ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 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 2 of 5
A nurse is caring for a client who has a new prescription for sumatriptan for migraines. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: Taking sumatriptan at the onset of migraine symptoms is critical, as it is most effective when used early to abort the migraine by constricting cranial blood vessels and blocking pain pathways.
Choice B is incorrect because sumatriptan can be taken with or without food; food does not significantly affect its absorption.
Choice C is incorrect because drowsiness is not a common side effect; sumatriptan may cause dizziness or tingling, but alertness is usually unaffected.
Choice D is incorrect because sumatriptan is used for acute migraine treatment, not daily for prevention, which requires other medications like propranolol.
Question 3 of 5
A nurse is providing teaching to a client who has a new prescription for fluoxetine for bulimia nervosa. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: Monitoring for signs of serotonin syndrome (e.g., agitation, tremors, hyperthermia) is critical with fluoxetine, an SSRI, as it increases serotonin levels, and overdose or drug interactions can cause this life-threatening condition.
Choice B is incorrect because fluoxetine is typically taken in the morning, as it can cause insomnia if taken at bedtime.
Choice C is incorrect because fluoxetine is more likely to cause weight loss or be weight-neutral in bulimia, not weight gain.
Choice D is incorrect because fluoxetine should not be discontinued abruptly, even if binge eating stops, as this can cause withdrawal symptoms or relapse; it requires provider guidance.
Question 4 of 5
A nurse is assessing a client who has a new diagnosis of chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: A barrel-shaped chest is a common finding in COPD due to chronic hyperinflation of the lungs, causing the chest to appear rounded and the anteroposterior diameter to increase.
Choice B is incorrect because COPD typically causes tachypnea (rapid breathing) as the body compensates for reduced oxygen exchange, not bradypnea.
Choice C is incorrect because, while clubbing of fingers can occur in advanced COPD with chronic hypoxia, it is less common and not a primary finding.
Choice D is incorrect because weight loss, not weight gain, is typical in COPD due to increased metabolic demand and difficulty eating from dyspnea.
Question 5 of 5
A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following medications should the nurse anticipate administering?
Correct Answer: C
Rationale: Lorazepam, a benzodiazepine, is commonly administered during alcohol withdrawal to manage symptoms like tremors, seizures, and agitation by calming the central nervous system.
Choice A is incorrect because naltrexone is used for maintenance therapy to reduce alcohol cravings, not for acute withdrawal.
Choice B is incorrect because disulfiram is used to deter alcohol consumption, not to treat withdrawal symptoms.
Choice D is incorrect because acamprosate is used to maintain abstinence in alcohol use disorder, not for managing acute withdrawal.