NUR 426 Exam 1 Voit ASU Spring
UPDATED ACTUAL Exam Questions and
CORRECT Answers
You should know the significance of the following (why would it be high vs low), but do not
need to memorize normal ranges - CORRECT ANSWER - The concept of "therapeutic
ranges" (pertaining to PT/INR, aPTT, PTT)
PT/INR→ (high=longer time in sec to form clot) warfarin, vitamin K deficiency, risk for
bleeding; (low= shorter time in sec to form clot) vitamin K supplementation, diet high in vitamin
K, birth control, risk for clots
aPTT/PTT→ (high=longer time in sec to form clot) heparin, hemophilia, risk for bleeding; (low=
shorter time in sec to form clot) vitamin K supplementation, risk for clots→ lead to MI or stroke
Fibrinogen→ (high) lots of clotting→ lead to stroke or MI; (low) no clotting, DIC, cancer
Clotting factors→ (high) smoking, overweight, pregnancy; (low) hemophilia, hemorrhage
D-dimer→ (high) DVT, smoking, infection, clotting disorder; (low) inc risk for bleeding
Platelet count→ (high) inflammation, infection, splenectomy, autoimmune; (low) bleeding,
thrombocytopenia, B12 deficiency
RBCs→ (high) COPD, congenital heart disease, dehydration, recent transfusion; (low) bleeding,
anemia, B12 deficiency, folate deficiency
Hemoglobin→ (high) chronically low blood O2 levels due to heart or lung issue; (low) bleeding,
iron deficiency, pregnancy, ASA
Hematocrit→ (high) dehydration; (low) bleeding, anemia
WBCs→ (high) infection, inflammation; (low) immunocompromised, cancer, chemotherapy,
malnutrition
ANC (Absolute Neutrophil Count)→ (high) autoimmune reaction; (low) immunocompromised,
neutropenia, TB, sepsis
Factor VIII - CORRECT ANSWER - Indications→ deficiency of factor 8 (Hemophilia A)
Side effects→ allergic rxn, rash (Benadryl), anaphylaxis (epi)
Considerations→ NSAIDs
,Hydroxyurea - CORRECT ANSWER - Indications→ inc production of Hb F (these cells
do not sickle), reduce adhesion and improve hydration of sickle cells
Side effects→ suppress blood cells in general (bleeding and infection), N/V, mouth sores,
bleeding
Considerations→ dec WBC and platelets (protective precautions), dec vasoconstriction (monitor
BP), increases Hb
Desmopressin - CORRECT ANSWER - Indications→ mild hemophilia (stimulates inc in
factor 8); a form of ADH; only effective if one can produce factor 7
Side effects→ fluid retention, hyponatremia, HA, nausea, GI upset
Considerations→ monitor I&Os, diuretics for fluid retention
Aspirin (ASA) - CORRECT ANSWER - Indications→ inflammation suppression, fever
reduction, inhibit platelet aggregation
Side effects→ GI upset, heartburn, kidney dysfunction, bleeding
Considerations→ risk for bleeding especially when combined with blood thinners
Ibuprofen - CORRECT ANSWER - Indications→ mild pain and inflammation
Side effects→ headache, drowsiness, GI bleeds
Considerations→ risk for bleeding
Celecoxib - CORRECT ANSWER - Indications→ inflammation suppression, fever
reduction, mild to mod pain
Side effects→ GI upset, kidney dysfunction
Considerations→ risk of bleeding with warfarin and glucocorticoids
Acetaminophen - CORRECT ANSWER - Indications→ fever, mild pain
Side effects→ liver damage, HTN in everyday use
Considerations→ monitor for OD, max dose 4g/day, avoid alcohol
, Diphenhydramine - CORRECT ANSWER - Indications→ mild allergic reaction, motion
sickness
Side effects→ drowsiness, nausea, anaphylaxis
Considerations→ assess for urinary retention, CBC, cough, respiratory status
Dornase Alfa - CORRECT ANSWER - Indications→ CF, to improve pulmonary function
Side effects→ chest pain, rash, dyspnea, fever
Considerations→ given via nebulizer
The following additional drugs/drug categories could be tested as potential drug interactions. Be
able to identify how these medications/drug categories would interact with medications related to
your Pharmacology Made Easy modules - CORRECT ANSWER - All other drugs
reviewed in the Hematologic System module (eg. how do these drugs interact with each other)→
anticoagulants/antiplatelets/antithrombotics→ inc bleeding; factor 8 and desmopressin→ help
with fibrinogen production; folic acid, iron preps, and B12→ tx for anemias
NSAIDS→ bleeding when combined with blood thinners/alcohol; dec ASA effects
Glucocorticoids→ celecoxib inc bleeding
Vitamin K→ Warfarin antidote
Aspirin→ bleeding when combined with blood thinners/alcohol; ibuprofen dec ASA effects
Live Vaccines→ inc in clotting?
Caffeine→ warfarin effects enhanced
Acetaminophen→ inc risk of bleeding w/Warfarin
Discuss the pharmacokinetic and pharmacodynamic concepts of hematologic drugs including:
mechanisms of action, adverse drug reactions, drug and food interactions, nursing implications,
and client education. - CORRECT ANSWER - -Mechanism of Action→ works on
coagulation cascade; anticoagulants prevent clots; thrombolytics dissolve clots
-Heparin (anticoagulants target intrinsic pathway) works quickly
-Warfarin (works on extrinsic pathway) works slowly
-Adverse Reactions→ bleeding from over toxicity; bruising is expected but excessive bruising is
not
UPDATED ACTUAL Exam Questions and
CORRECT Answers
You should know the significance of the following (why would it be high vs low), but do not
need to memorize normal ranges - CORRECT ANSWER - The concept of "therapeutic
ranges" (pertaining to PT/INR, aPTT, PTT)
PT/INR→ (high=longer time in sec to form clot) warfarin, vitamin K deficiency, risk for
bleeding; (low= shorter time in sec to form clot) vitamin K supplementation, diet high in vitamin
K, birth control, risk for clots
aPTT/PTT→ (high=longer time in sec to form clot) heparin, hemophilia, risk for bleeding; (low=
shorter time in sec to form clot) vitamin K supplementation, risk for clots→ lead to MI or stroke
Fibrinogen→ (high) lots of clotting→ lead to stroke or MI; (low) no clotting, DIC, cancer
Clotting factors→ (high) smoking, overweight, pregnancy; (low) hemophilia, hemorrhage
D-dimer→ (high) DVT, smoking, infection, clotting disorder; (low) inc risk for bleeding
Platelet count→ (high) inflammation, infection, splenectomy, autoimmune; (low) bleeding,
thrombocytopenia, B12 deficiency
RBCs→ (high) COPD, congenital heart disease, dehydration, recent transfusion; (low) bleeding,
anemia, B12 deficiency, folate deficiency
Hemoglobin→ (high) chronically low blood O2 levels due to heart or lung issue; (low) bleeding,
iron deficiency, pregnancy, ASA
Hematocrit→ (high) dehydration; (low) bleeding, anemia
WBCs→ (high) infection, inflammation; (low) immunocompromised, cancer, chemotherapy,
malnutrition
ANC (Absolute Neutrophil Count)→ (high) autoimmune reaction; (low) immunocompromised,
neutropenia, TB, sepsis
Factor VIII - CORRECT ANSWER - Indications→ deficiency of factor 8 (Hemophilia A)
Side effects→ allergic rxn, rash (Benadryl), anaphylaxis (epi)
Considerations→ NSAIDs
,Hydroxyurea - CORRECT ANSWER - Indications→ inc production of Hb F (these cells
do not sickle), reduce adhesion and improve hydration of sickle cells
Side effects→ suppress blood cells in general (bleeding and infection), N/V, mouth sores,
bleeding
Considerations→ dec WBC and platelets (protective precautions), dec vasoconstriction (monitor
BP), increases Hb
Desmopressin - CORRECT ANSWER - Indications→ mild hemophilia (stimulates inc in
factor 8); a form of ADH; only effective if one can produce factor 7
Side effects→ fluid retention, hyponatremia, HA, nausea, GI upset
Considerations→ monitor I&Os, diuretics for fluid retention
Aspirin (ASA) - CORRECT ANSWER - Indications→ inflammation suppression, fever
reduction, inhibit platelet aggregation
Side effects→ GI upset, heartburn, kidney dysfunction, bleeding
Considerations→ risk for bleeding especially when combined with blood thinners
Ibuprofen - CORRECT ANSWER - Indications→ mild pain and inflammation
Side effects→ headache, drowsiness, GI bleeds
Considerations→ risk for bleeding
Celecoxib - CORRECT ANSWER - Indications→ inflammation suppression, fever
reduction, mild to mod pain
Side effects→ GI upset, kidney dysfunction
Considerations→ risk of bleeding with warfarin and glucocorticoids
Acetaminophen - CORRECT ANSWER - Indications→ fever, mild pain
Side effects→ liver damage, HTN in everyday use
Considerations→ monitor for OD, max dose 4g/day, avoid alcohol
, Diphenhydramine - CORRECT ANSWER - Indications→ mild allergic reaction, motion
sickness
Side effects→ drowsiness, nausea, anaphylaxis
Considerations→ assess for urinary retention, CBC, cough, respiratory status
Dornase Alfa - CORRECT ANSWER - Indications→ CF, to improve pulmonary function
Side effects→ chest pain, rash, dyspnea, fever
Considerations→ given via nebulizer
The following additional drugs/drug categories could be tested as potential drug interactions. Be
able to identify how these medications/drug categories would interact with medications related to
your Pharmacology Made Easy modules - CORRECT ANSWER - All other drugs
reviewed in the Hematologic System module (eg. how do these drugs interact with each other)→
anticoagulants/antiplatelets/antithrombotics→ inc bleeding; factor 8 and desmopressin→ help
with fibrinogen production; folic acid, iron preps, and B12→ tx for anemias
NSAIDS→ bleeding when combined with blood thinners/alcohol; dec ASA effects
Glucocorticoids→ celecoxib inc bleeding
Vitamin K→ Warfarin antidote
Aspirin→ bleeding when combined with blood thinners/alcohol; ibuprofen dec ASA effects
Live Vaccines→ inc in clotting?
Caffeine→ warfarin effects enhanced
Acetaminophen→ inc risk of bleeding w/Warfarin
Discuss the pharmacokinetic and pharmacodynamic concepts of hematologic drugs including:
mechanisms of action, adverse drug reactions, drug and food interactions, nursing implications,
and client education. - CORRECT ANSWER - -Mechanism of Action→ works on
coagulation cascade; anticoagulants prevent clots; thrombolytics dissolve clots
-Heparin (anticoagulants target intrinsic pathway) works quickly
-Warfarin (works on extrinsic pathway) works slowly
-Adverse Reactions→ bleeding from over toxicity; bruising is expected but excessive bruising is
not
