NRSG2350 — 100 NCLEX-style Practice Questions (copy-paste ready)
1. Which cell type is responsible for producing erythropoietin (EPO) in response to hypoxia?
A. Hepatocyte
B. Renal interstitial cells
C. Bone marrow stromal cells
D. Splenic macrophages
2. A patient with iron-deficiency anemia is most likely to have which lab pattern?
A. Low MCV, low ferritin, low serum iron
B. High MCV, high ferritin, high serum iron
C. Low MCV, high ferritin, high TIBC
D. High MCV, low ferritin, low TIBC
3. Which medication is the antidote for warfarin (coumadin) toxicity?
A. Protamine sulfate
B. Vitamin K (phytonadione)
C. Fresh frozen plasma only
D. Fibrinogen concentrate
4. A patient on heparin has an aPTT of 110 seconds (baseline ~30). The nurse should:
A. Increase the infusion rate
B. Hold heparin and notify the provider
C. Give vitamin K
D. Administer protamine and record no action
5. Which clinical sign is most consistent with a pulmonary embolism (PE)?
A. Bradycardia and hypotension
, B. Sudden pleuritic chest pain and sudden dyspnea
C. Lower-extremity unilateral warmth only
D. Gradual productive cough over weeks
6. Virchow’s triad includes all of the following EXCEPT:
A. Endothelial injury
B. Platelet dysfunction
C. Venous stasis
D. Hypercoagulability
7. A patient with suspected DIC (disseminated intravascular coagulation) would most likely have which lab results?
A. Elevated fibrinogen, decreased PT/INR
B. Low platelets, prolonged PT and aPTT, elevated D-dimer
C. High platelets, shortened PT, low D-dimer
D. Normal PT/aPTT, elevated fibrinogen
8. Which medication directly inhibits thrombin (factor IIa)?
A. Warfarin
B. Dabigatran
C. Rivaroxaban
D. Aspirin
9. A patient with von Willebrand disease should avoid which OTC medication?
A. Acetaminophen
B. Ibuprofen
C. Calcium carbonate
D. Pseudoephedrine
,10.A factor VIII deficiency describes which disorder?
A. Von Willebrand disease type 1
B. Hemophilia A
C. Hemophilia B
D. DIC
11.Which lab test best monitors warfarin therapy?
A. aPTT
B. INR (derived from PT)
C. Platelet count
D. D-dimer
12.A nurse preparing to give IM injections to a patient with thrombocytopenia should:
A. Give injections normally; platelets don’t matter for IM
B. Use smallest needle, apply pressure after injection, and consider holding IM if platelets <50,000/mm³
C. Always use intramuscular route if platelets <20,000/mm³
D. Skip pressure after injection
13.Erythropoietin (epoetin alfa) is most appropriate for which patient?
A. Acute hemolytic anemia from autoimmune disease
B. Anemia of chronic kidney disease with low Hgb
C. Iron deficiency from chronic GI bleeding only treated with iron
D. Sickle cell vaso-occlusive crisis
14.Which finding is classic for hemolytic anemia?
A. Low reticulocyte count
B. Elevated indirect bilirubin and increased reticulocyte count
C. Low LDH and low bilirubin
, D. High ferritin with low TIBC
15.A patient with sickle cell disease presents with severe limb pain. Priority nursing action:
A. Start IV fluids and give opioid analgesia per protocol
B. Restrict fluids and give aspirin only
C. Send the patient home with oral ibuprofen
D. Give packed RBCs immediately without assessment
16.Which medication is indicated to reduce frequency of painful crises in sickle cell disease?
A. Hydroxyurea
B. Ferrous sulfate
C. Epoetin alfa
D. Warfarin
17.Pernicious anemia (B12 deficiency) commonly causes which unique sign?
A. Koilonychia
B. Beefy red tongue and paresthesias with neurologic deficits
C. Jaundice only, no neurological symptoms
D. Splenomegaly without neuropathy
18.A patient with chronic alcohol abuse is most at risk for which anemia?
A. Iron deficiency anemia only
B. Folate deficiency megaloblastic anemia
C. Sideroblastic anemia only
D. Hemolytic anemia from G6PD
19.Aplastic anemia typically presents with:
A. Isolated low RBCs only
B. Pancytopenia (low RBCs, WBCs, platelets)
1. Which cell type is responsible for producing erythropoietin (EPO) in response to hypoxia?
A. Hepatocyte
B. Renal interstitial cells
C. Bone marrow stromal cells
D. Splenic macrophages
2. A patient with iron-deficiency anemia is most likely to have which lab pattern?
A. Low MCV, low ferritin, low serum iron
B. High MCV, high ferritin, high serum iron
C. Low MCV, high ferritin, high TIBC
D. High MCV, low ferritin, low TIBC
3. Which medication is the antidote for warfarin (coumadin) toxicity?
A. Protamine sulfate
B. Vitamin K (phytonadione)
C. Fresh frozen plasma only
D. Fibrinogen concentrate
4. A patient on heparin has an aPTT of 110 seconds (baseline ~30). The nurse should:
A. Increase the infusion rate
B. Hold heparin and notify the provider
C. Give vitamin K
D. Administer protamine and record no action
5. Which clinical sign is most consistent with a pulmonary embolism (PE)?
A. Bradycardia and hypotension
, B. Sudden pleuritic chest pain and sudden dyspnea
C. Lower-extremity unilateral warmth only
D. Gradual productive cough over weeks
6. Virchow’s triad includes all of the following EXCEPT:
A. Endothelial injury
B. Platelet dysfunction
C. Venous stasis
D. Hypercoagulability
7. A patient with suspected DIC (disseminated intravascular coagulation) would most likely have which lab results?
A. Elevated fibrinogen, decreased PT/INR
B. Low platelets, prolonged PT and aPTT, elevated D-dimer
C. High platelets, shortened PT, low D-dimer
D. Normal PT/aPTT, elevated fibrinogen
8. Which medication directly inhibits thrombin (factor IIa)?
A. Warfarin
B. Dabigatran
C. Rivaroxaban
D. Aspirin
9. A patient with von Willebrand disease should avoid which OTC medication?
A. Acetaminophen
B. Ibuprofen
C. Calcium carbonate
D. Pseudoephedrine
,10.A factor VIII deficiency describes which disorder?
A. Von Willebrand disease type 1
B. Hemophilia A
C. Hemophilia B
D. DIC
11.Which lab test best monitors warfarin therapy?
A. aPTT
B. INR (derived from PT)
C. Platelet count
D. D-dimer
12.A nurse preparing to give IM injections to a patient with thrombocytopenia should:
A. Give injections normally; platelets don’t matter for IM
B. Use smallest needle, apply pressure after injection, and consider holding IM if platelets <50,000/mm³
C. Always use intramuscular route if platelets <20,000/mm³
D. Skip pressure after injection
13.Erythropoietin (epoetin alfa) is most appropriate for which patient?
A. Acute hemolytic anemia from autoimmune disease
B. Anemia of chronic kidney disease with low Hgb
C. Iron deficiency from chronic GI bleeding only treated with iron
D. Sickle cell vaso-occlusive crisis
14.Which finding is classic for hemolytic anemia?
A. Low reticulocyte count
B. Elevated indirect bilirubin and increased reticulocyte count
C. Low LDH and low bilirubin
, D. High ferritin with low TIBC
15.A patient with sickle cell disease presents with severe limb pain. Priority nursing action:
A. Start IV fluids and give opioid analgesia per protocol
B. Restrict fluids and give aspirin only
C. Send the patient home with oral ibuprofen
D. Give packed RBCs immediately without assessment
16.Which medication is indicated to reduce frequency of painful crises in sickle cell disease?
A. Hydroxyurea
B. Ferrous sulfate
C. Epoetin alfa
D. Warfarin
17.Pernicious anemia (B12 deficiency) commonly causes which unique sign?
A. Koilonychia
B. Beefy red tongue and paresthesias with neurologic deficits
C. Jaundice only, no neurological symptoms
D. Splenomegaly without neuropathy
18.A patient with chronic alcohol abuse is most at risk for which anemia?
A. Iron deficiency anemia only
B. Folate deficiency megaloblastic anemia
C. Sideroblastic anemia only
D. Hemolytic anemia from G6PD
19.Aplastic anemia typically presents with:
A. Isolated low RBCs only
B. Pancytopenia (low RBCs, WBCs, platelets)
