1) A patient is receiving an intravenous heparin drip. Which laboratory value requires
immediate action by the nurse?
a. Platelet count of 150,000
b. Activated partial thromboplastin time (aPTT) of 120 seconds Correct
c. INR of 1.0
d. Blood urea nitrogen (BUN) level of 12 mg/dL
2) A patient who has been taking warfarin (Coumadin) is admitted with coffee-ground
emesis. What can the nurse anticipate being prescribed for this patient?
a. Vitamin E
b. Vitamin K Correct
c. Protamine sulfate
d. Calcium gluconate
3) The patient has an international normalized ratio (INR) value of 1.5. In response to this,
the nurse could anticipate the health care provider placing which order?
a. Administer an additional dose of warfarin (Coumadin). Correct
b. Hold the next dose of warfarin (Coumadin).
c. Increase the heparin drip rate.
d. Administer protamine sulfate.
4) A patient is receiving warfarin (Coumadin) for a chronic condition. Which patient
statement requires immediate action by the nurse?
a. “I will avoid contact sports.”
b. “I will take my medication in the early evening each day.”
c. “I will increase dark-green, leafy vegetables in my diet.” Correct
d. “I will contact my health care provider if I develop excessive bruising.”
5) A nurse is preparing to administer enoxaparin sodium (Lovenox) to a patient for
prevention of deep vein thrombosis. Which is an essential nursing intervention?
a. Draw up the medication in a syringe with a 22-gauge, 1½-inch needle.
b. Utilize the Z-track method to inject the medication.
, c. Administer the medication into subcutaneous tissue. Correct
d. Rub the administration site after injecting.
6) A patient has arrived at the emergency department and requires immediate surgery. He
has been receiving heparin. Which intervention is essential?
a. Teach the patient about the phenytoin.
b. Administer protamine sulfate. Correct
c. Assess the INR before surgery.
d. Administer vitamin K.
7) A patient taking warfarin (Coumadin) asks for an aspirin for a headache. What is the
nurse’s best action?
a. Administer 650 mg of acetylsalicylic acid (ASA) and reassess pain in 30 minutes.
b. Teach the patient of potential drug interactions with anticoagulants. Correct
c. Explain to the patient that ASA is contraindicated and administer ibuprofen as
ordered.
d. Explain that the headache is an expected side effect and will subside shortly.
8) A patient is started on warfarin (Coumadin) therapy while also receiving intravenous
heparin. The patient is concerned about the risk for bleeding. What will the nurse tell the
patient?
a. “Your concern is valid. I will call the doctor to discontinue the heparin.”
b. “It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the
heparin is continued until the warfarin is therapeutic.” Correct
c. “Because of your valve replacement, it is especially important for you to be
anticoagulated. The heparin and warfarin together are more effective than one
alone.”
d. “Because you are now up and walking, you have a higher risk of blood clots and
therefore need to be on both medications.”
9) The nurse evaluates that the patient has understood discharge teaching regarding
warfarin (Coumadin) based on which statement?
a. “I will double my dose if I forget to take it the day before.”
b. “I should keep taking ibuprofen for my arthritis.”
immediate action by the nurse?
a. Platelet count of 150,000
b. Activated partial thromboplastin time (aPTT) of 120 seconds Correct
c. INR of 1.0
d. Blood urea nitrogen (BUN) level of 12 mg/dL
2) A patient who has been taking warfarin (Coumadin) is admitted with coffee-ground
emesis. What can the nurse anticipate being prescribed for this patient?
a. Vitamin E
b. Vitamin K Correct
c. Protamine sulfate
d. Calcium gluconate
3) The patient has an international normalized ratio (INR) value of 1.5. In response to this,
the nurse could anticipate the health care provider placing which order?
a. Administer an additional dose of warfarin (Coumadin). Correct
b. Hold the next dose of warfarin (Coumadin).
c. Increase the heparin drip rate.
d. Administer protamine sulfate.
4) A patient is receiving warfarin (Coumadin) for a chronic condition. Which patient
statement requires immediate action by the nurse?
a. “I will avoid contact sports.”
b. “I will take my medication in the early evening each day.”
c. “I will increase dark-green, leafy vegetables in my diet.” Correct
d. “I will contact my health care provider if I develop excessive bruising.”
5) A nurse is preparing to administer enoxaparin sodium (Lovenox) to a patient for
prevention of deep vein thrombosis. Which is an essential nursing intervention?
a. Draw up the medication in a syringe with a 22-gauge, 1½-inch needle.
b. Utilize the Z-track method to inject the medication.
, c. Administer the medication into subcutaneous tissue. Correct
d. Rub the administration site after injecting.
6) A patient has arrived at the emergency department and requires immediate surgery. He
has been receiving heparin. Which intervention is essential?
a. Teach the patient about the phenytoin.
b. Administer protamine sulfate. Correct
c. Assess the INR before surgery.
d. Administer vitamin K.
7) A patient taking warfarin (Coumadin) asks for an aspirin for a headache. What is the
nurse’s best action?
a. Administer 650 mg of acetylsalicylic acid (ASA) and reassess pain in 30 minutes.
b. Teach the patient of potential drug interactions with anticoagulants. Correct
c. Explain to the patient that ASA is contraindicated and administer ibuprofen as
ordered.
d. Explain that the headache is an expected side effect and will subside shortly.
8) A patient is started on warfarin (Coumadin) therapy while also receiving intravenous
heparin. The patient is concerned about the risk for bleeding. What will the nurse tell the
patient?
a. “Your concern is valid. I will call the doctor to discontinue the heparin.”
b. “It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the
heparin is continued until the warfarin is therapeutic.” Correct
c. “Because of your valve replacement, it is especially important for you to be
anticoagulated. The heparin and warfarin together are more effective than one
alone.”
d. “Because you are now up and walking, you have a higher risk of blood clots and
therefore need to be on both medications.”
9) The nurse evaluates that the patient has understood discharge teaching regarding
warfarin (Coumadin) based on which statement?
a. “I will double my dose if I forget to take it the day before.”
b. “I should keep taking ibuprofen for my arthritis.”
