,NURS 480 exam 2 Advanced Medical Surgical Nursing Questions And
Answers 2026/2027 West Coast University
Q1. A nurse is reviewing the laboratory results of a client with atrial
fibrillation who is receiving warfarin. Which finding should the nurse report to
the provider?
A. Hgb 14.2 g/dL
B. Hct 42%
C. Platelets 210,000/mm³
D. INR 5.8
Correct Answer: D
Rationale: An INR of 5.8 indicates excessive anticoagulation and
significantly increases bleeding risk.
Q2. Which laboratory test is used most directly to monitor the therapeutic
effect of warfarin?
A. aPTT
B. INR
C. Troponin
D. BNP
Correct Answer: B
Rationale: Warfarin therapy is monitored using PT/INR.
Q3. Which medication should the nurse recognize as an antidote for
excessive warfarin effects?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Atropine
Correct Answer: B
Rationale: Vitamin K reverses the anticoagulant effect of warfarin.
Q4. A client taking warfarin reports black, tarry stools. Which complication
should the nurse suspect?
A. Constipation
B. Gastrointestinal bleeding
, C. Hyperglycemia
D. Dehydration
Correct Answer: B
Rationale: Black, tarry stools can indicate upper gastrointestinal bleeding
and require prompt evaluation.
Q5. Which medication should the nurse question in a client receiving
warfarin?
A. Acetaminophen at an appropriate dose
B. Aspirin
C. Pantoprazole
D. Docusate
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation and can increase bleeding
risk when combined with warfarin.
Q6. Which instruction is appropriate for a client taking warfarin?
A. Use a soft-bristled toothbrush.
B. Use a hard-bristled toothbrush.
C. Take aspirin for every headache.
D. Stop warfarin when bruising occurs without contacting the provider.
Correct Answer: A
Rationale: A soft-bristled toothbrush reduces the risk of gingival bleeding.
Q7. A client taking warfarin asks which finding requires immediate reporting.
Which response is best?
A. Mild hunger before meals
B. Unexplained bleeding or blood in the urine
C. Mild thirst
D. Occasional fatigue after exercise
Correct Answer: B
Rationale: Unexplained bleeding or hematuria may indicate excessive
anticoagulation.
Q8. Which ECG characteristic is expected in normal sinus rhythm?
Answers 2026/2027 West Coast University
Q1. A nurse is reviewing the laboratory results of a client with atrial
fibrillation who is receiving warfarin. Which finding should the nurse report to
the provider?
A. Hgb 14.2 g/dL
B. Hct 42%
C. Platelets 210,000/mm³
D. INR 5.8
Correct Answer: D
Rationale: An INR of 5.8 indicates excessive anticoagulation and
significantly increases bleeding risk.
Q2. Which laboratory test is used most directly to monitor the therapeutic
effect of warfarin?
A. aPTT
B. INR
C. Troponin
D. BNP
Correct Answer: B
Rationale: Warfarin therapy is monitored using PT/INR.
Q3. Which medication should the nurse recognize as an antidote for
excessive warfarin effects?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Atropine
Correct Answer: B
Rationale: Vitamin K reverses the anticoagulant effect of warfarin.
Q4. A client taking warfarin reports black, tarry stools. Which complication
should the nurse suspect?
A. Constipation
B. Gastrointestinal bleeding
, C. Hyperglycemia
D. Dehydration
Correct Answer: B
Rationale: Black, tarry stools can indicate upper gastrointestinal bleeding
and require prompt evaluation.
Q5. Which medication should the nurse question in a client receiving
warfarin?
A. Acetaminophen at an appropriate dose
B. Aspirin
C. Pantoprazole
D. Docusate
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation and can increase bleeding
risk when combined with warfarin.
Q6. Which instruction is appropriate for a client taking warfarin?
A. Use a soft-bristled toothbrush.
B. Use a hard-bristled toothbrush.
C. Take aspirin for every headache.
D. Stop warfarin when bruising occurs without contacting the provider.
Correct Answer: A
Rationale: A soft-bristled toothbrush reduces the risk of gingival bleeding.
Q7. A client taking warfarin asks which finding requires immediate reporting.
Which response is best?
A. Mild hunger before meals
B. Unexplained bleeding or blood in the urine
C. Mild thirst
D. Occasional fatigue after exercise
Correct Answer: B
Rationale: Unexplained bleeding or hematuria may indicate excessive
anticoagulation.
Q8. Which ECG characteristic is expected in normal sinus rhythm?
