(2026/2027) PDF | Nursing | Galen College
1. A patient is prescribed warfarin (Coumadin) for atrial
fibrillation. Which statement by the patient indicates a
need for further teaching?
A. "I will limit how much spinach and kale I eat."
B. "I will use a soft-bristled toothbrush."
C. "I will take ibuprofen if I get a headache."
D. "I will get my blood drawn regularly to check my INR."
Answer: C. "I will take ibuprofen if I get a headache."
Rationale: NSAIDs like ibuprofen increase the risk of
gastrointestinal bleeding. Patients on warfarin should use
acetaminophen for pain and avoid NSAIDs/aspirin unless
prescribed .
2. The nurse is administering enoxaparin (Lovenox)
subcutaneously. Which technique is correct?
A. Expelling the air bubble from the prefilled syringe
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,before injection.
B. Massaging the site vigorously after injection to
distribute the medication.
C. Inserting the needle at a 90-degree angle into a
pinched skin fold on the abdomen.
D. Injecting into the vastus lateralis muscle for deep
absorption.
Answer: C. Inserting the needle at a 90-degree angle into
a pinched skin fold on the abdomen.
Rationale: Enoxaparin is given subcutaneously in the
abdomen. The air bubble should not be expelled (it locks
the dose), and the site should not be massaged (prevents
bruising) .
3. A client receiving IV heparin has an aPTT of 110
seconds (control: 30 seconds). What is the priority nursing
action?
A. Administer Vitamin K.
B. Increase the infusion rate.
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,C. Stop the infusion and notify the provider.
D. Document the finding as therapeutic.
Answer: C. Stop the infusion and notify the provider.
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times
the control (approx. 45–75 sec). 110 seconds is critically
high, indicating a severe bleeding risk. The infusion must
be stopped .
4. A patient is prescribed clopidogrel (Plavix) after a
drug-eluting stent placement. The nurse teaches the
patient to monitor for which adverse effect?
A. Constipation and dry mouth.
B. Black, tarry stools.
C. Metallic taste in the mouth.
D. Hypertension.
Answer: B. Black, tarry stools.
Rationale: Clopidogrel is an antiplatelet that increases
bleeding risk. Black, tarry stools indicate gastrointestinal
bleeding, which requires immediate medical attention .
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, 5. Which medication is the specific antidote for heparin
overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
Answer: B. Protamine sulfate.
Rationale: Protamine sulfate binds directly to heparin to
neutralize its anticoagulant effect. Vitamin K reverses
warfarin .
6. The nurse is reviewing lab results for a patient on
warfarin with a mechanical heart valve. What INR result
indicates the medication is therapeutic?
A. 1.0
B. 1.5
C. 2.8
D. 4.5
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