ATI RN
ATI RN Exit Exam 2023
1. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse plan to administer?
- A. Lorazepam
- B. Atenolol
- C. Naltrexone
- D. Methadone
Correct answer: A
Rationale: Lorazepam is the correct choice for managing acute alcohol withdrawal symptoms due to its effectiveness in controlling agitation and tremors associated with this condition. Atenolol (Choice B) is a beta-blocker mainly used for hypertension and angina, not for alcohol withdrawal symptoms. Naltrexone (Choice C) is used for alcohol dependence treatment by reducing cravings and the rewarding effects of alcohol, but it is not typically used in acute withdrawal situations. Methadone (Choice D) is an opioid agonist mainly used for opioid detoxification and maintenance therapy, not for alcohol withdrawal.
2. How should bleeding in a patient on warfarin be monitored?
- A. Monitor INR levels
- B. Monitor hemoglobin levels
- C. Monitor potassium levels
- D. Monitor platelet count
Correct answer: A
Rationale: The correct answer is to monitor INR levels. INR levels are the most critical indicator for monitoring bleeding risk in patients on warfarin. INR stands for International Normalized Ratio and specifically measures the clotting tendency of the blood. Monitoring hemoglobin levels, potassium levels, or platelet count are not as directly relevant to assessing bleeding risk in patients on warfarin.
3. A healthcare professional is reviewing the laboratory results of a client who is receiving chemotherapy. Which of the following findings should the healthcare professional report immediately?
- A. White blood cell count of 4,500/mm³
- B. Hemoglobin level of 8 g/dL
- C. Platelet count of 90,000/mm³
- D. Serum potassium level of 3.5 mEq/L
Correct answer: C
Rationale: A platelet count of 90,000/mm³ indicates thrombocytopenia, which increases the risk of bleeding and requires immediate intervention. Thrombocytopenia can lead to serious bleeding complications, so it is crucial to address this finding promptly. A low white blood cell count (choice A) may indicate neutropenia but is not as immediately life-threatening as severe thrombocytopenia. A hemoglobin level of 8 g/dL (choice B) would require intervention but is not as urgent as addressing a critically low platelet count. A serum potassium level of 3.5 mEq/L (choice D) is on the lower side of normal but does not pose an immediate risk to the client's safety compared to severe thrombocytopenia.
4. A nurse is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements indicates a need for further teaching?
- A. I will avoid leafy green vegetables while taking warfarin.
- B. I will have my INR checked regularly while taking warfarin.
- C. I will use a soft toothbrush while taking warfarin.
- D. I will take this medication at the same time each day.
Correct answer: A
Rationale: The correct answer is A. Clients taking warfarin should avoid leafy green vegetables because they are high in vitamin K, which can interfere with the effectiveness of warfarin by counteracting its anticoagulant effects. Choices B, C, and D are all correct statements related to taking warfarin. Regular INR monitoring is necessary to ensure the medication is within the therapeutic range, using a soft toothbrush reduces the risk of bleeding gums, and taking the medication at the same time daily helps maintain consistent blood levels.
5. A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?
- A. Glomerular filtration rate of 14 mL/min
- B. BUN 16 mg/dL
- C. Serum magnesium 1.8 mg/dL
- D. Serum phosphorus 4.0 mg/dL
Correct answer: A
Rationale: A glomerular filtration rate (GFR) of 14 mL/min is significantly low, indicating poor kidney function and the need for hemodialysis to remove waste products effectively. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and electrolyte balance but are not direct indicators for the initiation of hemodialysis. BUN (blood urea nitrogen) reflects the kidney's ability to filter waste products, serum magnesium levels are important for muscle and nerve function, and serum phosphorus levels are vital for bone health.
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