ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is assisting with the care of a client who is postoperative following a craniotomy. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: Clear drainage from the surgical site may indicate a cerebrospinal fluid leak, requiring provider notification. Pain, mild fever, and normal heart rate are expected.
Question 2 of 5
A nurse is assisting with the care of a client who is receiving a continuous IV infusion of heparin. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: Bruising at the IV site with heparin suggests bleeding, requiring provider notification. Normal blood pressure, urine output, and heart rate are not urgent.
Question 3 of 5
A nurse is caring for a client who requires seclusion to prevent harm to others on the unit. Which of the following is an appropriate action for the nurse to take?
Correct Answer: C
Rationale: Discussing with the client his inappropriate behavior prior to seclusion is important, but it's not the most appropriate action. The priority is to ensure the safety of the client and others, which can be achieved by documenting the client's behavior prior to seclusion. Offering fluids every 2 hours is a good practice to keep the client hydrated, especially if they are agitated or physically active. However, this is not the most appropriate action in this context. Documenting the client's behavior prior to being placed in seclusion is the most appropriate action. This documentation is crucial for legal and ethical reasons, and it helps in evaluating the effectiveness of the intervention. Assessing the client's behavior once every hour is important to monitor the client's condition and response to seclusion. However, this is not the most appropriate action in this context.
Question 4 of 5
A nurse is reporting a client's laboratory tests to the provider to obtain a prescription for the client's daily warfarin. Which of the following laboratory tests should the nurse plan to report to obtain the prescription for the warfarin?
Correct Answer: A
Rationale: Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver. These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR). The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments. The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly. The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.
Choice B is wrong because fibrinogen level is not affected by warfarin. Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade. Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DI
C), liver disease, or severe bleeding.
Choice C is wrong because aPTT is not affected by warfarin. aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII. These factors are not inhibited by warfarin. aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.
Choice D is wrong because platelet count is not affected by warfarin. Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis. Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.
Question 5 of 5
A nurse is assessing a client who has a new diagnosis of bipolar disorder. Which of the following findings should the nurse expect during a manic episode?
Correct Answer: B
Rationale: Euphoria and rapid speech are hallmark symptoms of a manic episode in bipolar disorder, reflecting elevated mood and increased psychomotor activity.
Choice A is incorrect because mania typically causes a decreased need for sleep, with clients feeling energized despite little rest.
Choice C is incorrect because weight loss, not weight gain, is more common during mania due to increased activity and reduced appetite.
Choice D is incorrect because difficulty concentrating is more associated with depression or mixed episodes; mania often involves heightened focus, though it may be disorganized.