ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has atrial fibrillation and is receiving warfarin. Which of the following laboratory results should the nurse report to the provider?
Correct Answer: A
Rationale: An INR of 4.5 is above the therapeutic range for atrial fibrillation (typically 2.0-3.0) and indicates an increased risk of bleeding, requiring immediate reporting to the provider for potential dose adjustment or vitamin K administration.
Choice B is wrong because a platelet count of 200,000/mm3 is within the normal range (150,000-400,000/mm3) and does not require reporting.
Choice C is wrong because aPTT is not used to monitor warfarin therapy (it monitors heparin); an aPTT of 40 seconds is within normal limits (30-40 seconds) and not concerning.
Choice D is wrong because a hemoglobin of 13 g/dL is within the normal range for males (13-17 g/dL) and females (12-16 g/dL) and does not indicate bleeding or anemia.
Question 2 of 5
A nurse is caring for a client who has a new prescription for phenytoin to treat seizures. Which of the following laboratory findings should the nurse monitor?
Correct Answer: B
Rationale: Monitoring liver function tests is essential for clients taking phenytoin, an anticonvulsant that can cause hepatotoxicity, leading to elevated liver enzymes or liver damage.
Choice A is incorrect because phenytoin is not commonly associated with thrombocytopenia; blood dyscrasias are rare but possible.
Choice C is incorrect because blood urea nitrogen is not directly affected by phenytoin; it is more relevant for drugs affecting renal function.
Choice D is incorrect because phenytoin can cause hyponatremia, but it is less critical than liver function monitoring, as hepatotoxicity is a more significant risk.
Question 3 of 5
A nurse is providing teaching to a client who has a new prescription for omeprazole for gastroesophageal reflux disease (GERD). Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: Taking omeprazole 30 minutes before breakfast optimizes its acid-suppressing effect by aligning with the body's natural acid production cycle, improving GERD symptom control.
Choice B is incorrect because omeprazole may take several days to provide significant relief, not immediate relief.
Choice C is incorrect because, while swallowing the capsule whole is correct for delayed-release formulations, the timing (before meals) is more critical to emphasize for efficacy.
Choice D is incorrect because taking omeprazole with an antacid is not recommended, as it may reduce the drug's effectiveness; antacids are used for immediate relief, not in combination with proton pump inhibitors.
Question 4 of 5
A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: A heart rate of 56/min is below the normal range (60-100/min) and may indicate digoxin toxicity, especially in heart failure clients, as digoxin slows the heart rate by enhancing vagal tone; this requires immediate reporting to the provider.
Choice B is wrong because a blood pressure of 140/90 mm Hg, while elevated, is not directly related to digoxin toxicity and should be monitored but is not the priority.
Choice C is wrong because a weight gain of 0.5 kg in 24 hours is not significant enough to indicate fluid overload in heart failure; a gain of >1 kg (2.2 lb) in 24 hours would be more concerning.
Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range (3.5-5.0 mEq/L), and while hypokalemia increases digoxin toxicity risk, this level is not concerning.
Question 5 of 5
A nurse is assessing a client who is at 36 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: Decreased fetal movement is a concerning finding that may indicate fetal distress or compromise, requiring immediate reporting to the provider for further evaluation, such as a nonstress testisbn or biophysical profile.
Choice B is wrong because a blood pressure of 120/80 mm Hg is within the normal range for pregnancy and does not require reporting.
Choice C is wrong because a fundal height of 36 cm at 36 weeks is normal, as fundal height in centimeters typically corresponds to gestational age (±2 cm).
Choice D is wrong because mild ankle edema is a common, benign finding in late pregnancy due to increased fluid retention and pressure from the gravid uterus, and it does not typically require reporting unless accompanied by other symptoms like sudden swelling or signs of preeclampsia.