NU 150 EXAM 2 PHARMACOLOGY —
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: ANTICOAGULANTS, ANTIPLATELETS & THROMBOLYTICS (Questions 1-
35)
1. The nurse is reviewing dietary restrictions for a client who is currently taking warfarin.
Which of the following statements by the client demonstrates a correct understanding of
the restrictions?
A. "I will avoid all carbohydrates."
B. "I will limit the amount of spinach salad I eat."
C. "I will stop drinking water."
D. "I will increase my intake of green leafy vegetables."
Correct Answer: B
Rationale: Spinach is high in vitamin K, which antagonizes warfarin's effects. Clients
should keep vitamin K intake consistent and avoid sudden increases .
2. A patient taking warfarin (Coumadin) asks about taking ibuprofen for arthritis pain.
The nurse's best response is:
A. "You can take ibuprofen safely with warfarin."
B. "Ibuprofen increases your risk of bleeding and should be avoided."
C. "Take ibuprofen only at bedtime."
D. "Double your warfarin dose if you take ibuprofen."
Correct Answer: B
Rationale: NSAIDs inhibit platelet aggregation and increase the risk of GI bleeding.
Combined with warfarin, the bleeding risk is significantly amplified.
,3. A patient is taking warfarin (Coumadin). Which statement indicates a need for further
teaching?
A. "I will use a soft toothbrush."
B. "I will take aspirin for my headaches."
C. "I will keep my appointments for INR checks."
D. "I will report any unusual bruising."
Correct Answer: B
Rationale: Aspirin and other NSAIDs increase bleeding risk when taken with warfarin.
Patients should use acetaminophen for pain relief (with provider approval).
4. The nurse is caring for a client who presents to the emergency department with
bleeding from the nose and an INR value of 4.7. The client has a home prescription for
warfarin. Which of the following does the nurse anticipate will be prescribed?
A. Heparin
B. Vitamin K
C. Aspirin
D. Alteplase
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin and is given to reverse excessive
anticoagulation and reduce bleeding .
5. A patient is prescribed warfarin following a DVT. The nurse knows the therapeutic INR
range for this indication is:
A. 1.0-1.5
B. 1.5-2.0
C. 2.0-3.0
D. 3.0-4.5
Correct Answer: C
*Rationale: For most indications including DVT treatment and prevention, atrial
fibrillation, and pulmonary embolism, the target INR is 2.0-3.0.*
,6. A patient taking warfarin reports eating a large spinach salad daily. The nurse should
anticipate which change in the patient's INR?
A. INR will increase significantly
B. INR will decrease
C. INR will remain unchanged
D. INR will fluctuate unpredictably
Correct Answer: B
Rationale: Spinach is rich in vitamin K, which antagonizes warfarin's anticoagulant effect.
Increased vitamin K intake decreases INR and increases the risk of clot formation.
7. A patient is prescribed warfarin. The nurse should teach the patient to maintain
consistent intake of:
A. Protein
B. Vitamin K-rich foods
C. Calcium
D. Iron
Correct Answer: B
Rationale: Fluctuations in vitamin K intake affect warfarin's anticoagulant effect. Patients
should maintain consistent intake of vitamin K-rich foods to prevent INR fluctuations.
8. What is the antidote for warfarin overdose in a patient with life-threatening bleeding?
A. Protamine sulfate
B. Vitamin K (phytonadione) and fresh frozen plasma or prothrombin complex
concentrate
C. Naloxone
D. Flumazenil
Correct Answer: B
*Rationale: Vitamin K is the specific antidote for warfarin, but it takes 6-24 hours to work.
In life-threatening bleeding, FFP or PCC is given for immediate reversal.*
, 9. A patient is receiving continuous IV heparin infusion. Which lab value is used to
monitor therapeutic effect?
A. INR
B. aPTT
C. PT
D. Platelet count
Correct Answer: B
*Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
unfractionated heparin therapy. Therapeutic range is typically 1.5-2.5 times the control
value.*
10. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by
continuous IV infusion. The client asks how long it will take for the hepari n to dissolve
the clot. Which response should the nurse give?
A. "The oral medication you will take after this IV will dissolve the clot."
B. "Heparin does not dissolve clots. It stops new clots from forming."
C. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
D. "A pharmacist is the person to answer that question."
Correct Answer: B
Rationale: Heparin does not dissolve existing clots; it prevents the formation of new clots
and extension of existing clots .
11. A patient is receiving continuous IV heparin infusion. The aPTT is 120 seconds (control
30 seconds). The nurse should:
A. Continue the infusion at the current rate
B. Stop the infusion and prepare protamine sulfate
C. Stop the infusion and hold heparin per protocol
D. Increase the infusion rate
Correct Answer: C
Rationale: An aPTT of 120 seconds (4 times control) indicates excessive anticoagulation
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: ANTICOAGULANTS, ANTIPLATELETS & THROMBOLYTICS (Questions 1-
35)
1. The nurse is reviewing dietary restrictions for a client who is currently taking warfarin.
Which of the following statements by the client demonstrates a correct understanding of
the restrictions?
A. "I will avoid all carbohydrates."
B. "I will limit the amount of spinach salad I eat."
C. "I will stop drinking water."
D. "I will increase my intake of green leafy vegetables."
Correct Answer: B
Rationale: Spinach is high in vitamin K, which antagonizes warfarin's effects. Clients
should keep vitamin K intake consistent and avoid sudden increases .
2. A patient taking warfarin (Coumadin) asks about taking ibuprofen for arthritis pain.
The nurse's best response is:
A. "You can take ibuprofen safely with warfarin."
B. "Ibuprofen increases your risk of bleeding and should be avoided."
C. "Take ibuprofen only at bedtime."
D. "Double your warfarin dose if you take ibuprofen."
Correct Answer: B
Rationale: NSAIDs inhibit platelet aggregation and increase the risk of GI bleeding.
Combined with warfarin, the bleeding risk is significantly amplified.
,3. A patient is taking warfarin (Coumadin). Which statement indicates a need for further
teaching?
A. "I will use a soft toothbrush."
B. "I will take aspirin for my headaches."
C. "I will keep my appointments for INR checks."
D. "I will report any unusual bruising."
Correct Answer: B
Rationale: Aspirin and other NSAIDs increase bleeding risk when taken with warfarin.
Patients should use acetaminophen for pain relief (with provider approval).
4. The nurse is caring for a client who presents to the emergency department with
bleeding from the nose and an INR value of 4.7. The client has a home prescription for
warfarin. Which of the following does the nurse anticipate will be prescribed?
A. Heparin
B. Vitamin K
C. Aspirin
D. Alteplase
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin and is given to reverse excessive
anticoagulation and reduce bleeding .
5. A patient is prescribed warfarin following a DVT. The nurse knows the therapeutic INR
range for this indication is:
A. 1.0-1.5
B. 1.5-2.0
C. 2.0-3.0
D. 3.0-4.5
Correct Answer: C
*Rationale: For most indications including DVT treatment and prevention, atrial
fibrillation, and pulmonary embolism, the target INR is 2.0-3.0.*
,6. A patient taking warfarin reports eating a large spinach salad daily. The nurse should
anticipate which change in the patient's INR?
A. INR will increase significantly
B. INR will decrease
C. INR will remain unchanged
D. INR will fluctuate unpredictably
Correct Answer: B
Rationale: Spinach is rich in vitamin K, which antagonizes warfarin's anticoagulant effect.
Increased vitamin K intake decreases INR and increases the risk of clot formation.
7. A patient is prescribed warfarin. The nurse should teach the patient to maintain
consistent intake of:
A. Protein
B. Vitamin K-rich foods
C. Calcium
D. Iron
Correct Answer: B
Rationale: Fluctuations in vitamin K intake affect warfarin's anticoagulant effect. Patients
should maintain consistent intake of vitamin K-rich foods to prevent INR fluctuations.
8. What is the antidote for warfarin overdose in a patient with life-threatening bleeding?
A. Protamine sulfate
B. Vitamin K (phytonadione) and fresh frozen plasma or prothrombin complex
concentrate
C. Naloxone
D. Flumazenil
Correct Answer: B
*Rationale: Vitamin K is the specific antidote for warfarin, but it takes 6-24 hours to work.
In life-threatening bleeding, FFP or PCC is given for immediate reversal.*
, 9. A patient is receiving continuous IV heparin infusion. Which lab value is used to
monitor therapeutic effect?
A. INR
B. aPTT
C. PT
D. Platelet count
Correct Answer: B
*Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
unfractionated heparin therapy. Therapeutic range is typically 1.5-2.5 times the control
value.*
10. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by
continuous IV infusion. The client asks how long it will take for the hepari n to dissolve
the clot. Which response should the nurse give?
A. "The oral medication you will take after this IV will dissolve the clot."
B. "Heparin does not dissolve clots. It stops new clots from forming."
C. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
D. "A pharmacist is the person to answer that question."
Correct Answer: B
Rationale: Heparin does not dissolve existing clots; it prevents the formation of new clots
and extension of existing clots .
11. A patient is receiving continuous IV heparin infusion. The aPTT is 120 seconds (control
30 seconds). The nurse should:
A. Continue the infusion at the current rate
B. Stop the infusion and prepare protamine sulfate
C. Stop the infusion and hold heparin per protocol
D. Increase the infusion rate
Correct Answer: C
Rationale: An aPTT of 120 seconds (4 times control) indicates excessive anticoagulation
