NCLEX-RN Pharmacology Hematologic
System Practice Questions |
20 NGN-Style MCQs with Detailed
Rationales, Clinical Scenarios & Nursing
Study Guide (ATI & NCLEX Prep)
Question 1
Clinical Scenario A 28-year-old female is diagnosed with iron
deficiency anemia and is prescribed oral ferrous sulfate. The nurse
is providing discharge teaching regarding the medication.
Question Stem Which statement by the client indicates
understanding of the teaching regarding ferrous sulfate?
A. "I will take this medication with a glass of milk." B. "I should
expect my stools to become dark and tarry." C. "I will take this
medication on an empty stomach with orange juice." D. "I can stop
taking the medication once my fatigue improves."
Correct Answer: C. "I will take this medication on an empty stomach
with orange juice."
Detailed Rationale Ferrous sulfate is an oral iron supplement used
to treat iron deficiency anemia. Iron is best absorbed in an acidic
environment; therefore, taking it on an empty stomach with a source
,of vitamin C, such as orange juice, significantly enhances
gastrointestinal absorption. Option A is incorrect because dairy
products, antacids, and calcium supplements bind to iron and
drastically reduce its absorption. Option B is incorrect because
while iron commonly causes dark green or black stools, describing
them as "tarry" is a red flag for melena (upper gastrointestinal
bleeding) and should be reported, not expected as a normal side
effect. Option D is incorrect because iron therapy must continue for
several months after hemoglobin levels normalize to replenish the
body's iron stores; stopping prematurely can lead to a relapse of
anemia. The nurse should also teach the client that iron can cause
gastrointestinal upset and constipation, advising increased fluid
and fiber intake to mitigate this.
Learning Objective After completing this question, the learner
should be able to: • Identify factors that enhance and inhibit oral
iron absorption. • Differentiate between expected side effects and
adverse effects of iron therapy. • Educate patients on the
importance of medication adherence for iron deficiency anemia.
Medication Safety Focus Patient education
=====================================================
Question 2
Clinical Scenario A 68-year-old male with a history of atrial
fibrillation is taking warfarin. He presents to the anticoagulation
clinic for routine monitoring.
Question Stem Which laboratory finding should the nurse report to
the provider immediately?
, A. aPTT 30 seconds B. Hemoglobin 13 g/dL C. PT 18 seconds D. INR
3.8
Correct Answer: D. INR 3.8
Detailed Rationale Warfarin is an oral anticoagulant that inhibits
vitamin K-dependent clotting factors. The therapeutic International
Normalized Ratio (INR) for most indications, such as atrial
fibrillation or deep vein thrombosis, is 2.0 to 3.0. An INR of 3.8 is
supratherapeutic and places the client at a significantly increased
risk for spontaneous, life-threatening bleeding. This finding requires
immediate notification of the provider to evaluate the need for
holding the dose or administering a reversal agent like vitamin K.
Option A (aPTT 30 seconds) is within the normal range (typically 25-
35 seconds) and is used to monitor unfractionated heparin, not
warfarin. Option B (Hemoglobin 13 g/dL) is a normal finding for an
adult male and does not indicate acute bleeding. Option C (PT 18
seconds) is mildly elevated but less specific and actionable than the
INR for warfarin monitoring. Regular INR monitoring is a critical
medication safety focus.
Learning Objective After completing this question, the learner
should be able to: • Interpret INR values in the context of warfarin
therapy. • Recognize laboratory values that indicate a high risk for
hemorrhage. • Prioritize communication with the healthcare
provider regarding supratherapeutic lab results.
Medication Safety Focus Monitoring
=====================================================
Question 3
System Practice Questions |
20 NGN-Style MCQs with Detailed
Rationales, Clinical Scenarios & Nursing
Study Guide (ATI & NCLEX Prep)
Question 1
Clinical Scenario A 28-year-old female is diagnosed with iron
deficiency anemia and is prescribed oral ferrous sulfate. The nurse
is providing discharge teaching regarding the medication.
Question Stem Which statement by the client indicates
understanding of the teaching regarding ferrous sulfate?
A. "I will take this medication with a glass of milk." B. "I should
expect my stools to become dark and tarry." C. "I will take this
medication on an empty stomach with orange juice." D. "I can stop
taking the medication once my fatigue improves."
Correct Answer: C. "I will take this medication on an empty stomach
with orange juice."
Detailed Rationale Ferrous sulfate is an oral iron supplement used
to treat iron deficiency anemia. Iron is best absorbed in an acidic
environment; therefore, taking it on an empty stomach with a source
,of vitamin C, such as orange juice, significantly enhances
gastrointestinal absorption. Option A is incorrect because dairy
products, antacids, and calcium supplements bind to iron and
drastically reduce its absorption. Option B is incorrect because
while iron commonly causes dark green or black stools, describing
them as "tarry" is a red flag for melena (upper gastrointestinal
bleeding) and should be reported, not expected as a normal side
effect. Option D is incorrect because iron therapy must continue for
several months after hemoglobin levels normalize to replenish the
body's iron stores; stopping prematurely can lead to a relapse of
anemia. The nurse should also teach the client that iron can cause
gastrointestinal upset and constipation, advising increased fluid
and fiber intake to mitigate this.
Learning Objective After completing this question, the learner
should be able to: • Identify factors that enhance and inhibit oral
iron absorption. • Differentiate between expected side effects and
adverse effects of iron therapy. • Educate patients on the
importance of medication adherence for iron deficiency anemia.
Medication Safety Focus Patient education
=====================================================
Question 2
Clinical Scenario A 68-year-old male with a history of atrial
fibrillation is taking warfarin. He presents to the anticoagulation
clinic for routine monitoring.
Question Stem Which laboratory finding should the nurse report to
the provider immediately?
, A. aPTT 30 seconds B. Hemoglobin 13 g/dL C. PT 18 seconds D. INR
3.8
Correct Answer: D. INR 3.8
Detailed Rationale Warfarin is an oral anticoagulant that inhibits
vitamin K-dependent clotting factors. The therapeutic International
Normalized Ratio (INR) for most indications, such as atrial
fibrillation or deep vein thrombosis, is 2.0 to 3.0. An INR of 3.8 is
supratherapeutic and places the client at a significantly increased
risk for spontaneous, life-threatening bleeding. This finding requires
immediate notification of the provider to evaluate the need for
holding the dose or administering a reversal agent like vitamin K.
Option A (aPTT 30 seconds) is within the normal range (typically 25-
35 seconds) and is used to monitor unfractionated heparin, not
warfarin. Option B (Hemoglobin 13 g/dL) is a normal finding for an
adult male and does not indicate acute bleeding. Option C (PT 18
seconds) is mildly elevated but less specific and actionable than the
INR for warfarin monitoring. Regular INR monitoring is a critical
medication safety focus.
Learning Objective After completing this question, the learner
should be able to: • Interpret INR values in the context of warfarin
therapy. • Recognize laboratory values that indicate a high risk for
hemorrhage. • Prioritize communication with the healthcare
provider regarding supratherapeutic lab results.
Medication Safety Focus Monitoring
=====================================================
Question 3
