Pharmacology Made Easy 5.0: The
Hematologic System Questions and Answers
Question 1
A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin.
Which of the following findings should the nurse identify as a possible indication of
hemorrhage?
- Rapid pulse
- Yellowing of the sclera
- Elevated blood pressure
- Pale-colored stools
Correct Answer
Rapid pulse
In the event of a moderate to severe hemorrhage, the volume of blood in the
circulatory system decreases significantly, resulting in hypotension. Tachycardia is a
compensatory mechanism of the heart that serves to combat the hypotension that
results from the decreased volume of blood. Tachycardia can be detected by
checking the client's pulse.
Question 2
A nurse in an emergency department is assessing a client who has been taking
warfarin and is experiencing rectal bleeding. Which of the following medications
should the nurse expect to administer to the client?
- Filgrastim
- Deferoxamine
- Protamine
- Vitamin K
Correct Answer
- Vitamin K
Vitamin K reverses the effects of warfarin by promoting the synthesis of coagulation
factors VI, IX, X, and prothrombin.
Page 1 of 17
,Question 3
A nurse should identify that clopidogrel is contraindicated for clients who have which
of the following conditions?
- Myocardial infarction
- Peptic ulcer disease
- Pancreatitis
- Myasthenia gravis
Correct Answer
- Peptic ulcer disease
Clients who have peptic ulcer disease should not take clopidogrel because it can
cause gastric bleeding.
Question 4
A nurse is caring for a client who is about to begin alteplase therapy to treat
pulmonary embolism. Which of the following medications should the nurse have
available in the event of a severe adverse reaction?
- Vitamin K
- Aminocaproic acid
- Protamine
- Deferoxamine
Correct Answer
- Aminocaproic acid
Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops excessive fibrinolytic
bleeding, a severe adverse effect of alteplase.
Page 2 of 17
, Question 5
A nurse is caring for a client who is about to begin factor VIII therapy to treat
hemophilia A. When administering factor VIII, which of the following actions should
the nurse take?
- Administer the powdered form orally.
- Premedicate with aspirin.
- Administer it via rapid IV bolus.
- Have emergency equipment ready.
Correct Answer
- Have emergency equipment ready.
Factor VIII can cause a hypersensitive reaction and anaphylaxis. The nurse should
monitor the client for hives, fever, wheezing, and difficulty breathing and have
emergency equipment and medications readily available.
Question 6
A nurse is reviewing the medication record of a client who is receiving alteplase
following an acute myocardial infarction (MI). Which of the following medications
should the nurse expect the client to be taking after the alteplase?
- Protamine
- Desmopressin
- Ferrous sulfate
- Heparin
Correct Answer
- Heparin
Heparin therapy should be initiated 24 hr after alteplase therapy due to increased
risk of bleeding if a thrombolytic and anticoagulant are administered concurrently.
Page 3 of 17
Hematologic System Questions and Answers
Question 1
A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin.
Which of the following findings should the nurse identify as a possible indication of
hemorrhage?
- Rapid pulse
- Yellowing of the sclera
- Elevated blood pressure
- Pale-colored stools
Correct Answer
Rapid pulse
In the event of a moderate to severe hemorrhage, the volume of blood in the
circulatory system decreases significantly, resulting in hypotension. Tachycardia is a
compensatory mechanism of the heart that serves to combat the hypotension that
results from the decreased volume of blood. Tachycardia can be detected by
checking the client's pulse.
Question 2
A nurse in an emergency department is assessing a client who has been taking
warfarin and is experiencing rectal bleeding. Which of the following medications
should the nurse expect to administer to the client?
- Filgrastim
- Deferoxamine
- Protamine
- Vitamin K
Correct Answer
- Vitamin K
Vitamin K reverses the effects of warfarin by promoting the synthesis of coagulation
factors VI, IX, X, and prothrombin.
Page 1 of 17
,Question 3
A nurse should identify that clopidogrel is contraindicated for clients who have which
of the following conditions?
- Myocardial infarction
- Peptic ulcer disease
- Pancreatitis
- Myasthenia gravis
Correct Answer
- Peptic ulcer disease
Clients who have peptic ulcer disease should not take clopidogrel because it can
cause gastric bleeding.
Question 4
A nurse is caring for a client who is about to begin alteplase therapy to treat
pulmonary embolism. Which of the following medications should the nurse have
available in the event of a severe adverse reaction?
- Vitamin K
- Aminocaproic acid
- Protamine
- Deferoxamine
Correct Answer
- Aminocaproic acid
Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops excessive fibrinolytic
bleeding, a severe adverse effect of alteplase.
Page 2 of 17
, Question 5
A nurse is caring for a client who is about to begin factor VIII therapy to treat
hemophilia A. When administering factor VIII, which of the following actions should
the nurse take?
- Administer the powdered form orally.
- Premedicate with aspirin.
- Administer it via rapid IV bolus.
- Have emergency equipment ready.
Correct Answer
- Have emergency equipment ready.
Factor VIII can cause a hypersensitive reaction and anaphylaxis. The nurse should
monitor the client for hives, fever, wheezing, and difficulty breathing and have
emergency equipment and medications readily available.
Question 6
A nurse is reviewing the medication record of a client who is receiving alteplase
following an acute myocardial infarction (MI). Which of the following medications
should the nurse expect the client to be taking after the alteplase?
- Protamine
- Desmopressin
- Ferrous sulfate
- Heparin
Correct Answer
- Heparin
Heparin therapy should be initiated 24 hr after alteplase therapy due to increased
risk of bleeding if a thrombolytic and anticoagulant are administered concurrently.
Page 3 of 17
