NCLEX-RN Hematologic System
Pharmacology Practice Questions |
20 Original NGN-Style MCQs with
Rationales
Question 1
Clinical Scenario
A 68-year-old male is prescribed enoxaparin 40 mg subcutaneously
once daily for deep vein thrombosis (DVT) prophylaxis following hip
replacement surgery.
Question Stem
Which action by the nurse demonstrates correct administration of
this medication?
Options
A. Aspirating for blood return before injecting the medication.
B. Massaging the injection site gently after administration to
promote absorption.
C. Expelling the air bubble from the prefilled syringe before injection.
D. Injecting the medication into the anterolateral or posterolateral
abdominal wall.
,Correct Answer
Correct Answer: D. Injecting the medication into the anterolateral or
posterolateral abdominal wall.
Detailed Rationale
Enoxaparin should be administered subcutaneously into the
anterolateral or posterolateral abdominal wall (the "love handles")
to ensure proper, consistent absorption and minimize tissue
trauma. The nurse should NOT aspirate before injection, as this
increases the risk of hematoma formation in the subcutaneous
tissue. Massaging the injection site is strictly contraindicated
because it can cause tissue damage, increase bruising, and
unpredictably alter the absorption rate of the medication.
Furthermore, the air bubble in the prefilled enoxaparin syringe
should NOT be expelled. This air bubble is intentionally designed to
be injected to ensure the full, exact dose is delivered and to act as a
seal in the subcutaneous tissue, preventing medication leakage and
subsequent bruising. Following injection, applying gentle pressure
with a dry gauze without rubbing is the recommended practice to
ensure medication safety and efficacy.
Learning Objective
Demonstrate correct subcutaneous injection technique for low-
molecular-weight heparins.
Identify actions to prevent medication administration errors with
prefilled syringes.
Medication Safety Focus
Medication administration
, Question 2
Clinical Scenario
A 32-year-old female with iron deficiency anemia is prescribed
ferrous sulfate 325 mg orally twice daily.
Question Stem
Which statement by the client indicates a need for further teaching
regarding this medication?
Options
A. "I will take this medication with a glass of orange juice."
B. "I should expect my stools to become dark green or black."
C. "I will take this medication with my daily antacid to prevent
stomach upset."
D. "I will use a straw when drinking liquid iron preparations to
prevent tooth staining."
Correct Answer
Correct Answer: C. "I will take this medication with my daily antacid
to prevent stomach upset."
Detailed Rationale
Antacids, dairy products, calcium supplements, and certain other
medications (like proton pump inhibitors) significantly decrease the
gastrointestinal absorption of oral iron preparations. The client
should be taught to take ferrous sulfate on an empty stomach, or if
GI upset occurs, with a small amount of food, but specifically paired
with vitamin C (such as a glass of orange juice) to enhance iron
absorption. Dark green or black stools are an expected, harmless
Pharmacology Practice Questions |
20 Original NGN-Style MCQs with
Rationales
Question 1
Clinical Scenario
A 68-year-old male is prescribed enoxaparin 40 mg subcutaneously
once daily for deep vein thrombosis (DVT) prophylaxis following hip
replacement surgery.
Question Stem
Which action by the nurse demonstrates correct administration of
this medication?
Options
A. Aspirating for blood return before injecting the medication.
B. Massaging the injection site gently after administration to
promote absorption.
C. Expelling the air bubble from the prefilled syringe before injection.
D. Injecting the medication into the anterolateral or posterolateral
abdominal wall.
,Correct Answer
Correct Answer: D. Injecting the medication into the anterolateral or
posterolateral abdominal wall.
Detailed Rationale
Enoxaparin should be administered subcutaneously into the
anterolateral or posterolateral abdominal wall (the "love handles")
to ensure proper, consistent absorption and minimize tissue
trauma. The nurse should NOT aspirate before injection, as this
increases the risk of hematoma formation in the subcutaneous
tissue. Massaging the injection site is strictly contraindicated
because it can cause tissue damage, increase bruising, and
unpredictably alter the absorption rate of the medication.
Furthermore, the air bubble in the prefilled enoxaparin syringe
should NOT be expelled. This air bubble is intentionally designed to
be injected to ensure the full, exact dose is delivered and to act as a
seal in the subcutaneous tissue, preventing medication leakage and
subsequent bruising. Following injection, applying gentle pressure
with a dry gauze without rubbing is the recommended practice to
ensure medication safety and efficacy.
Learning Objective
Demonstrate correct subcutaneous injection technique for low-
molecular-weight heparins.
Identify actions to prevent medication administration errors with
prefilled syringes.
Medication Safety Focus
Medication administration
, Question 2
Clinical Scenario
A 32-year-old female with iron deficiency anemia is prescribed
ferrous sulfate 325 mg orally twice daily.
Question Stem
Which statement by the client indicates a need for further teaching
regarding this medication?
Options
A. "I will take this medication with a glass of orange juice."
B. "I should expect my stools to become dark green or black."
C. "I will take this medication with my daily antacid to prevent
stomach upset."
D. "I will use a straw when drinking liquid iron preparations to
prevent tooth staining."
Correct Answer
Correct Answer: C. "I will take this medication with my daily antacid
to prevent stomach upset."
Detailed Rationale
Antacids, dairy products, calcium supplements, and certain other
medications (like proton pump inhibitors) significantly decrease the
gastrointestinal absorption of oral iron preparations. The client
should be taught to take ferrous sulfate on an empty stomach, or if
GI upset occurs, with a small amount of food, but specifically paired
with vitamin C (such as a glass of orange juice) to enhance iron
absorption. Dark green or black stools are an expected, harmless
