NCLEX-RN Pharmacology Hematologic
System Exam Questions |
20 Original Practice MCQs with Rationales
| Anticoagulants, Antiplatelets &
Hematology Nursing Study Guide
Question 1
Clinical Scenario
A 28-year-old female client is diagnosed with iron deficiency anemia
and is prescribed oral ferrous sulfate 325 mg twice daily. The nurse
is providing discharge teaching regarding the proper administration
of this medication.
Question Stem
Which statement by the client indicates an understanding of the
teaching regarding ferrous sulfate?
Options
A. "I will take this medication with a glass of milk to prevent stomach
upset."
B. "I should stop taking the medication immediately if my stools turn
black."
C. "I will take this medication with a glass of orange juice to improve
,absorption."
D. "I can crush the extended-release tablets if they are too large to
swallow."
Correct Answer
Correct Answer: C. "I will take this medication with a glass of orange
juice to improve absorption."
Detailed Rationale
The correct answer is C. Ferrous sulfate is best absorbed in an
acidic environment. Taking it with a source of vitamin C, such as
orange juice, enhances gastric acidity and significantly improves
iron absorption in the gastrointestinal tract. Option A is incorrect
because calcium, found in milk and dairy products, binds to iron
and inhibits its absorption. Option B is incorrect because while
ferrous sulfate commonly causes dark green or black stools, this is
a harmless, expected side effect, not a reason to stop the
medication. However, the nurse should teach the client to
differentiate this from black, tarry, foul-smelling stools (melena),
which indicate gastrointestinal bleeding and require immediate
reporting. Option D is incorrect because extended-release tablets
should never be crushed, chewed, or broken, as this destroys the
delivery mechanism and can lead to rapid, toxic absorption of the
medication. Nursing considerations include advising the client to
take ferrous sulfate on an empty stomach for optimal absorption,
though it may be taken with food if gastrointestinal distress occurs.
Learning Objective
Identify strategies to maximize the absorption of oral iron
preparations.
,Differentiate between expected side effects and adverse effects of
iron therapy.
Educate patients on the proper administration of extended-release
medications.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 65-year-old male client is 2 days post-operative from a total hip
replacement. The provider prescribes enoxaparin 40 mg
subcutaneously once daily for deep vein thrombosis (DVT)
prophylaxis.
Question Stem
Which action should the nurse take when administering this
medication?
Options
A. Inject the medication into the anterolateral abdominal wall.
B. Aspirate for blood return before injecting the medication.
C. Massage the injection site firmly after administration to promote
absorption.
D. Administer the medication via slow IV push over 2 minutes.
Correct Answer
Correct Answer: A. Inject the medication into the anterolateral
abdominal wall.
, Detailed Rationale
The correct answer is A. Enoxaparin, a low-molecular-weight
heparin (LMWH), should be administered via deep subcutaneous
injection into the anterolateral or posterolateral abdominal wall (the
"love handles"), at least 2 inches away from the umbilicus. This site
provides consistent subcutaneous tissue for optimal absorption.
Option B is incorrect because aspirating is not recommended for
subcutaneous injections of anticoagulants, as it can cause tissue
trauma and increase the risk of hematoma formation. Option C is
incorrect because massaging the injection site after administering
an anticoagulant can cause tissue trauma, bruising, and
hematoma. Option D is incorrect because enoxaparin is strictly for
subcutaneous administration and must never be given
intravenously, as this would cause immediate, life-threatening
systemic anticoagulation and bleeding. The nurse should also pinch
a skin fold, insert the needle at a 90-degree angle, and avoid
expelling the air bubble in the prefilled syringe to ensure the full
dose is delivered.
Learning Objective
Demonstrate the correct technique for subcutaneous
administration of low-molecular-weight heparins.
Identify actions that increase the risk of hematoma formation during
anticoagulant administration.
Recognize contraindicated routes of administration for specific
anticoagulant formulations.
Medication Safety Focus
Medication administration
System Exam Questions |
20 Original Practice MCQs with Rationales
| Anticoagulants, Antiplatelets &
Hematology Nursing Study Guide
Question 1
Clinical Scenario
A 28-year-old female client is diagnosed with iron deficiency anemia
and is prescribed oral ferrous sulfate 325 mg twice daily. The nurse
is providing discharge teaching regarding the proper administration
of this medication.
Question Stem
Which statement by the client indicates an understanding of the
teaching regarding ferrous sulfate?
Options
A. "I will take this medication with a glass of milk to prevent stomach
upset."
B. "I should stop taking the medication immediately if my stools turn
black."
C. "I will take this medication with a glass of orange juice to improve
,absorption."
D. "I can crush the extended-release tablets if they are too large to
swallow."
Correct Answer
Correct Answer: C. "I will take this medication with a glass of orange
juice to improve absorption."
Detailed Rationale
The correct answer is C. Ferrous sulfate is best absorbed in an
acidic environment. Taking it with a source of vitamin C, such as
orange juice, enhances gastric acidity and significantly improves
iron absorption in the gastrointestinal tract. Option A is incorrect
because calcium, found in milk and dairy products, binds to iron
and inhibits its absorption. Option B is incorrect because while
ferrous sulfate commonly causes dark green or black stools, this is
a harmless, expected side effect, not a reason to stop the
medication. However, the nurse should teach the client to
differentiate this from black, tarry, foul-smelling stools (melena),
which indicate gastrointestinal bleeding and require immediate
reporting. Option D is incorrect because extended-release tablets
should never be crushed, chewed, or broken, as this destroys the
delivery mechanism and can lead to rapid, toxic absorption of the
medication. Nursing considerations include advising the client to
take ferrous sulfate on an empty stomach for optimal absorption,
though it may be taken with food if gastrointestinal distress occurs.
Learning Objective
Identify strategies to maximize the absorption of oral iron
preparations.
,Differentiate between expected side effects and adverse effects of
iron therapy.
Educate patients on the proper administration of extended-release
medications.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 65-year-old male client is 2 days post-operative from a total hip
replacement. The provider prescribes enoxaparin 40 mg
subcutaneously once daily for deep vein thrombosis (DVT)
prophylaxis.
Question Stem
Which action should the nurse take when administering this
medication?
Options
A. Inject the medication into the anterolateral abdominal wall.
B. Aspirate for blood return before injecting the medication.
C. Massage the injection site firmly after administration to promote
absorption.
D. Administer the medication via slow IV push over 2 minutes.
Correct Answer
Correct Answer: A. Inject the medication into the anterolateral
abdominal wall.
, Detailed Rationale
The correct answer is A. Enoxaparin, a low-molecular-weight
heparin (LMWH), should be administered via deep subcutaneous
injection into the anterolateral or posterolateral abdominal wall (the
"love handles"), at least 2 inches away from the umbilicus. This site
provides consistent subcutaneous tissue for optimal absorption.
Option B is incorrect because aspirating is not recommended for
subcutaneous injections of anticoagulants, as it can cause tissue
trauma and increase the risk of hematoma formation. Option C is
incorrect because massaging the injection site after administering
an anticoagulant can cause tissue trauma, bruising, and
hematoma. Option D is incorrect because enoxaparin is strictly for
subcutaneous administration and must never be given
intravenously, as this would cause immediate, life-threatening
systemic anticoagulation and bleeding. The nurse should also pinch
a skin fold, insert the needle at a 90-degree angle, and avoid
expelling the air bubble in the prefilled syringe to ensure the full
dose is delivered.
Learning Objective
Demonstrate the correct technique for subcutaneous
administration of low-molecular-weight heparins.
Identify actions that increase the risk of hematoma formation during
anticoagulant administration.
Recognize contraindicated routes of administration for specific
anticoagulant formulations.
Medication Safety Focus
Medication administration
