Mosby's Canadian Nursing Drug Reference,
2nd Edition
Authors :
Linda Skidmore-Roth & Faith Richardson
High-Yield NCLEX pharmacology area. on
Mosby’s Canadian Nursing Drug Reference, 2nd
Edition for:
Anticoagulants & Antiplatelets
(Focus: heparin, warfarin, enoxaparin, aspirin,
clopidogrel)
1.
A client is receiving heparin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
,A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: B. aPTT
Rationale: Heparin therapy is monitored using activated partial
thromboplastin time (aPTT), which reflects intrinsic pathway
anticoagulation. INR is used for warfarin; platelet count
monitors HIT risk.
Citation: Mosby’s Canadian Nursing Drug Reference (2nd ed.),
Heparin
2.
Which finding in a client receiving heparin requires immediate
action by the nurse?
A. aPTT 60 seconds
B. Platelet count decrease from 250,000 to 90,000/mm³
C. Mild bruising at injection site
D. Heart rate 88 bpm
Answer: B. Platelet count decrease from 250,000 to
90,000/mm³
Rationale: A significant drop suggests heparin-induced
thrombocytopenia (HIT), a serious complication requiring
discontinuation. Mild bruising is expected.
Citation: Mosby’s, Heparin
,3.
The nurse is preparing to administer protamine sulfate. This
medication is used to reverse the effects of:
A. Warfarin
B. Aspirin
C. Heparin
D. Clopidogrel
Answer: C. Heparin
Rationale: Protamine sulfate binds and neutralizes heparin.
Warfarin is reversed with vitamin K.
Citation: Mosby’s, Heparin; Protamine sulfate
4.
A client on warfarin has an INR of 4.5. What is the nurse’s
priority action?
A. Administer the next dose
B. Hold the medication and notify provider
C. Increase dietary vitamin K
D. Give protamine sulfate
Answer: B. Hold the medication and notify provider
Rationale: INR above therapeutic range increases bleeding risk.
Warfarin should be held. Protamine is not used for warfarin.
Citation: Mosby’s, Warfarin
, 5.
Which food should the nurse instruct a client on warfarin to
consume consistently?
A. Spinach
B. Oranges
C. Bananas
D. Chicken
Answer: A. Spinach
Rationale: Spinach is high in vitamin K. Clients should maintain
consistent intake to avoid INR fluctuations.
Citation: Mosby’s, Warfarin
6.
Which statement by a client taking warfarin indicates a need for
further teaching?
A. “I will use a soft toothbrush.”
B. “I will avoid contact sports.”
C. “I will take aspirin for headaches.”
D. “I will have regular INR checks.”
Answer: C. “I will take aspirin for headaches.”
Rationale: Aspirin increases bleeding risk when combined with
warfarin and should be avoided unless prescribed.
Citation: Mosby’s, Warfarin; Aspirin
2nd Edition
Authors :
Linda Skidmore-Roth & Faith Richardson
High-Yield NCLEX pharmacology area. on
Mosby’s Canadian Nursing Drug Reference, 2nd
Edition for:
Anticoagulants & Antiplatelets
(Focus: heparin, warfarin, enoxaparin, aspirin,
clopidogrel)
1.
A client is receiving heparin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
,A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: B. aPTT
Rationale: Heparin therapy is monitored using activated partial
thromboplastin time (aPTT), which reflects intrinsic pathway
anticoagulation. INR is used for warfarin; platelet count
monitors HIT risk.
Citation: Mosby’s Canadian Nursing Drug Reference (2nd ed.),
Heparin
2.
Which finding in a client receiving heparin requires immediate
action by the nurse?
A. aPTT 60 seconds
B. Platelet count decrease from 250,000 to 90,000/mm³
C. Mild bruising at injection site
D. Heart rate 88 bpm
Answer: B. Platelet count decrease from 250,000 to
90,000/mm³
Rationale: A significant drop suggests heparin-induced
thrombocytopenia (HIT), a serious complication requiring
discontinuation. Mild bruising is expected.
Citation: Mosby’s, Heparin
,3.
The nurse is preparing to administer protamine sulfate. This
medication is used to reverse the effects of:
A. Warfarin
B. Aspirin
C. Heparin
D. Clopidogrel
Answer: C. Heparin
Rationale: Protamine sulfate binds and neutralizes heparin.
Warfarin is reversed with vitamin K.
Citation: Mosby’s, Heparin; Protamine sulfate
4.
A client on warfarin has an INR of 4.5. What is the nurse’s
priority action?
A. Administer the next dose
B. Hold the medication and notify provider
C. Increase dietary vitamin K
D. Give protamine sulfate
Answer: B. Hold the medication and notify provider
Rationale: INR above therapeutic range increases bleeding risk.
Warfarin should be held. Protamine is not used for warfarin.
Citation: Mosby’s, Warfarin
, 5.
Which food should the nurse instruct a client on warfarin to
consume consistently?
A. Spinach
B. Oranges
C. Bananas
D. Chicken
Answer: A. Spinach
Rationale: Spinach is high in vitamin K. Clients should maintain
consistent intake to avoid INR fluctuations.
Citation: Mosby’s, Warfarin
6.
Which statement by a client taking warfarin indicates a need for
further teaching?
A. “I will use a soft toothbrush.”
B. “I will avoid contact sports.”
C. “I will take aspirin for headaches.”
D. “I will have regular INR checks.”
Answer: C. “I will take aspirin for headaches.”
Rationale: Aspirin increases bleeding risk when combined with
warfarin and should be avoided unless prescribed.
Citation: Mosby’s, Warfarin; Aspirin
