You can use format to control how results are printed.
user> (format "%.0f" (Math/pow 2 38))
"274877906944"
Also, if there is no danger of losing wanted data, you can cast to an exact type:
user> 274877906944.0
2.74877906944E11
user> (long 274877906944.0)
274877906944
There are BigInts for larger inputs
user> (bigint 27487790694400000000.0)
27487790694400000000N