A patient develops heparin induced thrombocytopenia

13. A patient develops Heparin-Induced Thrombocytopenia (HIT). As the nurse, you
would expect the Heparin to be discontinued and the patient to be started on what other type of
anticoagulant?
A. Direct thrombin inhibitor
B. Protamine sulfate
C. Switched to subcutaneous Heparin injections
D. Vitamin-K agonist

The answer is A. The Heparin is discontinued and direct thrombin inhibitors can be
started like: Argatroban, Bivalirudin etc.
14. What is the antidote for Heparin?
A. Protamine sulfate
B. Vitamin K
C. Flumazenil
D. Narcan
The answer is A. Protamine sulfate is the antidote for Heparin.
15. You’re providing care to a patient who has been receiving long-term doses of
Heparin. What finding in this patient demonstrates the patient may be experiencing a
complication that can occur due to long-term use of this drug?
A. Uncontrolled hypertension
B. Bone fractures
C. Hyperkalemia
D. Raynaud’s Syndrome
The answer is B. Osteoporosis can occur due to long-term, high doses of Heparin. Bone
fractures would indicate this patient is experiencing this complication. Heparin can stimulate
osteoclasts and inhibits osteoblast, which affects the strength of the bones.

Warfarin (Coumadin) is an anticoagulant that helps prevent and treat blood clots. The
nurse should be aware of how the drug works, why it is ordered, nursing implications, signs and
symptoms of toxicity, and how to teach the patient how to take the medication.
Warfarin (Coumadin) NCLEX Questions
1. Warfarin (Coumadin) is an anticoagulant. What family of anticoagulant medications
does this drug belong to?
A. Direct thrombin inhibitors
B. Indirect thrombin inhibitors

C. Vitamin K antagonists
D. Factor Xa inhibitors
The answer is C. Warfarin (Coumadin) is an anticoagulant that belongs to the Vitamin K
antagonists.
2. Which statement below BEST describes how Warfarin (Coumadin) works as an
anticoagulant?
A. “It inhibits the formation of thrombin and fibrin in the clotting process.”
B. “It increases the production of Factor Xa, which blocks thrombin and decreases the
clotting process.”
C. “It binds to antithrombin and reverses the clotting process.”
D. “It stops the coagulation process by blocking the formation of clotting factors in the
liver that require Vitamin K to form.”
The answer is D. Warfarin (Coumadin) stops the coagulation process by blocking the
formation of clotting factors in the liver that require Vitamin K to form. This is why this drug is
part of the Vitamin K antagonist family.