NR-293
Pharmacology for Nursing Practice
EXAM 3 PRACTICE
100 Multiple-Choice Questions
Correct Answers • Expert Rationales • Higher-Level Clinical Application
2026/2027 Study Edition
WHAT’S INSIDE
100 Multiple-Choice Questions & Correct Answers
Expert Rationales
Higher-Level Clinical Application
COURSE-ALIGNED STUDY RESOURCE
For independent exam preparation and concept review
1
,Exam 3 Contents
Domain Questions
Hematologic & Anticoagulant Pharmacology 15
Immune, Inflammatory & Musculoskeletal 15
Pharmacology
Reproductive & Women's Health 14
Pharmacology
Renal, Fluid & Electrolyte Pharmacology 12
Oncology & High-Risk Medication Concepts 14
Drug Interactions, Toxicity & Monitoring 14
Integrated Nursing Application & 16
Prioritization
2
,Hematologic & Anticoagulant Pharmacology
Question 1. A patient receiving unfractionated heparin develops active bleeding. Which
medication should the nurse anticipate as a reversal agent?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Acetylcysteine
Correct Answer: A. Protamine sulfate
Expert Rationale: Protamine sulfate binds and neutralizes unfractionated heparin and is used
when clinically significant heparin reversal is required. Vitamin K reverses warfarin's
anticoagulant effect rather than heparin.
Question 2. Which laboratory test is commonly used to monitor an IV unfractionated heparin
infusion according to institutional protocol?
A. aPTT or an anti-Xa assay
B. INR only
C. HbA1c
D. Serum amylase
Correct Answer: A. aPTT or an anti-Xa assay
Expert Rationale: Unfractionated heparin is commonly titrated using an activated partial
thromboplastin time (aPTT) or an anti-Xa assay, depending on the protocol. INR is primarily
associated with warfarin monitoring.
Question 3. A patient taking warfarin has an INR substantially above the prescribed
therapeutic range and has active bleeding. Which medication may be ordered to help reverse
warfarin's effect?
A. Phytonadione (vitamin K)
B. Protamine sulfate
C. Flumazenil
3
, D. Atropine
Correct Answer: A. Phytonadione (vitamin K)
Expert Rationale: Vitamin K supports synthesis of vitamin K-dependent clotting factors and
may be used for warfarin reversal. The urgency and use of additional reversal products
depend on bleeding severity and clinical orders.
Question 4. Which patient statement about warfarin indicates a need for further teaching?
A. 'I will keep my intake of vitamin K-containing foods reasonably consistent.'
B. 'I will tell clinicians and dentists that I take an anticoagulant.'
C. 'I can start herbal supplements without checking for interactions.'
D. 'I will report unusual bleeding.'
Correct Answer: C. 'I can start herbal supplements without checking for interactions.'
Expert Rationale: Warfarin has many drug, food, and herbal interactions. Patients should
check with an appropriate clinician before starting supplements or OTC products.
Question 5. A patient receiving heparin has a marked platelet decrease several days after
therapy begins. Which complication should the nurse suspect?
A. Heparin-induced thrombocytopenia
B. Iron-deficiency anemia
C. Hyperkalemia from insulin
D. Neutropenia from acetaminophen
Correct Answer: A. Heparin-induced thrombocytopenia
Expert Rationale: A substantial platelet decline during heparin exposure can indicate heparin-
induced thrombocytopenia (HIT), an immune-mediated complication associated with
thrombosis risk and requiring prompt evaluation.
Question 6. Which instruction is most appropriate for a patient taking an anticoagulant?
A. Use an electric razor when practical and avoid unnecessary trauma
B. Take aspirin daily unless specifically told not to
C. Use a hard-bristle toothbrush
4
Pharmacology for Nursing Practice
EXAM 3 PRACTICE
100 Multiple-Choice Questions
Correct Answers • Expert Rationales • Higher-Level Clinical Application
2026/2027 Study Edition
WHAT’S INSIDE
100 Multiple-Choice Questions & Correct Answers
Expert Rationales
Higher-Level Clinical Application
COURSE-ALIGNED STUDY RESOURCE
For independent exam preparation and concept review
1
,Exam 3 Contents
Domain Questions
Hematologic & Anticoagulant Pharmacology 15
Immune, Inflammatory & Musculoskeletal 15
Pharmacology
Reproductive & Women's Health 14
Pharmacology
Renal, Fluid & Electrolyte Pharmacology 12
Oncology & High-Risk Medication Concepts 14
Drug Interactions, Toxicity & Monitoring 14
Integrated Nursing Application & 16
Prioritization
2
,Hematologic & Anticoagulant Pharmacology
Question 1. A patient receiving unfractionated heparin develops active bleeding. Which
medication should the nurse anticipate as a reversal agent?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Acetylcysteine
Correct Answer: A. Protamine sulfate
Expert Rationale: Protamine sulfate binds and neutralizes unfractionated heparin and is used
when clinically significant heparin reversal is required. Vitamin K reverses warfarin's
anticoagulant effect rather than heparin.
Question 2. Which laboratory test is commonly used to monitor an IV unfractionated heparin
infusion according to institutional protocol?
A. aPTT or an anti-Xa assay
B. INR only
C. HbA1c
D. Serum amylase
Correct Answer: A. aPTT or an anti-Xa assay
Expert Rationale: Unfractionated heparin is commonly titrated using an activated partial
thromboplastin time (aPTT) or an anti-Xa assay, depending on the protocol. INR is primarily
associated with warfarin monitoring.
Question 3. A patient taking warfarin has an INR substantially above the prescribed
therapeutic range and has active bleeding. Which medication may be ordered to help reverse
warfarin's effect?
A. Phytonadione (vitamin K)
B. Protamine sulfate
C. Flumazenil
3
, D. Atropine
Correct Answer: A. Phytonadione (vitamin K)
Expert Rationale: Vitamin K supports synthesis of vitamin K-dependent clotting factors and
may be used for warfarin reversal. The urgency and use of additional reversal products
depend on bleeding severity and clinical orders.
Question 4. Which patient statement about warfarin indicates a need for further teaching?
A. 'I will keep my intake of vitamin K-containing foods reasonably consistent.'
B. 'I will tell clinicians and dentists that I take an anticoagulant.'
C. 'I can start herbal supplements without checking for interactions.'
D. 'I will report unusual bleeding.'
Correct Answer: C. 'I can start herbal supplements without checking for interactions.'
Expert Rationale: Warfarin has many drug, food, and herbal interactions. Patients should
check with an appropriate clinician before starting supplements or OTC products.
Question 5. A patient receiving heparin has a marked platelet decrease several days after
therapy begins. Which complication should the nurse suspect?
A. Heparin-induced thrombocytopenia
B. Iron-deficiency anemia
C. Hyperkalemia from insulin
D. Neutropenia from acetaminophen
Correct Answer: A. Heparin-induced thrombocytopenia
Expert Rationale: A substantial platelet decline during heparin exposure can indicate heparin-
induced thrombocytopenia (HIT), an immune-mediated complication associated with
thrombosis risk and requiring prompt evaluation.
Question 6. Which instruction is most appropriate for a patient taking an anticoagulant?
A. Use an electric razor when practical and avoid unnecessary trauma
B. Take aspirin daily unless specifically told not to
C. Use a hard-bristle toothbrush
4
