ARCHER -CAT EXAM QUESTIONS AND
ANSWERS WITH RATIONALES
UPDATED VERSION 2024
The nurse cares for a client who has just been admitted with heparin-
induced thrombocytopenia (HIT). Which of the following medications
may have caused this condition?
A. Epoetin alfa
B. Clopidogrel
C. Iron dextran
D. Enoxaparin
,Choice D is correct. HIT is a severe complication to a client taking
heparinoids. Enoxaparin is low-molecular weight-based heparin
(LMWH). Although it is not likely to cause HIT when compared to
unfractionated heparin, the client still runs the risk of developing HIT.
Choices A, B, and C are incorrect. Epoetin alfa is a colony-stimulating
factor indicated for anemia secondary to renal disease. This medication
would not cause HIT. Clopidogrel is an antiplatelet medication that is
not implicated in HIT. Iron dextran is utilized in treating anemia and
would not be involved in HIT.
The RN is caring for a client who is recovering from carotid
endarterectomy. Which assessment would the nurse recognize as a sign
that the client experienced hypoglossal nerve injury?
A. Tongue deviation
B. Inspiratory stridor
C. Tracheal deviation
D. Severe headache
Choice A is correct. Carotid endarterectomy is a procedure to remove
plaque build-up in the carotid artery to improve blood flow to the brain.
,Complications following this procedure include cranial neuropathies,
hemodynamic instability, stroke, myocardial infarction, and hematoma.
Hypoglossal nerve damage is one of the most common cranial
neuropathies following carotid endarterectomy and would be displayed
as tongue deviation.
Choice B is incorrect. Inspiratory stridor or hoarseness would suggest
injury to the laryngeal nerve.
Choice C is incorrect. A tracheal deviation would suggest possible
carotid artery hemorrhage due to blood collecting and putting pressure
on the airway.
Choice D is incorrect. A severe headache following this procedure would
suggest cerebral hyperperfusion syndrome (CHS) due to increased blood
flow to the brain and insufficient cerebrovascular autoregulation.
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The client has been prescribed a continuous infusion of heparin for
multiple venous thromboembolism. The nurse understands that the goal
of this treatment is to prolong the
A. partial thromboplastin time, 1.5 to 2.5 times the normal control.
, B. international normalized ratio, 2 to 3
C. prothrombin time, 1.5 to 2.5 times the normal control.
D. international normalized ratio, 3 to 4
Choice A is correct. The goal for heparin therapy delivered by
continuous infusion is to prolong the partial thromboplastin time, by 1.5
to 2.5 times the normal control value.
Choices B, C, and D are incorrect. Heparin does not impact these
laboratory values. PT and INR is prolonged by warfarin - not heparin.
The partial thromboplastin time (PTT) assesses the intrinsic clotting
cascade and the action of factors II, V, VIII, IX, XI, and XII. Because
factors II, IX, and X are vitamin K dependent and are produced in the
liver, liver disease can prolong the PTT. Desired therapeutic ranges for
anticoagulation are usually between 1.5 and 2.5 times normal (control)
values.
The nurse in the pediatric clinic is speaking to a parent of an 18-month-
old toddler when the parent asks about their child's protruding abdomen.
The most appropriate response by the nurse is:
A. "Your baby overate, resulting in a larger abdomen today."
B. "Your toddler does not yet have developed abdominal muscles."
ANSWERS WITH RATIONALES
UPDATED VERSION 2024
The nurse cares for a client who has just been admitted with heparin-
induced thrombocytopenia (HIT). Which of the following medications
may have caused this condition?
A. Epoetin alfa
B. Clopidogrel
C. Iron dextran
D. Enoxaparin
,Choice D is correct. HIT is a severe complication to a client taking
heparinoids. Enoxaparin is low-molecular weight-based heparin
(LMWH). Although it is not likely to cause HIT when compared to
unfractionated heparin, the client still runs the risk of developing HIT.
Choices A, B, and C are incorrect. Epoetin alfa is a colony-stimulating
factor indicated for anemia secondary to renal disease. This medication
would not cause HIT. Clopidogrel is an antiplatelet medication that is
not implicated in HIT. Iron dextran is utilized in treating anemia and
would not be involved in HIT.
The RN is caring for a client who is recovering from carotid
endarterectomy. Which assessment would the nurse recognize as a sign
that the client experienced hypoglossal nerve injury?
A. Tongue deviation
B. Inspiratory stridor
C. Tracheal deviation
D. Severe headache
Choice A is correct. Carotid endarterectomy is a procedure to remove
plaque build-up in the carotid artery to improve blood flow to the brain.
,Complications following this procedure include cranial neuropathies,
hemodynamic instability, stroke, myocardial infarction, and hematoma.
Hypoglossal nerve damage is one of the most common cranial
neuropathies following carotid endarterectomy and would be displayed
as tongue deviation.
Choice B is incorrect. Inspiratory stridor or hoarseness would suggest
injury to the laryngeal nerve.
Choice C is incorrect. A tracheal deviation would suggest possible
carotid artery hemorrhage due to blood collecting and putting pressure
on the airway.
Choice D is incorrect. A severe headache following this procedure would
suggest cerebral hyperperfusion syndrome (CHS) due to increased blood
flow to the brain and insufficient cerebrovascular autoregulation.
5 Sanity-Saving Tips for Arguing on the Internet
The client has been prescribed a continuous infusion of heparin for
multiple venous thromboembolism. The nurse understands that the goal
of this treatment is to prolong the
A. partial thromboplastin time, 1.5 to 2.5 times the normal control.
, B. international normalized ratio, 2 to 3
C. prothrombin time, 1.5 to 2.5 times the normal control.
D. international normalized ratio, 3 to 4
Choice A is correct. The goal for heparin therapy delivered by
continuous infusion is to prolong the partial thromboplastin time, by 1.5
to 2.5 times the normal control value.
Choices B, C, and D are incorrect. Heparin does not impact these
laboratory values. PT and INR is prolonged by warfarin - not heparin.
The partial thromboplastin time (PTT) assesses the intrinsic clotting
cascade and the action of factors II, V, VIII, IX, XI, and XII. Because
factors II, IX, and X are vitamin K dependent and are produced in the
liver, liver disease can prolong the PTT. Desired therapeutic ranges for
anticoagulation are usually between 1.5 and 2.5 times normal (control)
values.
The nurse in the pediatric clinic is speaking to a parent of an 18-month-
old toddler when the parent asks about their child's protruding abdomen.
The most appropriate response by the nurse is:
A. "Your baby overate, resulting in a larger abdomen today."
B. "Your toddler does not yet have developed abdominal muscles."
