstrate a good understanding regarding the treatment with terbinafine?
Select all that apply.
A. "Following a successful course of treatment, my chance of getting cured is
90%."
B. "I will have to take terbinafine for 3 to 6 months."
C. "I will need liver function tests before starting terbinafine."
D. "I will take this on an empty stomach to help improve its absorption."
E. "It may cause taste or vision changes, so I will report vision changes to my
doctor."
F. "Dark urine, pale stools, and persistent nausea may indicate a serious side
effect."
B. "I will have to take terbinafine for 3 to 6 months."
C. "I will need liver function tests before starting terbinafine."
E. "It may cause taste or vision changes, so I will report vision changes to my
doctor."
F. "Dark urine, pale stools, and persistent nausea may indicate a serious side effect."
Onychomycosis, also known as Tinea unguium, is a fungus infection of the nails
(fingernails, toenails) that causes the nails to look thick, discolored, opaque, and
crumbling. Dermatophytes cause 90% of these toenail infections. The remaining
10% are caused by non-dermatophytes (Saprophytes) and yeast (Candida).
Treatment involves topical antifungals and systemic antifungals (Terbinafine,
Lamisil). By inhibiting squalene epoxidase, terbinafine blocks the synthesis of
ergosterol (Ergosterol is a crucial component of the fungal cell membranes). The
nurse should be aware of the interactions and common side effects of terbinafine
because it is one of the commonly prescribed antifungal drugs. Client education
points include:
Even after prolonged treatment, failure and recurrence rate is high (20 to 50%
failure). The cure rate with terbinafine is close to 50% (Choice A is incorrect).
Duration of treatment of toenail onychomycosis is typically much longer (3 to 6
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months) compared to that of fingernails (1 month). Educate the client regarding the
prolonged duration of treatment and instruct them to be compliant (Choice B is
correct).
Educate the client regarding essential side effects and when to contact the
healthcare provider. Common side effects include headache, gastrointestinal side
effects (abdominal pain, nausea, dyspepsia, diarrhea), rash, and taste changes.
To minimize gastrointestinal side effects, terbinafine should be taken with food.
Taking it on an empty stomach may exacerbate gastrointestinal side effe
The nurse is preparing a staff in-service regarding sensorineural hearing loss.
It would be appropriate for the nurse to identify which factors cause this type
of hearing loss? Select all that apply.
A. Presbycusis
B. Ototoxic substance
C. Foreign body
D. Exposure to loud noise
E. Edema
A. Presbycusis
B. Ototoxic substance
D. Exposure to loud noise
These are all risk factors for sensorineural hearing loss. Presbycusis is progressive
and irreversible hearing loss that is often associated with aging. Ototoxic substances
(gentamycin, vancomycin) may also induce sensorineural hearing loss. Exposure to
loud noise is a pointed risk factor because this causes damage to the hair cells of the
cochlea.
The emergency department (ED) nurse is caring for a client with liver cirrhosis
Nurses' Note
57-year-old male reporting increasing dyspnea and abdominal pressure after
missing his previously scheduled paracentesis. The client reports he feels
'uncomfortable.' He is alert and oriented x 4; sclera is yellow along with
jaundice skin appearance. Respirations were labored, tachypnea, and clear
breath sounds. Abdominal distention noted, hypoactive bowel sounds in all
four quadrants. Ascites and dependent edema were noted. Peripheral pulses
