1. Which component is primarily responsible for initiating the intrinsic pathway of
coagulation?
A. Tissue factor (Factor III)
B. Factor XII (Hageman factor)
C. Platelet factor 3
D. Factor VII
Answer: B
Rationale: The intrinsic pathway begins when blood contacts damaged endothelium and Factor
XII (Hageman factor) is activated.
2. Which vitamin is essential for the synthesis of clotting factors II, VII, IX, and X?
A. Vitamin A
B. Vitamin C
C. Vitamin K
D. Vitamin D
Answer: C
Rationale: Vitamin K is required for the hepatic synthesis of prothrombin and clotting factors II,
VII, IX, and X.
3. The final step in the coagulation cascade involves:
A. Conversion of prothrombin to thrombin
B. Conversion of fibrinogen to fibrin
C. Activation of platelets
D. Lysis of the clot
Answer: B
Rationale: Thrombin converts fibrinogen to fibrin, forming a stable clot — the last step of
coagulation.
4. Which laboratory test evaluates the intrinsic pathway?
A. PT (Prothrombin Time)
B. INR
,C. aPTT (Activated Partial Thromboplastin Time)
D. Platelet count
Answer: C
Rationale: aPTT measures the activity of the intrinsic and common pathways and monitors
heparin therapy.
5. Which anticoagulant works by inhibiting vitamin K synthesis?
A. Heparin
B. Warfarin
C. Aspirin
D. Clopidogrel
Answer: B
Rationale: Warfarin inhibits vitamin K–dependent clotting factors, prolonging PT/INR.
6. A nurse notes that a patient’s PT/INR is elevated. This indicates:
A. Increased clotting ability
B. Slower clot formation
C. Dehydration
D. Platelet overactivity
Answer: B
Rationale: An elevated PT/INR means clotting is delayed, often due to warfarin therapy or
vitamin K deficiency.
7. Heparin’s antidote is:
A. Vitamin K
B. Protamine sulfate
C. Calcium gluconate
D. Atropine
Answer: B
Rationale: Protamine sulfate neutralizes heparin and is given in cases of overdose or excessive
bleeding.
, 8. The nurse monitors a client receiving heparin therapy. Which lab test is most important?
A. PT
B. INR
C. aPTT
D. Platelet count only
Answer: C
Rationale: Heparin affects the intrinsic pathway; aPTT is used to monitor its effectiveness.
9. Which condition is caused by excessive clot formation and simultaneous bleeding?
A. Hemophilia
B. DIC (Disseminated Intravascular Coagulation)
C. Thrombocytopenia
D. Leukemia
Answer: B
Rationale: DIC involves both abnormal clot formation and consumption of clotting factors,
leading to bleeding.
10. Which of the following best describes primary hemostasis?
A. Formation of fibrin mesh
B. Activation of clotting factors
C. Platelet plug formation
D. Fibrinolysis
Answer: C
Rationale: Primary hemostasis involves platelet aggregation forming a temporary plug before
fibrin reinforcement.
11. Which medication inhibits platelet aggregation by blocking thromboxane A2?
A. Aspirin
B. Warfarin
C. Heparin
D. Dabigatran
coagulation?
A. Tissue factor (Factor III)
B. Factor XII (Hageman factor)
C. Platelet factor 3
D. Factor VII
Answer: B
Rationale: The intrinsic pathway begins when blood contacts damaged endothelium and Factor
XII (Hageman factor) is activated.
2. Which vitamin is essential for the synthesis of clotting factors II, VII, IX, and X?
A. Vitamin A
B. Vitamin C
C. Vitamin K
D. Vitamin D
Answer: C
Rationale: Vitamin K is required for the hepatic synthesis of prothrombin and clotting factors II,
VII, IX, and X.
3. The final step in the coagulation cascade involves:
A. Conversion of prothrombin to thrombin
B. Conversion of fibrinogen to fibrin
C. Activation of platelets
D. Lysis of the clot
Answer: B
Rationale: Thrombin converts fibrinogen to fibrin, forming a stable clot — the last step of
coagulation.
4. Which laboratory test evaluates the intrinsic pathway?
A. PT (Prothrombin Time)
B. INR
,C. aPTT (Activated Partial Thromboplastin Time)
D. Platelet count
Answer: C
Rationale: aPTT measures the activity of the intrinsic and common pathways and monitors
heparin therapy.
5. Which anticoagulant works by inhibiting vitamin K synthesis?
A. Heparin
B. Warfarin
C. Aspirin
D. Clopidogrel
Answer: B
Rationale: Warfarin inhibits vitamin K–dependent clotting factors, prolonging PT/INR.
6. A nurse notes that a patient’s PT/INR is elevated. This indicates:
A. Increased clotting ability
B. Slower clot formation
C. Dehydration
D. Platelet overactivity
Answer: B
Rationale: An elevated PT/INR means clotting is delayed, often due to warfarin therapy or
vitamin K deficiency.
7. Heparin’s antidote is:
A. Vitamin K
B. Protamine sulfate
C. Calcium gluconate
D. Atropine
Answer: B
Rationale: Protamine sulfate neutralizes heparin and is given in cases of overdose or excessive
bleeding.
, 8. The nurse monitors a client receiving heparin therapy. Which lab test is most important?
A. PT
B. INR
C. aPTT
D. Platelet count only
Answer: C
Rationale: Heparin affects the intrinsic pathway; aPTT is used to monitor its effectiveness.
9. Which condition is caused by excessive clot formation and simultaneous bleeding?
A. Hemophilia
B. DIC (Disseminated Intravascular Coagulation)
C. Thrombocytopenia
D. Leukemia
Answer: B
Rationale: DIC involves both abnormal clot formation and consumption of clotting factors,
leading to bleeding.
10. Which of the following best describes primary hemostasis?
A. Formation of fibrin mesh
B. Activation of clotting factors
C. Platelet plug formation
D. Fibrinolysis
Answer: C
Rationale: Primary hemostasis involves platelet aggregation forming a temporary plug before
fibrin reinforcement.
11. Which medication inhibits platelet aggregation by blocking thromboxane A2?
A. Aspirin
B. Warfarin
C. Heparin
D. Dabigatran
