Pharmacology
Nursing Clotting and Hematologic Agents
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Pharmacology
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
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,Pharmacology Nursing: Clotting and Hematologic Agents 2026/2027 UPDATE
1. A patient is receiving a continuous intravenous infusion of unfractionated heparin. The
nurse notes the most recent aPTT is 110 seconds (control 30 seconds). Which action is the
priority?
A. Increase the infusion rate by 10%
B. Stop the infusion and prepare protamine sulfate
C. Continue the infusion and recheck the aPTT in 4 hours
D. Administer Vitamin K intramuscularly
Answer: B
Rationale: An aPTT of 110 seconds is significantly above the therapeutic range (typically
1.5-2.5 times the control). The infusion must be stopped to prevent hemorrhage, and
protamine sulfate is the specific antagonist for heparin.
2. Which statement by a patient starting warfarin therapy indicates a need for further
teaching?
A. I will use an electric razor for shaving.
B. I need to have my blood drawn regularly to check my INR.
C. I will report any dark, tarry stools to my provider immediately.
D. I should eat a large salad with spinach every night to stay healthy.
, Answer: D
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors. Large,
inconsistent amounts of leafy greens (rich in Vitamin K) can antagonize warfarin’s effect.
Patients should maintain a consistent intake rather than suddenly increasing it.
3. A patient is diagnosed with Heparin-Induced Thrombocytopenia (HIT). Which medication
does the nurse anticipate administering as an alternative anticoagulant?
A. Enoxaparin
B. Argatroban
C. Warfarin
D. Aspirin
Answer: B
Rationale: Argatroban is a direct thrombin inhibitor used specifically for patients with
HIT. Enoxaparin is a low-molecular-weight heparin and is contraindicated in HIT because
of cross-reactivity.
4. The nurse is preparing to administer enoxaparin subcutaneously. Which technique is
correct?
A. Aspirating for blood return before injecting
B. Expelling the air bubble from the prefilled syringe
C. Massaging the injection site after administration
Nursing Clotting and Hematologic Agents
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Pharmacology
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,Pharmacology Nursing: Clotting and Hematologic Agents 2026/2027 UPDATE
1. A patient is receiving a continuous intravenous infusion of unfractionated heparin. The
nurse notes the most recent aPTT is 110 seconds (control 30 seconds). Which action is the
priority?
A. Increase the infusion rate by 10%
B. Stop the infusion and prepare protamine sulfate
C. Continue the infusion and recheck the aPTT in 4 hours
D. Administer Vitamin K intramuscularly
Answer: B
Rationale: An aPTT of 110 seconds is significantly above the therapeutic range (typically
1.5-2.5 times the control). The infusion must be stopped to prevent hemorrhage, and
protamine sulfate is the specific antagonist for heparin.
2. Which statement by a patient starting warfarin therapy indicates a need for further
teaching?
A. I will use an electric razor for shaving.
B. I need to have my blood drawn regularly to check my INR.
C. I will report any dark, tarry stools to my provider immediately.
D. I should eat a large salad with spinach every night to stay healthy.
, Answer: D
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors. Large,
inconsistent amounts of leafy greens (rich in Vitamin K) can antagonize warfarin’s effect.
Patients should maintain a consistent intake rather than suddenly increasing it.
3. A patient is diagnosed with Heparin-Induced Thrombocytopenia (HIT). Which medication
does the nurse anticipate administering as an alternative anticoagulant?
A. Enoxaparin
B. Argatroban
C. Warfarin
D. Aspirin
Answer: B
Rationale: Argatroban is a direct thrombin inhibitor used specifically for patients with
HIT. Enoxaparin is a low-molecular-weight heparin and is contraindicated in HIT because
of cross-reactivity.
4. The nurse is preparing to administer enoxaparin subcutaneously. Which technique is
correct?
A. Aspirating for blood return before injecting
B. Expelling the air bubble from the prefilled syringe
C. Massaging the injection site after administration
