“NCLEX PN ARCHER REVIEW EXAM 2026
”LATEST EXAM 2026 – 2027 SOLVED
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NCLEX PN ARCHER REVIEW
The nurse is caring for a client diagnosed with hyperthyroidism. Which of the
following signs and symptoms would be expected?
Select all that apply.
Weight loss
Diarrhea
Decreased appetite
Insomnia
Palpitations
Weight loss
Diarrhea
Insomnia
Palpitations
Rationale:
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Hyperthyroidism results in overactive thyroid, resulting in an increased amount of
thyroid hormones. There is an increase in metabolism and, therefore, weight loss
despite an increased appetite. Symptoms include increased hunger, thirst, diarrhea,
insomnia, palpitations, and tremors.
Weight loss despite increased appetite is a symptom of hyperthyroidism.
Diarrhea is a symptom of hyperthyroidism.
Insomnia is a symptom of hyperthyroidism.
Increased thyroid hormones increase the heart rate. Clients may experience
palpitations. Arrhythmias (atrial fibrillation) may follow.
Iron deficiency anemia findings:
Tachycardia
Pica
Pallor
Glossitis
Rationale:
Anemia triggers compensatory mechanisms, including an increased heart rate, to
enhance tissue oxygen delivery. Tachycardia is a common finding in clients with iron
deficiency anemia. Iron deficiency anemia can develop pica, characterized by
cravings for non-food substances such as ice, clay, or dirt. This unusual craving is
believed to be an adaptive response aimed at obtaining necessary nutrients,
including iron. Iron deficiency anemia reduces the production of red blood cells and
hemoglobin, leading to decreased oxygen supply to body tissues. This can result in
pallor, especially in the conjunctiva, nail beds, and mucous membranes.
The nurse is collecting data on a client with celiac disease. Which of the
following findings would be expected?
Select all that apply.
dehydration
nausea and vomiting
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abdominal distention
skin rash
Rationale:
In Celiac disease, clients have large amounts of diarrhea that put them at risk for
dehydration. IV fluid administration will be a priority for this client.
A client with Celiac disease may present with nausea and vomiting if they have not
been following a gluten-free diet. Their body will not be able to absorb gluten, and
therefore the consumption of it can cause nausea, vomiting, and diarrhea.
Abdominal distention is an expected finding in a client with Celiac disease due to
gluten intolerance and malabsorption. Their abdomen will not only be distended but
uncomfortable and tender to palpation.
A skin rash called dermatitis herpetiformis is a common celiac disease symptom
characterized by itchy, blistering patches on the skin.
ADHD medication:
Methylphenidate
Rationale:
ADHD may be treated by psychostimulants such as amphetamines or
methylphenidate. These medications work by projecting the dopamine and
norepinephrine in the front of the brain to ameliorate the symptoms of inattention,
impulsivity, and hyperactivity.
When assessing a client's eyes for accommodation, what actions would the
nurse perform? Select all that apply.
Bring a penlight from the side of the client's face and briefly shine the light on
the pupil.
Hold a forefinger, a pencil, or another straight object about 10 to 15 cm (4” to
6”) from the bridge of the client's nose.
Hold a finger about 6” to 8” from the bridge of the client's nose.
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Darken the room.
Ask the client to look straight ahead.
Ask the client to first look at a close object, then at a distant object, then back
at the close object.
Hold a forefinger, a pencil, or another straight object about 10 to 15 cm (4” to
6”) from the bridge of the client's nose.
Ask the client to first look at a close object, then at a distant object, then back
at the close object.
Rationale:
To test accommodation, the nurse would hold the forefinger, a pencil, or another
straight object about 4-6 inches from the bridge of the client's nose. Then the nurse
would ask the client to first look at a close object, then at a distant object, then back
to the object being held. The pupil normally constricts when looking at a near object
and dilates when looking at a distant object.
The nurse is observing a client ambulate with crutches using the three-point
gait. Which observation requires follow-up by the nurse? The client
A. places the crutches 15 cm (6 inches) in front of and 15 cm (6 inches) to the
side of each foot prior to walking.
B. advances both crutches and the injured leg forward and then moves the
non-injured leg.
C. has the elbows flexed 30 degrees with the hands and arms supporting the
body weight.
D. moves a crutch at the same time as the opposing leg.
moves a crutch at the same time as the opposing leg.
Rationale:
This technique does not reflect the three-point gait. This gait pattern depicts the two-
point gait, which requires at least partial weight bearing of both lower extremities. In
the two-point gait, the left crutch and right leg move forward, followed by the right
crutch and left leg.
NGN The emergency department (ED) nurse is caring for a 42-year-old
reporting flank pain
Item 2 of 6
The nurse is analyzing the client's findings