1
NU 518 EXAM 3 LATEST 2026/2027 |
ADVANCED PHARMACOLOGY | 40 VERIFIED
Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: HEMATOLOGIC AND IMMUNOLOGIC PHARMACOLOGY - Questions 1-10
Q1: Low Molecular Weight Heparin Monitoring
The student is reviewing anticoagulant therapy. A patient is prescribed enoxaparin. Which
laboratory test is used to monitor enoxaparin therapy?
A. INR
B. aPTT
C. Anti-Xa level
D. Bleeding time
Correct Answer: C
Rationale: Enoxaparin is a low molecular weight heparin (LMWH) that primarily inhibits factor Xa.
Unlike unfractionated heparin, which is monitored by aPTT, LMWH is monitored by anti-Xa levels
when monitoring is indicated (e.g., renal impairment, obesity, pregnancy). INR monitors warfarin.
[100% CORRECT]
Q2: Warfarin Patient Education
The student is reviewing anticoagulant education. A patient is prescribed warfarin. Which dietary
instruction should the nurse include?
A. Maintain consistent intake of vitamin K-rich foods
B. Avoid all green leafy vegetables
C. Increase vitamin K intake to enhance warfarin effect
D. Take warfarin with grapefruit juice
Correct Answer: A
Rationale: Warfarin is a vitamin K antagonist. Patients should maintain a consistent intake of vitamin
K-rich foods (e.g., spinach, kale, broccoli) rather than avoiding them entirely or increasing them
abruptly, as fluctuations affect INR. Grapefruit juice can interact with many drugs but is not a
primary concern with warfarin. [100% CORRECT]
Q3: Direct Oral Anticoagulant Advantage
, 2
The student is reviewing anticoagulants. What is a major advantage of direct oral anticoagulants
(DOACs) such as apixaban over warfarin?
A. No routine INR monitoring required
B. Reversible with vitamin K
C. Requires frequent blood draws
D. Cheaper than warfarin
Correct Answer: A
Rationale: DOACs (apixaban, rivaroxaban, dabigatran) have predictable pharmacokinetics and do not
require routine INR monitoring, unlike warfarin. They are not reversed by vitamin K (specific reversal
agents exist: andexanet alfa for Xa inhibitors, idarucizumab for dabigatran). They may be more
expensive. [100% CORRECT]
Q4: Antiplatelet Drug Mechanism
The student is reviewing antiplatelet therapy. What is the mechanism of action of clopidogrel?
A. Irreversible inhibition of P2Y12 ADP receptors on platelets
B. Reversible inhibition of cyclooxygenase-1
C. Blockade of glycoprotein IIb/IIIa receptors
D. Inhibition of phosphodiesterase
Correct Answer: A
Rationale: Clopidogrel is a prodrug that irreversibly inhibits the P2Y12 ADP receptor on platelets,
preventing platelet activation and aggregation. Aspirin inhibits cyclooxygenase-1. Glycoprotein
IIb/IIIa inhibitors include abciximab. Phosphodiesterase inhibitors include dipyridamole. [100%
CORRECT]
Q5: Thrombolytic Therapy
The student is reviewing thrombolytics. A patient is receiving alteplase for acute ischemic stroke.
Which assessment is the priority?
A. Neurological status and signs of bleeding
B. Blood glucose
C. Urine output
D. Skin color
Correct Answer: A
Rationale: Alteplase is a thrombolytic that dissolves clots but carries a high risk of bleeding, including
intracranial hemorrhage. Neurological status should be monitored closely for changes, and any signs
of bleeding (e.g., gum bleeding, hematuria, headache) should be reported immediately. [100%
CORRECT]
Q6: Erythropoietin Adverse Effect
NU 518 EXAM 3 LATEST 2026/2027 |
ADVANCED PHARMACOLOGY | 40 VERIFIED
Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: HEMATOLOGIC AND IMMUNOLOGIC PHARMACOLOGY - Questions 1-10
Q1: Low Molecular Weight Heparin Monitoring
The student is reviewing anticoagulant therapy. A patient is prescribed enoxaparin. Which
laboratory test is used to monitor enoxaparin therapy?
A. INR
B. aPTT
C. Anti-Xa level
D. Bleeding time
Correct Answer: C
Rationale: Enoxaparin is a low molecular weight heparin (LMWH) that primarily inhibits factor Xa.
Unlike unfractionated heparin, which is monitored by aPTT, LMWH is monitored by anti-Xa levels
when monitoring is indicated (e.g., renal impairment, obesity, pregnancy). INR monitors warfarin.
[100% CORRECT]
Q2: Warfarin Patient Education
The student is reviewing anticoagulant education. A patient is prescribed warfarin. Which dietary
instruction should the nurse include?
A. Maintain consistent intake of vitamin K-rich foods
B. Avoid all green leafy vegetables
C. Increase vitamin K intake to enhance warfarin effect
D. Take warfarin with grapefruit juice
Correct Answer: A
Rationale: Warfarin is a vitamin K antagonist. Patients should maintain a consistent intake of vitamin
K-rich foods (e.g., spinach, kale, broccoli) rather than avoiding them entirely or increasing them
abruptly, as fluctuations affect INR. Grapefruit juice can interact with many drugs but is not a
primary concern with warfarin. [100% CORRECT]
Q3: Direct Oral Anticoagulant Advantage
, 2
The student is reviewing anticoagulants. What is a major advantage of direct oral anticoagulants
(DOACs) such as apixaban over warfarin?
A. No routine INR monitoring required
B. Reversible with vitamin K
C. Requires frequent blood draws
D. Cheaper than warfarin
Correct Answer: A
Rationale: DOACs (apixaban, rivaroxaban, dabigatran) have predictable pharmacokinetics and do not
require routine INR monitoring, unlike warfarin. They are not reversed by vitamin K (specific reversal
agents exist: andexanet alfa for Xa inhibitors, idarucizumab for dabigatran). They may be more
expensive. [100% CORRECT]
Q4: Antiplatelet Drug Mechanism
The student is reviewing antiplatelet therapy. What is the mechanism of action of clopidogrel?
A. Irreversible inhibition of P2Y12 ADP receptors on platelets
B. Reversible inhibition of cyclooxygenase-1
C. Blockade of glycoprotein IIb/IIIa receptors
D. Inhibition of phosphodiesterase
Correct Answer: A
Rationale: Clopidogrel is a prodrug that irreversibly inhibits the P2Y12 ADP receptor on platelets,
preventing platelet activation and aggregation. Aspirin inhibits cyclooxygenase-1. Glycoprotein
IIb/IIIa inhibitors include abciximab. Phosphodiesterase inhibitors include dipyridamole. [100%
CORRECT]
Q5: Thrombolytic Therapy
The student is reviewing thrombolytics. A patient is receiving alteplase for acute ischemic stroke.
Which assessment is the priority?
A. Neurological status and signs of bleeding
B. Blood glucose
C. Urine output
D. Skin color
Correct Answer: A
Rationale: Alteplase is a thrombolytic that dissolves clots but carries a high risk of bleeding, including
intracranial hemorrhage. Neurological status should be monitored closely for changes, and any signs
of bleeding (e.g., gum bleeding, hematuria, headache) should be reported immediately. [100%
CORRECT]
Q6: Erythropoietin Adverse Effect
