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ARCHER/HURST QUESTIONS EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026
EDITION
The nurse is caring for a client diagnosed with chronic renal failure who has been
taking Epoetin alfa for 2 months. What should the nurse monitor for pertaining to
Epoetin alfa during the client's clinic visit?
Select all that apply
1. Hypertension
2. Halitosis
3. Hemoptysis
4. Oliguria
5. Dependent edema
1., 3., & 5. Correct: Epoetin alfa can cause or worsen high blood pressure, induce rapid
weight gain, and swelling of feet and hands . Clients may experience coughing up of
blood as a result of a rapid increase in the number of RBCs
A client receiving torsemide 20 mg every day reports an onset of cramping in the
lower extremities. Based on this report, what current lab finding would the nurse
expect?
1. Potassium level of 3.1 mEq/L (3.1 mmol/L)
2. Calcium level of 11 mg/dL (2.75 mmol/L)
3. Sodium level of 140 mEq/L (140 mmol/L)
4. pH level of 7.40
1. Correct: Torsemide is a loop diuretic, which causes the excretion of K+. Hypokalemia
can result from use of this diuretic. Normal range for potassium is 3.5 to 5.0 mEq/L (3.5
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to 5.0 mmol/L). Therefore the level of 3.1 mEq/L (3.1 mmoL/L) is hypokalemia, and a
common sign and symptom includes muscle cramps.
Which signs and symptoms would indicate to the nurse that the client is having an
anaphylactic response after receiving penicillin?
Select all that apply
1. Reports a tightness in throat
2. Faint expiratory wheeze on auscultation.
3. Client statement, "I feel like something is wrong."
4. Bounding radial pulse rate of 100/min
5. BP 100/70
1., 2. & 3. Correct: Swelling of face, mouth, throat, and a tightness in throat are
indicative of an inflammatory response that could obstruct the airway. Wheezes
and stridor are indicators of breathing difficulties seen with anaphylactic reaction.
A sense that something bad is happening should serve as a warning that something
bad is really going on. Suspect anaphylactic response.
4. Incorrect: The pulse rate would be increased, but the client would have a thready,
weak pulse, not bounding. The pulse may also be irregular.
The family of a client recently placed on antipsychotic medications for the
treatment of schizophrenia calls the nursing hot line and reports that the client's
temperature is 105.1ºF (40.6ºC), and that the client's muscles are stiff. What
should the nurse tell the family?
1. Continue to monitor for signs and symptoms of infection.
2. Transport the client to the emergency room.
3. The signs and symptoms will subside within a day or so.
4. They should call the primary healthcare provider tomorrow
2. Correct. The client may be experiencing neuroleptic malignant syndrome, a
potentially life threatening adverse reaction. Symptoms include high fever, unstable
blood pressure and myoglobinemia. The client should be taken to the ER.
A nurse manager is monitoring staff nurse compliance with regulatory guidelines
regarding administration of controlled substances. Which actions by the staff
nurses indicate to the nurse manager compliance is being maintained?
Select all that apply
1. Removes meperidine from computer controlled dispensing system and places in
client medication drawer for later use.
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2. Second nurse verifies and signs as a witness to morphine 2 mg wasted according
to facility protocol.
3. Verification is made of the number of narcotics available against the inventory
record prior to narcotic removal.
4. Second nurse provides verifying signature for removal of hydromorphone from
the computer controlled dispensing system.
5. Narcotic discrepancy in the computer controlled dispensing system is reported
to the primary healthcare provider.
2. Second nurse verifies and signs as a witness to morphine 2 mg wasted according to
facility protocol.
3. Verification is made of the number of narcotics available against the inventory record
prior to narcotic removal.
The nurse has been teaching the parents of a child taking methylphenidate for the
treatment of attention deficit hyperactivity disorder (ADHD). Which comments by
the parents indicate adequate understanding of the important considerations for
methylphenidate?
Select all that apply
1. "I know that I need to monitor weight."
2. "I am supposed to call if my child has decreased attentiveness."
3. "This medication may cause increased drowsiness."
4. "I know that I need to monitor my childs height."
5. "If my child can’t sleep, the dosage may need to be increased."
1., 2. & 4. Correct: Continued use of the medication may cause delays in growth
and loss of appetite. Lack of appetite may cause weight loss. This drug may affect
child's growth rate. The child's attentiveness should increase with this medication
and if there is no improvement in attentiveness with this medication then notify the
primary healthcare provider.
3. Incorrect: The medication is more likely to cause insomnia especially if administered
late in the day. If this medication can cause insomnia.
5. Incorrect: If the client cannot sleep, it is likely that the afternoon dose will be
decreased or omitted.
A client with nausea, vomiting, and diarrhea for the past three days has been
prescribed one liter of normal saline with 40 mEq (40 mmol/L) of potassium
chloride to infuse at 250 mL per hour. Which assessment would the nurse report to
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the primary healthcare provider prior to initiating the infusion?
1. Blood pressure of 106/54
2. Apical pulse of 112 per minute
3. Tenting of the skin over the sternum
4. Urinary output of 148 mL for the past 6 hours
4. Correct: The client's output is below normal. This could indicate a problem with renal
perfusion. Potassium is excreted through the kidneys, so if the kidneys are not being
perfused, the client would retain potassium. The healthcare provider would need to be
aware of the client's low urine output.
A client comes to the clinic and states that she believes she is pregnant. What
probable signs of pregnancy does the nurse expect to see?
Select All That Apply
1. Amenorrhea
2. Facial chloasma
3. Fetal movement
4. Breast tenderness
5. Positive pregnancy test
6. Urinary frequency
2., & 5. Correct: Probable signs are things that most likely indicate pregnancy and are
signs the primary healthcare provider will identify. Facial chloasma, also known as the
mask of pregnancy, is a probable sign. A positive pregnancy test is also a probable sign
of pregnancy. Why isn't it a positive sign of pregnancy? There are other conditions that
can increase hCG levels.
A client in her first trimester of pregnancy has been attending educational sessions
on pregnancy. What statements by the client would indicate to the nurse that client
teaching has been successful?
Select All That Apply
1. "Good food sources of iron includes spinach, raisins, and dark chocolate."
2. "I will eat at least 40 grams of protein a day."
3. "Taking folic acid will help prevent heart defects from occurring."
4. "Swimming is an acceptable exercise for me while I am pregnant."
5. "I can gain 2 pounds (0.9 kg) per week during my first trimester."
6. "I need to stay out of hot tubs while pregnant."
1., 4., & 6. Correct: Good sources of iron include liver, spinach, lentils, raisins, fortified
cereals, dark chocolate, and dried fruits. Walking and swimming are the best exercises
for a pregnant woman. Remember, no high impact. We also do not want them to get
overheated, so do not let mom get into hot tubes or under heating blankets because
ARCHER/HURST QUESTIONS EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026
EDITION
The nurse is caring for a client diagnosed with chronic renal failure who has been
taking Epoetin alfa for 2 months. What should the nurse monitor for pertaining to
Epoetin alfa during the client's clinic visit?
Select all that apply
1. Hypertension
2. Halitosis
3. Hemoptysis
4. Oliguria
5. Dependent edema
1., 3., & 5. Correct: Epoetin alfa can cause or worsen high blood pressure, induce rapid
weight gain, and swelling of feet and hands . Clients may experience coughing up of
blood as a result of a rapid increase in the number of RBCs
A client receiving torsemide 20 mg every day reports an onset of cramping in the
lower extremities. Based on this report, what current lab finding would the nurse
expect?
1. Potassium level of 3.1 mEq/L (3.1 mmol/L)
2. Calcium level of 11 mg/dL (2.75 mmol/L)
3. Sodium level of 140 mEq/L (140 mmol/L)
4. pH level of 7.40
1. Correct: Torsemide is a loop diuretic, which causes the excretion of K+. Hypokalemia
can result from use of this diuretic. Normal range for potassium is 3.5 to 5.0 mEq/L (3.5
, Page 2 of 58
to 5.0 mmol/L). Therefore the level of 3.1 mEq/L (3.1 mmoL/L) is hypokalemia, and a
common sign and symptom includes muscle cramps.
Which signs and symptoms would indicate to the nurse that the client is having an
anaphylactic response after receiving penicillin?
Select all that apply
1. Reports a tightness in throat
2. Faint expiratory wheeze on auscultation.
3. Client statement, "I feel like something is wrong."
4. Bounding radial pulse rate of 100/min
5. BP 100/70
1., 2. & 3. Correct: Swelling of face, mouth, throat, and a tightness in throat are
indicative of an inflammatory response that could obstruct the airway. Wheezes
and stridor are indicators of breathing difficulties seen with anaphylactic reaction.
A sense that something bad is happening should serve as a warning that something
bad is really going on. Suspect anaphylactic response.
4. Incorrect: The pulse rate would be increased, but the client would have a thready,
weak pulse, not bounding. The pulse may also be irregular.
The family of a client recently placed on antipsychotic medications for the
treatment of schizophrenia calls the nursing hot line and reports that the client's
temperature is 105.1ºF (40.6ºC), and that the client's muscles are stiff. What
should the nurse tell the family?
1. Continue to monitor for signs and symptoms of infection.
2. Transport the client to the emergency room.
3. The signs and symptoms will subside within a day or so.
4. They should call the primary healthcare provider tomorrow
2. Correct. The client may be experiencing neuroleptic malignant syndrome, a
potentially life threatening adverse reaction. Symptoms include high fever, unstable
blood pressure and myoglobinemia. The client should be taken to the ER.
A nurse manager is monitoring staff nurse compliance with regulatory guidelines
regarding administration of controlled substances. Which actions by the staff
nurses indicate to the nurse manager compliance is being maintained?
Select all that apply
1. Removes meperidine from computer controlled dispensing system and places in
client medication drawer for later use.
, Page 3 of 58
2. Second nurse verifies and signs as a witness to morphine 2 mg wasted according
to facility protocol.
3. Verification is made of the number of narcotics available against the inventory
record prior to narcotic removal.
4. Second nurse provides verifying signature for removal of hydromorphone from
the computer controlled dispensing system.
5. Narcotic discrepancy in the computer controlled dispensing system is reported
to the primary healthcare provider.
2. Second nurse verifies and signs as a witness to morphine 2 mg wasted according to
facility protocol.
3. Verification is made of the number of narcotics available against the inventory record
prior to narcotic removal.
The nurse has been teaching the parents of a child taking methylphenidate for the
treatment of attention deficit hyperactivity disorder (ADHD). Which comments by
the parents indicate adequate understanding of the important considerations for
methylphenidate?
Select all that apply
1. "I know that I need to monitor weight."
2. "I am supposed to call if my child has decreased attentiveness."
3. "This medication may cause increased drowsiness."
4. "I know that I need to monitor my childs height."
5. "If my child can’t sleep, the dosage may need to be increased."
1., 2. & 4. Correct: Continued use of the medication may cause delays in growth
and loss of appetite. Lack of appetite may cause weight loss. This drug may affect
child's growth rate. The child's attentiveness should increase with this medication
and if there is no improvement in attentiveness with this medication then notify the
primary healthcare provider.
3. Incorrect: The medication is more likely to cause insomnia especially if administered
late in the day. If this medication can cause insomnia.
5. Incorrect: If the client cannot sleep, it is likely that the afternoon dose will be
decreased or omitted.
A client with nausea, vomiting, and diarrhea for the past three days has been
prescribed one liter of normal saline with 40 mEq (40 mmol/L) of potassium
chloride to infuse at 250 mL per hour. Which assessment would the nurse report to
, Page 4 of 58
the primary healthcare provider prior to initiating the infusion?
1. Blood pressure of 106/54
2. Apical pulse of 112 per minute
3. Tenting of the skin over the sternum
4. Urinary output of 148 mL for the past 6 hours
4. Correct: The client's output is below normal. This could indicate a problem with renal
perfusion. Potassium is excreted through the kidneys, so if the kidneys are not being
perfused, the client would retain potassium. The healthcare provider would need to be
aware of the client's low urine output.
A client comes to the clinic and states that she believes she is pregnant. What
probable signs of pregnancy does the nurse expect to see?
Select All That Apply
1. Amenorrhea
2. Facial chloasma
3. Fetal movement
4. Breast tenderness
5. Positive pregnancy test
6. Urinary frequency
2., & 5. Correct: Probable signs are things that most likely indicate pregnancy and are
signs the primary healthcare provider will identify. Facial chloasma, also known as the
mask of pregnancy, is a probable sign. A positive pregnancy test is also a probable sign
of pregnancy. Why isn't it a positive sign of pregnancy? There are other conditions that
can increase hCG levels.
A client in her first trimester of pregnancy has been attending educational sessions
on pregnancy. What statements by the client would indicate to the nurse that client
teaching has been successful?
Select All That Apply
1. "Good food sources of iron includes spinach, raisins, and dark chocolate."
2. "I will eat at least 40 grams of protein a day."
3. "Taking folic acid will help prevent heart defects from occurring."
4. "Swimming is an acceptable exercise for me while I am pregnant."
5. "I can gain 2 pounds (0.9 kg) per week during my first trimester."
6. "I need to stay out of hot tubs while pregnant."
1., 4., & 6. Correct: Good sources of iron include liver, spinach, lentils, raisins, fortified
cereals, dark chocolate, and dried fruits. Walking and swimming are the best exercises
for a pregnant woman. Remember, no high impact. We also do not want them to get
overheated, so do not let mom get into hot tubes or under heating blankets because
