Page 1 of 47
ARCHER REVIEW READINESS ASSESSMENT
EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
A 52-year-old client with a 20-year history of alcohol abuse is hospitalized with
mild ascites, jaundice, and bruising. Imaging demonstrates the presence of
esophageal varices, while the client's elevated serum ammonia level indicates
hepatic encephalopathy. The nurse is concerned the client's esophageal
varices may rupture and proceeds to educate the client accordingly. Which
item should the nurse include in the client's education session?
A. "Do not lift heavy objects."
B. "Avoid walking briskly."
C. "Avoid taking barbiturates."
D. "Avoid ingesting antacids."
A. "Do not lift heavy objects."
Lifting heavy objects, straining during defecation, stretching, and the Valsalva
maneuver may cause a marked increase in variceal pressure and should, therefore,
be avoided by clients with esophageal varices, cirrhotic clients, and those with portal
hypertension.
The nurse is caring for a client who is postoperative following a lobectomy.
The client is receiving fentanyl via an epidural. The nurse should monitor the
client for which complication?
A. Diarrhea
B. Hypotension
C. Hyperventilation
D. Urinary incontinence
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B. Hypotension
Epidural analgesia commonly causes clients to experience hypotension. The
medication administered via epidural has an immediate onset and may cause a
reduction in venous return and a decrease in afterload. Both of these factors will
reduce the BP. To prevent this complication, IV isotonic fluids are commonly
prescribed before initiating the epidural. The nurse should also stress to the client
the need to change positions slowly and call for help before getting out of bed to
prevent orthostatic hypotension.
The nurse is caring for a child with eczema. Which of the following findings
should the nurse expect? Select all that apply
A. Erythema
B. Pruritus
C. Papules
D. Skin ulcers
E. Scaly circular rash
A. Erythema
B. Pruritus
C. Papules
Erythema is the superficial reddening of the skin. This redness is one of the most
common symptoms of eczema and would be an expected assessment finding for all
types of eczema. Pruritus is severe itching of the skin. Itching is one of the most
common symptoms of eczema and would be an expected assessment finding for all
types of eczema. Papules are solid elevations of skin with no visible fluid less than 1
cm in diameter. Although not all patients with eczema will necessarily have papules,
they are a common assessment finding.
The nurse is assisting the primary healthcare provider (PHCP) with a lumbar
puncture to assess for meningitis. What should be the first action of the
nurse?
A. Lay the client on his side.
B. Ask the client to void.
C. Obtain an advanced directive from the client.
D. Withhold food and drinks from the client prior to the procedure.
B. Ask the client to void.
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The LP procedure may take up to 15-30 minutes. Following the procedure, the client
is asked to lie flat for about one to two hours. Lying flat may reduce the intensity of
post-LP headache, although it may not prevent it. A need to urinate during or
immediately after the procedure interrupts this protocol. Therefore, as an additional
comfort measure, the client should be reminded to empty their bladder before the
procedure begins. This should be the first action of the nurse.B. Ask the client to
void.
A 12-year-old is diagnosed with a vaso-occlusive sickle cell crisis and
complains of severe headaches. What should be the nurse's initial
intervention?
A. Give oxygen at 6 liters per minute via nasal cannula.
B. Assess the client's neurologic status.
C. Give an intravenous dose of morphine.
D. Increase the client's IV rate.
B. Assess the client’s neurologic status.
This client with sickle cell crisis has a high risk of cerebrovascular accidents (CVA).
Since the client has a severe headache, it is best to rule out a CVA before initiating
all other interventions.
The nurse cares for many clients at the end of life who experience symptoms,
such as pain, that are physically distressing to the client and their loved ones.
Which statement reflects the American Nurses Association's position on pain
management at the end of life?
A. Advocate for pain management unless life-threatening side effects occur.
B. Advocate for pain management even if the life-threatening side effects
hasten death.
C. Prohibit the respiratory system from depressing drugs because this is
euthanasia.
D. Allow families to administer respiratory system depressing drugs to hasten
death.
B. Advocate for pain management even if the life-threatening side effects
hasten death.
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The ANA advocates for pain mgmt even if the life-threatening side effects hasten
death. In the past, pain mgmt agents like narcotic analgesics were not given if they
caused respiratory depression that could lead to the cessation of life. This
administration of respiratory system depressing drugs at the end of life is not
considered euthanasia. The ANA doesn't encourage families to administer
respiratory system-depressing drugs to hasten death but it does allow families to
administer respiratory system-depressing drugs to relieve pain at the end of life.
The nurse is preparing a 3-year-old child for an incision and drainage of a
large left leg abscess. The nurse understands which of the following types of
anesthesia will be administered to the child?
A. Peripheral nerve block
B. Spinal anesthesia
C. General Anesthesia
D. Local Anesthesia
C. General Anesthesia
A large leg abscess will need significant time for incision and drainage. Children are
not mature enough to cooperate adequately during such surgical procedures.
Children undergoing most surgeries require GA because this minimizes their fears of
intrusive or mutilating procedures. GA provides necessary sedation so the surgery
can be safely performed.
A nasogastric tube has been inserted into a client with bowel obstruction for
gastric decompression. The nurse should set the suction on which setting?
A. Intermittent suction at 70 mmHg
B. Intermittent suction at 100 mmHg
C. Continuous suction at 100 mmHg
D. Continuous suction at 70 mmHg
A. Intermittent suction at 70 mmHg
Gastric decompression should always be intermittent and at low suction pressure. A
suction pressure below 80 mmHg is considered low suction.
The nurse is reviewing acetaminophen (APAP) toxicity with students. The
nurse should remind students that the maximum acetaminophen dosage for
an adult is
ARCHER REVIEW READINESS ASSESSMENT
EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
A 52-year-old client with a 20-year history of alcohol abuse is hospitalized with
mild ascites, jaundice, and bruising. Imaging demonstrates the presence of
esophageal varices, while the client's elevated serum ammonia level indicates
hepatic encephalopathy. The nurse is concerned the client's esophageal
varices may rupture and proceeds to educate the client accordingly. Which
item should the nurse include in the client's education session?
A. "Do not lift heavy objects."
B. "Avoid walking briskly."
C. "Avoid taking barbiturates."
D. "Avoid ingesting antacids."
A. "Do not lift heavy objects."
Lifting heavy objects, straining during defecation, stretching, and the Valsalva
maneuver may cause a marked increase in variceal pressure and should, therefore,
be avoided by clients with esophageal varices, cirrhotic clients, and those with portal
hypertension.
The nurse is caring for a client who is postoperative following a lobectomy.
The client is receiving fentanyl via an epidural. The nurse should monitor the
client for which complication?
A. Diarrhea
B. Hypotension
C. Hyperventilation
D. Urinary incontinence
, Page 2 of 47
B. Hypotension
Epidural analgesia commonly causes clients to experience hypotension. The
medication administered via epidural has an immediate onset and may cause a
reduction in venous return and a decrease in afterload. Both of these factors will
reduce the BP. To prevent this complication, IV isotonic fluids are commonly
prescribed before initiating the epidural. The nurse should also stress to the client
the need to change positions slowly and call for help before getting out of bed to
prevent orthostatic hypotension.
The nurse is caring for a child with eczema. Which of the following findings
should the nurse expect? Select all that apply
A. Erythema
B. Pruritus
C. Papules
D. Skin ulcers
E. Scaly circular rash
A. Erythema
B. Pruritus
C. Papules
Erythema is the superficial reddening of the skin. This redness is one of the most
common symptoms of eczema and would be an expected assessment finding for all
types of eczema. Pruritus is severe itching of the skin. Itching is one of the most
common symptoms of eczema and would be an expected assessment finding for all
types of eczema. Papules are solid elevations of skin with no visible fluid less than 1
cm in diameter. Although not all patients with eczema will necessarily have papules,
they are a common assessment finding.
The nurse is assisting the primary healthcare provider (PHCP) with a lumbar
puncture to assess for meningitis. What should be the first action of the
nurse?
A. Lay the client on his side.
B. Ask the client to void.
C. Obtain an advanced directive from the client.
D. Withhold food and drinks from the client prior to the procedure.
B. Ask the client to void.
, Page 3 of 47
The LP procedure may take up to 15-30 minutes. Following the procedure, the client
is asked to lie flat for about one to two hours. Lying flat may reduce the intensity of
post-LP headache, although it may not prevent it. A need to urinate during or
immediately after the procedure interrupts this protocol. Therefore, as an additional
comfort measure, the client should be reminded to empty their bladder before the
procedure begins. This should be the first action of the nurse.B. Ask the client to
void.
A 12-year-old is diagnosed with a vaso-occlusive sickle cell crisis and
complains of severe headaches. What should be the nurse's initial
intervention?
A. Give oxygen at 6 liters per minute via nasal cannula.
B. Assess the client's neurologic status.
C. Give an intravenous dose of morphine.
D. Increase the client's IV rate.
B. Assess the client’s neurologic status.
This client with sickle cell crisis has a high risk of cerebrovascular accidents (CVA).
Since the client has a severe headache, it is best to rule out a CVA before initiating
all other interventions.
The nurse cares for many clients at the end of life who experience symptoms,
such as pain, that are physically distressing to the client and their loved ones.
Which statement reflects the American Nurses Association's position on pain
management at the end of life?
A. Advocate for pain management unless life-threatening side effects occur.
B. Advocate for pain management even if the life-threatening side effects
hasten death.
C. Prohibit the respiratory system from depressing drugs because this is
euthanasia.
D. Allow families to administer respiratory system depressing drugs to hasten
death.
B. Advocate for pain management even if the life-threatening side effects
hasten death.
, Page 4 of 47
The ANA advocates for pain mgmt even if the life-threatening side effects hasten
death. In the past, pain mgmt agents like narcotic analgesics were not given if they
caused respiratory depression that could lead to the cessation of life. This
administration of respiratory system depressing drugs at the end of life is not
considered euthanasia. The ANA doesn't encourage families to administer
respiratory system-depressing drugs to hasten death but it does allow families to
administer respiratory system-depressing drugs to relieve pain at the end of life.
The nurse is preparing a 3-year-old child for an incision and drainage of a
large left leg abscess. The nurse understands which of the following types of
anesthesia will be administered to the child?
A. Peripheral nerve block
B. Spinal anesthesia
C. General Anesthesia
D. Local Anesthesia
C. General Anesthesia
A large leg abscess will need significant time for incision and drainage. Children are
not mature enough to cooperate adequately during such surgical procedures.
Children undergoing most surgeries require GA because this minimizes their fears of
intrusive or mutilating procedures. GA provides necessary sedation so the surgery
can be safely performed.
A nasogastric tube has been inserted into a client with bowel obstruction for
gastric decompression. The nurse should set the suction on which setting?
A. Intermittent suction at 70 mmHg
B. Intermittent suction at 100 mmHg
C. Continuous suction at 100 mmHg
D. Continuous suction at 70 mmHg
A. Intermittent suction at 70 mmHg
Gastric decompression should always be intermittent and at low suction pressure. A
suction pressure below 80 mmHg is considered low suction.
The nurse is reviewing acetaminophen (APAP) toxicity with students. The
nurse should remind students that the maximum acetaminophen dosage for
an adult is
