ATI RN
ATI Exit Exam 2023
1. A nurse is reviewing laboratory results for a client who has rheumatoid arthritis and is prescribed methotrexate. Which of the following results should the nurse report to the provider?
- A. White blood cell count 8,000/mm³
- B. Platelet count 150,000/mm³
- C. Hemoglobin 14 g/dL
- D. Aspartate aminotransferase (AST) 60 units/L
Correct answer: D
Rationale: The correct answer is D: Aspartate aminotransferase (AST) 60 units/L. An elevated AST level indicates liver damage, which can be a side effect of methotrexate and should be reported. Elevated white blood cell count (choice A), platelet count (choice B), or normal hemoglobin level (choice C) are not directly related to methotrexate therapy for rheumatoid arthritis.
2. A client is receiving warfarin for atrial fibrillation. Which of the following laboratory tests should the nurse expect to be ordered to monitor the effect of warfarin?
- A. Platelet count
- B. International normalized ratio (INR)
- C. Prothrombin time (PT)
- D. Partial thromboplastin time (PTT)
Correct answer: B
Rationale: The correct answer is B: International normalized ratio (INR). When a client is on warfarin therapy, the INR is monitored regularly to assess the anticoagulant effects of the medication. A therapeutic INR range for most indications is between 2.0 to 3.0. Choices A, C, and D are not typically used to monitor the effect of warfarin. Platelet count assesses the number of platelets in the blood, PT measures the clotting time of plasma, and PTT evaluates the intrinsic pathway of coagulation.
3. A nurse is administering digoxin 0.125 mg Po to an adult client. For which of the following findings should the nurse report to the provider?
- A. Potassium level 4.2 mEq/L
- B. Apical pulse 58/min
- C. Digoxin level 1 ng/ml
- D. Constipation for 2 days
Correct answer: B
Rationale: The correct answer is B. An apical pulse below 60/min indicates bradycardia, a potential sign of digoxin toxicity. The nurse should report this finding to the provider for further evaluation and possible adjustment of the digoxin dose. Choice A, a potassium level of 4.2 mEq/L, is within the normal range (3.5-5.0 mEq/L) and does not indicate toxicity. Choice C, a digoxin level of 1 ng/ml, is within the therapeutic range (0.5-2 ng/ml) and is not suggestive of toxicity. Choice D, constipation for 2 days, is not directly related to digoxin administration and would not require an immediate report to the provider.
4. A client has a new prescription for spironolactone. Which of the following instructions should the nurse include?
- A. Take this medication with a potassium supplement.
- B. Avoid foods that contain potassium.
- C. Limit your fluid intake while taking this medication.
- D. Take this medication on an empty stomach.
Correct answer: B
Rationale: The correct answer is B because spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium. Instructing the client to avoid foods high in potassium helps prevent hyperkalemia, a potential side effect of spironolactone. Choice A is incorrect because taking spironolactone with a potassium supplement can increase the risk of hyperkalemia. Choice C is not directly related to spironolactone use. Choice D is also incorrect as spironolactone does not need to be taken on an empty stomach.
5. A nurse is providing teaching about newborn care to a group of parents. Which of the following instructions should the nurse include?
- A. You should not bathe your newborn every day.
- B. You should avoid covering your newborn with a heavy blanket during naps.
- C. You should expect your newborn's stools to be soft and yellow.
- D. You should keep your newborn's head elevated while they sleep.
Correct answer: D
Rationale: The correct answer is D: 'You should keep your newborn's head elevated while they sleep.' Keeping the newborn's head elevated while sleeping helps prevent conditions like sudden infant death syndrome (SIDS). Choice A is incorrect because newborns do not need to be bathed every day; it is recommended to bathe them 2-3 times a week. Choice B is incorrect as heavy blankets can increase the risk of suffocation for newborns. Choice C is incorrect as newborn stools are typically soft and yellow in color, not firm and light brown.
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