NR 341 PHARMACOLOGY CLINICAL
JUDGMENT EXAM (CJE) 2026/2027 – 25
VERIFIED QUESTIONS & ANSWERS
PLUS RATIONALES | CHAMBERLAIN
UNIVERSITY NURSING PREP | INSTANT
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SECTION 1: CARDIOVASCULAR PHARMACOLOGY
(Questions 1–15)
1. A patient is receiving a continuous heparin infusion. The nurse notes that the
patient's aPTT is 110 seconds (control value: 30 seconds). What is the nurse's
priority action?
A) Increase the heparin infusion rate
B) Stop the heparin infusion and notify the healthcare provider
C) Continue the infusion as prescribed
D) Administer vitamin K
Correct Answer: B. Stop the heparin infusion and notify the healthcare provider.
Rationale: The therapeutic aPTT for heparin is typically 1.5 to 2.5 times the control
(approximately 45–75 seconds). An aPTT of 110 seconds is critically high, indicating a
high bleeding risk. The infusion should be stopped, and the provider notified
immediately. Vitamin K is the antidote for warfarin, not heparin. The antidote for
heparin is protamine sulfate.
2. A patient with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value should the nurse monitor to determine therapeutic
effectiveness?
A) aPTT
, B) INR (International Normalized Ratio)
C) Platelet count
D) Bleeding time
Correct Answer: B. INR (International Normalized Ratio).
Rationale: Warfarin is monitored using the INR. The therapeutic INR range for atrial
fibrillation is typically 2.0–3.0. aPTT monitors heparin therapy. Platelet count monitors
for heparin-induced thrombocytopenia (HIT), not warfarin effectiveness. Bleeding time
is not used for warfarin monitoring.
3. A patient with heart failure is prescribed digoxin (Lanoxin). The nurse notes
the patient's serum potassium level is 3.2 mEq/L. Which action should the nurse
take first?
A) Administer the digoxin as prescribed
B) Hold the digoxin and notify the provider
C) Administer potassium chloride IV push
D) Double the next dose of digoxin
Correct Answer: B. Hold the digoxin and notify the provider.
Rationale: Hypokalemia (normal range 3.5–5.0 mEq/L) increases the risk of digoxin
toxicity. The nurse should hold the digoxin and notify the provider. Potassium should be
replaced as prescribed, but not as an IV push. Double-dosing digoxin would increase
toxicity risk.
4. A patient is prescribed amiodarone for ventricular tachycardia. Which
adverse effect requires long-term monitoring? (Select all that apply)
A) Pulmonary toxicity
B) Thyroid dysfunction
C) Corneal microdeposits
D) Hepatotoxicity
E) Photosensitivity
Correct Answers: A, B, C, D, E.
Rationale: Amiodarone has multiple serious adverse effects requiring long-term
monitoring. Pulmonary toxicity (pulmonary fibrosis) can be fatal; baseline and periodic
JUDGMENT EXAM (CJE) 2026/2027 – 25
VERIFIED QUESTIONS & ANSWERS
PLUS RATIONALES | CHAMBERLAIN
UNIVERSITY NURSING PREP | INSTANT
DOWNLOAD
SECTION 1: CARDIOVASCULAR PHARMACOLOGY
(Questions 1–15)
1. A patient is receiving a continuous heparin infusion. The nurse notes that the
patient's aPTT is 110 seconds (control value: 30 seconds). What is the nurse's
priority action?
A) Increase the heparin infusion rate
B) Stop the heparin infusion and notify the healthcare provider
C) Continue the infusion as prescribed
D) Administer vitamin K
Correct Answer: B. Stop the heparin infusion and notify the healthcare provider.
Rationale: The therapeutic aPTT for heparin is typically 1.5 to 2.5 times the control
(approximately 45–75 seconds). An aPTT of 110 seconds is critically high, indicating a
high bleeding risk. The infusion should be stopped, and the provider notified
immediately. Vitamin K is the antidote for warfarin, not heparin. The antidote for
heparin is protamine sulfate.
2. A patient with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value should the nurse monitor to determine therapeutic
effectiveness?
A) aPTT
, B) INR (International Normalized Ratio)
C) Platelet count
D) Bleeding time
Correct Answer: B. INR (International Normalized Ratio).
Rationale: Warfarin is monitored using the INR. The therapeutic INR range for atrial
fibrillation is typically 2.0–3.0. aPTT monitors heparin therapy. Platelet count monitors
for heparin-induced thrombocytopenia (HIT), not warfarin effectiveness. Bleeding time
is not used for warfarin monitoring.
3. A patient with heart failure is prescribed digoxin (Lanoxin). The nurse notes
the patient's serum potassium level is 3.2 mEq/L. Which action should the nurse
take first?
A) Administer the digoxin as prescribed
B) Hold the digoxin and notify the provider
C) Administer potassium chloride IV push
D) Double the next dose of digoxin
Correct Answer: B. Hold the digoxin and notify the provider.
Rationale: Hypokalemia (normal range 3.5–5.0 mEq/L) increases the risk of digoxin
toxicity. The nurse should hold the digoxin and notify the provider. Potassium should be
replaced as prescribed, but not as an IV push. Double-dosing digoxin would increase
toxicity risk.
4. A patient is prescribed amiodarone for ventricular tachycardia. Which
adverse effect requires long-term monitoring? (Select all that apply)
A) Pulmonary toxicity
B) Thyroid dysfunction
C) Corneal microdeposits
D) Hepatotoxicity
E) Photosensitivity
Correct Answers: A, B, C, D, E.
Rationale: Amiodarone has multiple serious adverse effects requiring long-term
monitoring. Pulmonary toxicity (pulmonary fibrosis) can be fatal; baseline and periodic
