ATI RN
ATI RN Comprehensive Exit Exam
1. Which of the following lab values indicates a patient on warfarin is at a therapeutic level?
- A. INR of 1.1
- B. PT of 12 seconds
- C. INR of 2.5
- D. Platelet count of 150,000
Correct answer: C
Rationale: An INR of 2.5 indicates a therapeutic level for a patient on warfarin. The INR (International Normalized Ratio) is the most accurate way to monitor and adjust warfarin doses. An INR of 1.1 (Choice A) is below the therapeutic range, indicating a need for an increased dose. PT (Prothrombin Time) of 12 seconds (Choice B) is not specific for warfarin therapy monitoring. Platelet count (Choice D) is not directly related to monitoring warfarin therapy.
2. A nurse is caring for a client who is at risk for developing deep vein thrombosis (DVT). Which of the following actions should the nurse implement?
- A. Massage the client's legs every 2 hours.
- B. Encourage the client to remain on bed rest.
- C. Apply sequential compression devices to the client's legs.
- D. Administer anticoagulants as prescribed.
Correct answer: C
Rationale: The correct action the nurse should implement is to apply sequential compression devices to the client's legs. This intervention helps prevent venous stasis and reduce the risk of deep vein thrombosis (DVT). Massaging the client's legs may dislodge a clot and is contraindicated in this situation (choice A). Encouraging bed rest may increase the risk of DVT due to prolonged immobility (choice B). While administering anticoagulants is a common treatment for DVT, in this case, the question is about preventive measures, and using sequential compression devices is a non-pharmacological approach.
3. A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is experiencing dyspnea. Which of the following actions should the nurse take?
- A. Encourage the client to take deep breaths.
- B. Place the client in a high-Fowler's position.
- C. Administer a bronchodilator.
- D. Administer oxygen at 6 L/min via face mask.
Correct answer: B
Rationale: The correct answer is to place the client in a high-Fowler's position. This position helps improve breathing by expanding the lungs and aiding in better oxygenation. Encouraging the client to take deep breaths may not be effective in managing dyspnea in COPD as it can lead to fatigue. Administering a bronchodilator may be necessary but placing the client in a high-Fowler's position should be the priority. Administering oxygen at 6 L/min via face mask may also be needed, but positioning is the initial intervention to optimize respiratory function.
4. A nurse is caring for a client following the application of a cast. Which of the following actions should the nurse take first?
- A. Place an ice pack over the cast
- B. Palpate the pulse distal to the cast
- C. Teach the client to keep the cast clean and dry
- D. Position the casted extremity on a pillow
Correct answer: B
Rationale: Palpating the pulse distal to the cast is the priority as it assesses for circulation. Ensuring adequate blood flow is essential to prevent complications such as compartment syndrome. Placing an ice pack over the cast could cause constriction of blood vessels, further compromising circulation. Teaching the client about cast care and positioning the casted extremity on a pillow are important but do not take precedence over assessing circulation.
5. A nurse is assessing a client who is experiencing a panic attack. Which of the following findings should the nurse expect?
- A. Bradycardia.
- B. Hypotension.
- C. Chest pain.
- D. Dilated pupils.
Correct answer: D
Rationale: During a panic attack, the sympathetic nervous system is activated, leading to physiological responses such as dilated pupils. Bradycardia (slow heart rate) and hypotension (low blood pressure) are not typically associated with panic attacks. While chest pain can occur during a panic attack due to rapid breathing and muscle tension, dilated pupils are a more specific finding related to sympathetic activation in this context.
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