CNUR 202 PHARMACOLOGY PART 2 REVIEW | COMPLETE NURSING MEDICATION STUDY
GUIDE, DRUG CLASSES, PRACTICE QUESTIONS & EXAM PREP 2026/2027
Cardiovascular disorders - correct answer ✔✔Most vascular diseases result from malfunction of
endothelial cells or smooth muscle cells
Major factor in atherosclerosis, acute coronary syndromes, hypertension, and thromboembolic
disorders, capillaries media (muscle and elastic tissues), CT
Regulation of blood pressure - correct answer ✔✔Blood pressure is the pressure of blood in the
arteries, two major determinants of arterial blood pressure are cardiac output- CO= HR x SV,
peripheral vascular resistance (diastolic pressure)- Afterload, arterial BP, compensatory effects,
Neural
¡Sympathetic nervous system
Hormonal
¡Renin-angiotensin-aldosterone (RAA system)
¡Antidiuretic hormone (vasopressin)
Vascular
Substances released from endothelial cells
Vasoconstriction
Vasodilators
Vascular Remodeling- endothelial dysfunction, thickened arterial walls- decreased lumen
How does hypertension alter cardiovascular function? - correct answer ✔✔▫increasing the
workload = thickening and sclerosis of arterial walls.
▫increased cardiac workload = myocardium hypertrophies = heart failure
▫endothelial dysfunction and arterial changes cause narrow arterial lumen, decrease blood
supply to tissue, increase risk for thrombocytosis
,Hypertension - correct answer ✔✔Is defined as a SBP greater than140 mm Hg or a DBP greater
than 90 mm Hg on multiple blood pressure measurements
¡in patients without renal disease, diabetes, or proteinuria
A systolic pressure of 140 or less, with a diastolic pressure below 90, is called isolated systolic
hypertension and is more common amongst older adults. is a significant risk factor for
developing
¡cerebrovascular disease
¡coronary artery disease
¡congestive heart failure
¡renal failure
¡peripheral vascular disease
¡dementia
¡atrial fibrillation
¡erectile dysfunction, silent killer
Canadian Hypertension Education Program - correct answer ✔✔Recommendations
¡Home blood pressure (BP) monitoring
¡Annual BP assessment for individuals with prehypertension (130-139/85-89 mm Hg)
¡Ongoing routine assessment of blood pressure at clinic visits
¡Assessment of overall cardiovascular risk, Lifestyle modifications
¡Healthy diet
¡Regular physical activity
¡Moderation in alcohol
¡Reduction in dietary sodium
¡Stress reduction, Treat to target
¡less than 140/90 mm Hg
¡less than 130/80 mm Hg in those with diabetes or chronic kidney disease
,Combinations of therapies
Regular follow- up
Focus on adherence- major focus for nursing care
BP classification - correct answer ✔✔Four stages based on blood pressure measurements:
1.Normal 120/80-129/89
2.Prehypertension 130/85-139/89
3.Stage 1 hypertension 140/90-159/99
4.Stage 2 hypertension 160+/100+
Unknown cause
¡Is called essential, idiopathic, or primary hypertension
¡Accounts for 90% of the cases
Known cause
¡Called secondary hypertension- renal, endocrine, SNS
¡Accounts for 10% of the cases
Masked hypertension- <140/90 at hospital and high at home
White-coat hypertension- higher in hospital, anxiety, nerves
Types of antihypertensive drugs - correct answer ✔✔Angiotensin-converting enzyme inhibitors
(ACE-I)
Angiotensin II receptor blockers (ARBs)
Calcium channel blockers (CCBs)
Adrenergic drugs (a-2 receptor agonists & beta blockers)
Vasodilators (direct acting)
Diuretics
, Angiotension Converting Enzyme Inhibitors - correct answer ✔✔ACE inhibitors - "prils"
ramipril, lisinopril- newer, longer half life, one dose, prodrug needs to be activatedd in liver,
captopril(capoten)- short half life, slow, how it affects pt(HF), q6h, low dose, liver dysfunction
First line therapy for HTN and HF
Often used in combination:
¡thiazide diuretics or calcium channel blockers, not for monotherapy in darker skinned
individuals
MOA- Cardiac and renal effects
Inhibit the conversion of angiotensin I to angiotensin II
Prevent the breakdown of bradykinin and substance P (vasodilators)
Inhibit aldosterone secretion
Results:
¡Decreased SVR
¡Decreased afterload -
¡Prevention of sodium and water resorption
¡Diuresis and reduced preload - filling pressure at the end of diastole, Indications- Hypertension
(discussing today)
Heart failure- slows LVHF after MI
Post myocardial infarction
Renal failure patients with diabetes, Contraindications- Allergy: especially a previous reaction of
angioedema- laryngeal swelling
Pregnant/Lactating women
Used with caution in women of child bearing age
Children
Bilateral renal artery stenosis- proteinuria (aggrivate or contribtute to)
Hyperkalemia*****, increased sodium and water secretion, K re absorption increase, Adverse
Effects- Fatigue
Headache
GUIDE, DRUG CLASSES, PRACTICE QUESTIONS & EXAM PREP 2026/2027
Cardiovascular disorders - correct answer ✔✔Most vascular diseases result from malfunction of
endothelial cells or smooth muscle cells
Major factor in atherosclerosis, acute coronary syndromes, hypertension, and thromboembolic
disorders, capillaries media (muscle and elastic tissues), CT
Regulation of blood pressure - correct answer ✔✔Blood pressure is the pressure of blood in the
arteries, two major determinants of arterial blood pressure are cardiac output- CO= HR x SV,
peripheral vascular resistance (diastolic pressure)- Afterload, arterial BP, compensatory effects,
Neural
¡Sympathetic nervous system
Hormonal
¡Renin-angiotensin-aldosterone (RAA system)
¡Antidiuretic hormone (vasopressin)
Vascular
Substances released from endothelial cells
Vasoconstriction
Vasodilators
Vascular Remodeling- endothelial dysfunction, thickened arterial walls- decreased lumen
How does hypertension alter cardiovascular function? - correct answer ✔✔▫increasing the
workload = thickening and sclerosis of arterial walls.
▫increased cardiac workload = myocardium hypertrophies = heart failure
▫endothelial dysfunction and arterial changes cause narrow arterial lumen, decrease blood
supply to tissue, increase risk for thrombocytosis
,Hypertension - correct answer ✔✔Is defined as a SBP greater than140 mm Hg or a DBP greater
than 90 mm Hg on multiple blood pressure measurements
¡in patients without renal disease, diabetes, or proteinuria
A systolic pressure of 140 or less, with a diastolic pressure below 90, is called isolated systolic
hypertension and is more common amongst older adults. is a significant risk factor for
developing
¡cerebrovascular disease
¡coronary artery disease
¡congestive heart failure
¡renal failure
¡peripheral vascular disease
¡dementia
¡atrial fibrillation
¡erectile dysfunction, silent killer
Canadian Hypertension Education Program - correct answer ✔✔Recommendations
¡Home blood pressure (BP) monitoring
¡Annual BP assessment for individuals with prehypertension (130-139/85-89 mm Hg)
¡Ongoing routine assessment of blood pressure at clinic visits
¡Assessment of overall cardiovascular risk, Lifestyle modifications
¡Healthy diet
¡Regular physical activity
¡Moderation in alcohol
¡Reduction in dietary sodium
¡Stress reduction, Treat to target
¡less than 140/90 mm Hg
¡less than 130/80 mm Hg in those with diabetes or chronic kidney disease
,Combinations of therapies
Regular follow- up
Focus on adherence- major focus for nursing care
BP classification - correct answer ✔✔Four stages based on blood pressure measurements:
1.Normal 120/80-129/89
2.Prehypertension 130/85-139/89
3.Stage 1 hypertension 140/90-159/99
4.Stage 2 hypertension 160+/100+
Unknown cause
¡Is called essential, idiopathic, or primary hypertension
¡Accounts for 90% of the cases
Known cause
¡Called secondary hypertension- renal, endocrine, SNS
¡Accounts for 10% of the cases
Masked hypertension- <140/90 at hospital and high at home
White-coat hypertension- higher in hospital, anxiety, nerves
Types of antihypertensive drugs - correct answer ✔✔Angiotensin-converting enzyme inhibitors
(ACE-I)
Angiotensin II receptor blockers (ARBs)
Calcium channel blockers (CCBs)
Adrenergic drugs (a-2 receptor agonists & beta blockers)
Vasodilators (direct acting)
Diuretics
, Angiotension Converting Enzyme Inhibitors - correct answer ✔✔ACE inhibitors - "prils"
ramipril, lisinopril- newer, longer half life, one dose, prodrug needs to be activatedd in liver,
captopril(capoten)- short half life, slow, how it affects pt(HF), q6h, low dose, liver dysfunction
First line therapy for HTN and HF
Often used in combination:
¡thiazide diuretics or calcium channel blockers, not for monotherapy in darker skinned
individuals
MOA- Cardiac and renal effects
Inhibit the conversion of angiotensin I to angiotensin II
Prevent the breakdown of bradykinin and substance P (vasodilators)
Inhibit aldosterone secretion
Results:
¡Decreased SVR
¡Decreased afterload -
¡Prevention of sodium and water resorption
¡Diuresis and reduced preload - filling pressure at the end of diastole, Indications- Hypertension
(discussing today)
Heart failure- slows LVHF after MI
Post myocardial infarction
Renal failure patients with diabetes, Contraindications- Allergy: especially a previous reaction of
angioedema- laryngeal swelling
Pregnant/Lactating women
Used with caution in women of child bearing age
Children
Bilateral renal artery stenosis- proteinuria (aggrivate or contribtute to)
Hyperkalemia*****, increased sodium and water secretion, K re absorption increase, Adverse
Effects- Fatigue
Headache
