ATI RN
ATI Exit Exam 2023
1. 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.
2. A nurse is assessing a client who is 1 hour postoperative following a hysterectomy. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 78/min.
- B. Blood pressure of 120/80 mm Hg.
- C. Oxygen saturation of 94%.
- D. Respiratory rate of 16/min.
Correct answer: A
Rationale: A heart rate of 78/min is within the normal range; however, postoperative patients require close monitoring for any signs of complications. While the heart rate is normal, other critical findings such as increased pain, excessive bleeding, or other concerning symptoms may need immediate attention. Choices B, C, and D all indicate normal postoperative vital signs and oxygen saturation levels, which do not raise immediate concerns requiring reporting to the provider.
3. A healthcare provider is caring for a client who has been diagnosed with sepsis. Which of the following laboratory results indicates that the client is developing disseminated intravascular coagulation (DIC)?
- A. Elevated hemoglobin
- B. Elevated white blood cell count
- C. Decreased fibrinogen level
- D. Decreased platelet count
Correct answer: D
Rationale: The correct answer is D, decreased platelet count. In disseminated intravascular coagulation (DIC), there is widespread activation of clotting factors leading to the formation of multiple blood clots throughout the body, which can deplete platelets. A decreased platelet count is a hallmark of DIC. Elevated hemoglobin (choice A) and elevated white blood cell count (choice B) are not specific indicators of DIC. While fibrinogen levels (choice C) can be decreased in DIC due to consumption, a decreased platelet count is a more specific and early sign of DIC development.
4. A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider?
- A. Passing small clots in the urine.
- B. Continuous bladder irrigation.
- C. Red-tinged urine with numerous clots.
- D. Urine output of 50 mL/hr.
Correct answer: C
Rationale: The correct answer is C: Red-tinged urine with numerous clots. This finding should be reported because it indicates excessive bleeding following a TURP procedure. Passing small clots in the urine (choice A) is expected post-TURP. Continuous bladder irrigation (choice B) is a standard procedure after TURP to prevent clot retention. Urine output of 50 mL/hr (choice D) is within the expected range postoperatively and does not indicate a complication.
5. A nurse is providing teaching to a client about the adverse effects of sertraline. Which of the following adverse effects should the nurse include?
- A. Excessive sweating.
- B. Increased urinary frequency.
- C. Dry cough.
- D. Metallic taste in the mouth.
Correct answer: A
Rationale: The correct adverse effect of sertraline that the nurse should include in the teaching is excessive sweating. Sertraline is known to cause this side effect in some individuals. Increased urinary frequency (choice B) is not a commonly reported adverse effect of sertraline. Dry cough (choice C) and metallic taste in the mouth (choice D) are also not typically associated with sertraline use. Therefore, the nurse should focus on educating the client about the potential adverse effect of excessive sweating.
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