ATI RN
ATI RN Custom Exams Set 2
1. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?
- A. Discontinue the heparin drip prior to initiating the Coumadin
- B. Check the client’s INR prior to beginning Coumadin
- C. Clarify the order with the health care provider as soon as possible
- D. Administer the Coumadin along with the heparin drip as ordered
Correct answer: D
Rationale: The correct action for the nurse to take is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip prior to initiating Coumadin could leave the patient without anticoagulation coverage during the period when warfarin's effects are not yet established. Checking the client's INR prior to beginning Coumadin is important but not the immediate action to take when both medications are ordered together. Clarifying the order with the health care provider is unnecessary in this scenario as it is common practice to give heparin and warfarin concurrently in the transition period.
2. A client taking haloperidol is exhibiting extrapyramidal symptoms. Which intervention should the nurse anticipate?
- A. Increase the dose of haloperidol.
- B. Administer benztropine.
- C. Administer naloxone.
- D. Monitor blood pressure before administering the next dose.
Correct answer: B
Rationale: The correct intervention for a client exhibiting extrapyramidal symptoms while taking haloperidol is to administer benztropine. Benztropine is an anticholinergic medication commonly used to manage extrapyramidal symptoms caused by antipsychotic medications like haloperidol. Increasing the dose of haloperidol (Choice A) would exacerbate the symptoms rather than alleviate them. Administering naloxone (Choice C) is not indicated for extrapyramidal symptoms. Monitoring blood pressure (Choice D) is important but not the primary intervention for managing extrapyramidal symptoms.
3. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings should the healthcare provider expect? Select one that does not apply.
- A. Restlessness
- B. Fatigue
- C. Excessive worry
- D. Mania
Correct answer: D
Rationale: In generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, and excessive worry. These symptoms are typical in individuals with GAD due to persistent and excessive anxiety. Mania, on the other hand, is not a characteristic symptom of GAD. Mania is associated with bipolar disorder and is characterized by distinct features like elevated mood, grandiosity, and impulsivity. Therefore, the correct answer is 'D: Mania,' as it does not align with the expected findings in generalized anxiety disorder.
4. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?
- A. Filgrastim (Neupogen)
- B. Aldesleukin (Proleukin)
- C. Interferon alfa-2b (Intron A)
- D. Darbepoetin alfa (Aranesp)
Correct answer: B
Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.
5. A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?
- A. White blood cell count with differential
- B. RBC, hemoglobin, and hematocrit
- C. INR and aPTT
- D. d-dimer and C-reactive protein
Correct answer: B
Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.