D'Youville College NUR 632 – Advanced
Pharmacology Exam 3 | Latest Updated Exam
with Verified Q&A (Rationales Included) |
Updated 2026 - Graded A+
Question 1
Influenza vaccine may be administered annually to:
A. Patients with an egg allergy
B. Pregnant patients
C. Patients age 6 weeks or older
D. Patients with acute febrile illness
Answer: B
Rationale: Influenza vaccine is recommended annually for pregnant patients, patients
with chronic conditions, and healthy individuals. Patients with egg allergy can receive
the vaccine with precautions. It is not recommended for patients with acute febrile
illness until symptoms resolve. The minimum age is 6 months.
Question 2
Kenneth is taking warfarin and is asking about what he can take for minor aches and
pains. The best recommendation is:
A. Ibuprofen 400 mg three times a day
B. Acetaminophen, not to exceed 4 grams per day
C. Prescribe acetaminophen with codeine
D. Aspirin 640 mg three times a day
Answer: B
Rationale: Acetaminophen is the safest analgesic for patients on warfarin as it does
not affect platelet function or increase bleeding risk. NSAIDs (ibuprofen, aspirin)
increase bleeding risk when combined with warfarin.
Question 3
Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was
discharged on warfarin. She asks her primary care provider NP why she was getting
pg. 1
,both medications while in the hospital. The best response is to:
A. Contact the hospitalist as this is not the normal guideline for prescribing these two
medications and she may have had a more complicated case.
B. Explain that warfarin is often started while a patient is still on heparin because
warfarin takes a few days to reach effectiveness.
C. Encourage the patient to contact the Customer Service department at the hospital as
this was most likely a medication error during her admission.
D. Draw anticoagulation studies to make sure she does not have dangerously high
bleeding times.
Answer: B
Rationale: Warfarin has a delayed onset of action (3-5 days). Heparin provides
immediate anticoagulation while warfarin reaches therapeutic levels. This is standard
practice, not a medication error.
Question 4
The safest drug to use to treat pregnant women who require anticoagulant therapy is:
A. Low-molecular-weight heparin
B. Warfarin
C. Aspirin
D. Heparin
Answer: D
Rationale: Unfractionated heparin does not cross the placenta and is considered safe
during pregnancy. Warfarin is teratogenic and contraindicated. LMWH is also used but
unfractionated heparin is often preferred due to shorter half-life.
Question 5
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should
be considered in which patients?
A. Pregnant women
B. Elderly men
C. Overweight or obese patients
D. Patients with multiple comorbidities
Answer: C
Rationale: Overweight or obese patients may require higher initial doses of warfarin
due to increased volume of distribution. Elderly patients and those with comorbidities
typically require lower starting doses.
pg. 2
,Question 6
Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the
clinic to review his medications. He is healthy with only mild hypertension that is well
controlled. He asks about getting "a shot" to prevent blood clots like his friend Ralph did
before international travel. The correct response would be:
A. Administer one dose of low-molecular weight heparin 24 hours before travel.
B. Prescribe one dose of warfarin to be taken the day of travel.
C. Consult with a hematologist regarding a treatment plan for Cecil.
D. Explain that Cecil is not at high risk of a blood clot and provide education about how
to prevent blood clots while traveling.
Answer: D
Rationale: Cecil is healthy with no risk factors for DVT; prophylactic anticoagulation is
not indicated. Education on ambulation, hydration, and leg exercises during travel is
appropriate.
Question 7
Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin
a day. Why would this be recommended?
A. He has arthritis and this will help with the inflammation and pain.
B. Aspirin has anti-platelet activity and prevents clots that cause heart attacks.
C. Aspirin acidifies the urine and he needs this for prostate health.
D. He has a history of GI bleed, and one aspirin a day is a safe dosage.
Answer: B
Rationale: Low-dose aspirin is used for cardiovascular prophylaxis due to its anti-
platelet effects, reducing the risk of MI and stroke in at-risk patients.
Question 8
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also
takes aspirin four or more times a day for arthritis pain. What are the symptoms of
aspirin toxicity for which she would need to be evaluated?
A. Tinnitus
B. Diarrhea
C. Hearing loss
D. Photosensitivity
Answer: A
pg. 3
, Rationale: Tinnitus (ringing in the ears) is an early sign of salicylate toxicity. Other
symptoms include headache, dizziness, confusion, and respiratory alkalosis.
Question 9
Patient education when prescribing clopidogrel includes:
A. Do not take any herbal products without discussing it with the provider.
B. Monitor urine output closely and contact the provider if it decreases.
C. Clopidogrel can be constipating, use a stool softener if needed.
D. The patient will need regular anticoagulant studies while on clopidogrel.
Answer: A
Rationale: Herbal products (especially St. John's wort, ginkgo, and garlic) can interact
with clopidogrel. The patient should discuss any herbal use with the provider.
Clopidogrel does not require routine anticoagulant monitoring.
Question 10
For patients taking warfarin, INRs are best drawn:
A. Monthly throughout therapy
B. Three times a week throughout therapy
C. Two hours after the last dose of warfarin to get an accurate peak level
D. In the morning if the patient takes their warfarin at night
Answer: D
Rationale: INR is drawn in the morning regardless of dosing time to ensure consistent
timing and to adjust the next dose if needed. Monthly monitoring is insufficient initially.
Question 11
Patients receiving heparin therapy require monitoring of:
A. Platelets every 2 to 3 days for thrombocytopenia that may occur on day 4 of therapy
B. Electrolytes for elevated potassium levels in the first 24 hours of therapy
C. INR throughout therapy to stay within the range of 2.0
D. Blood pressure for hypertension that may occur in the first 2 days of treatment
Answer: A
Rationale: Heparin-induced thrombocytopenia (HIT) typically occurs 4-10 days after
initiation. Platelet counts should be monitored every 2-3 days.
pg. 4
Pharmacology Exam 3 | Latest Updated Exam
with Verified Q&A (Rationales Included) |
Updated 2026 - Graded A+
Question 1
Influenza vaccine may be administered annually to:
A. Patients with an egg allergy
B. Pregnant patients
C. Patients age 6 weeks or older
D. Patients with acute febrile illness
Answer: B
Rationale: Influenza vaccine is recommended annually for pregnant patients, patients
with chronic conditions, and healthy individuals. Patients with egg allergy can receive
the vaccine with precautions. It is not recommended for patients with acute febrile
illness until symptoms resolve. The minimum age is 6 months.
Question 2
Kenneth is taking warfarin and is asking about what he can take for minor aches and
pains. The best recommendation is:
A. Ibuprofen 400 mg three times a day
B. Acetaminophen, not to exceed 4 grams per day
C. Prescribe acetaminophen with codeine
D. Aspirin 640 mg three times a day
Answer: B
Rationale: Acetaminophen is the safest analgesic for patients on warfarin as it does
not affect platelet function or increase bleeding risk. NSAIDs (ibuprofen, aspirin)
increase bleeding risk when combined with warfarin.
Question 3
Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was
discharged on warfarin. She asks her primary care provider NP why she was getting
pg. 1
,both medications while in the hospital. The best response is to:
A. Contact the hospitalist as this is not the normal guideline for prescribing these two
medications and she may have had a more complicated case.
B. Explain that warfarin is often started while a patient is still on heparin because
warfarin takes a few days to reach effectiveness.
C. Encourage the patient to contact the Customer Service department at the hospital as
this was most likely a medication error during her admission.
D. Draw anticoagulation studies to make sure she does not have dangerously high
bleeding times.
Answer: B
Rationale: Warfarin has a delayed onset of action (3-5 days). Heparin provides
immediate anticoagulation while warfarin reaches therapeutic levels. This is standard
practice, not a medication error.
Question 4
The safest drug to use to treat pregnant women who require anticoagulant therapy is:
A. Low-molecular-weight heparin
B. Warfarin
C. Aspirin
D. Heparin
Answer: D
Rationale: Unfractionated heparin does not cross the placenta and is considered safe
during pregnancy. Warfarin is teratogenic and contraindicated. LMWH is also used but
unfractionated heparin is often preferred due to shorter half-life.
Question 5
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should
be considered in which patients?
A. Pregnant women
B. Elderly men
C. Overweight or obese patients
D. Patients with multiple comorbidities
Answer: C
Rationale: Overweight or obese patients may require higher initial doses of warfarin
due to increased volume of distribution. Elderly patients and those with comorbidities
typically require lower starting doses.
pg. 2
,Question 6
Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the
clinic to review his medications. He is healthy with only mild hypertension that is well
controlled. He asks about getting "a shot" to prevent blood clots like his friend Ralph did
before international travel. The correct response would be:
A. Administer one dose of low-molecular weight heparin 24 hours before travel.
B. Prescribe one dose of warfarin to be taken the day of travel.
C. Consult with a hematologist regarding a treatment plan for Cecil.
D. Explain that Cecil is not at high risk of a blood clot and provide education about how
to prevent blood clots while traveling.
Answer: D
Rationale: Cecil is healthy with no risk factors for DVT; prophylactic anticoagulation is
not indicated. Education on ambulation, hydration, and leg exercises during travel is
appropriate.
Question 7
Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin
a day. Why would this be recommended?
A. He has arthritis and this will help with the inflammation and pain.
B. Aspirin has anti-platelet activity and prevents clots that cause heart attacks.
C. Aspirin acidifies the urine and he needs this for prostate health.
D. He has a history of GI bleed, and one aspirin a day is a safe dosage.
Answer: B
Rationale: Low-dose aspirin is used for cardiovascular prophylaxis due to its anti-
platelet effects, reducing the risk of MI and stroke in at-risk patients.
Question 8
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also
takes aspirin four or more times a day for arthritis pain. What are the symptoms of
aspirin toxicity for which she would need to be evaluated?
A. Tinnitus
B. Diarrhea
C. Hearing loss
D. Photosensitivity
Answer: A
pg. 3
, Rationale: Tinnitus (ringing in the ears) is an early sign of salicylate toxicity. Other
symptoms include headache, dizziness, confusion, and respiratory alkalosis.
Question 9
Patient education when prescribing clopidogrel includes:
A. Do not take any herbal products without discussing it with the provider.
B. Monitor urine output closely and contact the provider if it decreases.
C. Clopidogrel can be constipating, use a stool softener if needed.
D. The patient will need regular anticoagulant studies while on clopidogrel.
Answer: A
Rationale: Herbal products (especially St. John's wort, ginkgo, and garlic) can interact
with clopidogrel. The patient should discuss any herbal use with the provider.
Clopidogrel does not require routine anticoagulant monitoring.
Question 10
For patients taking warfarin, INRs are best drawn:
A. Monthly throughout therapy
B. Three times a week throughout therapy
C. Two hours after the last dose of warfarin to get an accurate peak level
D. In the morning if the patient takes their warfarin at night
Answer: D
Rationale: INR is drawn in the morning regardless of dosing time to ensure consistent
timing and to adjust the next dose if needed. Monthly monitoring is insufficient initially.
Question 11
Patients receiving heparin therapy require monitoring of:
A. Platelets every 2 to 3 days for thrombocytopenia that may occur on day 4 of therapy
B. Electrolytes for elevated potassium levels in the first 24 hours of therapy
C. INR throughout therapy to stay within the range of 2.0
D. Blood pressure for hypertension that may occur in the first 2 days of treatment
Answer: A
Rationale: Heparin-induced thrombocytopenia (HIT) typically occurs 4-10 days after
initiation. Platelet counts should be monitored every 2-3 days.
pg. 4
