NUR-641E Advanced Pathophysiology and Pharmacology for the
Nurse Educator Questions with Correct Answers (Grade A+)
Question 1: Pharmacokinetics
Answer: Involves ADME (absorption, distribution, metabolism and elimination). Absorption: absorption
from the administration site either directly or indirectly into the blood/plasma. Distribution: reversibly or
irreversibly move from the bloodstream into the interstitial and intracellular fluid. Metabolism:
bio-transformed via hepatic metabolism or by other tissues. Elimination: lastly, the drug & its metabolites
are eliminated from the body
Question 2: The route of administration with the highest bio-availability is
Answer: Intravenous; putting entire dose into a patient's vein and bypassing absorption. Intravenous route
avoids first-pass metabolism in the liver.
Question 3: rectal administration disadvantages
Answer: variable and erratic absorption
Question 4: Steady state (SS)
Answer: is usually reached within 4-5 half-lives of a drug
Question 5: The half-life of a drug is defined as
Answer: how long it takes for half the drug to be excreted from the body
Question 6: Half-life of a drug
Answer: Determines how frequently the drug must be administered Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug Zero-order (nonlinear) pharmacokinetics
means a drug is metabolized at a constant rate per unit time.
Question 7: CYP3A4 substrate drugs
Answer: May have enhanced activity if any CYP3A4 inducer drugs are used along with it.
Question 8: Drug development steps (according to the FDA)
Answer: Discovery: laboratory research to develop the new drug Pre-clinical research with animal testing
Page 1
, Question 8 (continued)
for safety (Phase I) Clinical research on human subjects for medication safety (Phase II) Clinical research
in humans comparing the new drug to accepted medications or placebo depending on the study (Phase III)
FDA review of the results to determine approval Post-marketing study to identify adverse effects not found
in earlier clinical studies (Phase IV)
Question 9: Medication safety organizations
Answer: The Institute for Safe Medication Practices (ISMP) The Institute of Medicine (IOM) The Joint
Commission The National Coordinating Council for Medication Error Reporting and Prevention
(NCCMERP) Food and Drug Administration (FDA) Safe Use Initiative
Question 10: Adverse Drug Reactions (ADRs)
Answer: Two basic type of ADRs: pharmacological and idiosyncratic. 85% to 90% of ADRs are
pharmacological. Adverse drug reactions are usually preventable, frequently occur in a hospital or nursing
home setting, and include medication errors, adverse drug effects, allergic and idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate that ADRs be reported. Polypharmacy
involves using multiple healthcare providers for care, using multiple medications, and using several
pharmacies for prescription filling.
Question 11: Cardiovascular-Angiotensin converting enzyme inhibitors (ACEIs):
Answer: Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril; *ACEIs reduce blood pressure by
suppressing the release of angiotensin-converting enzyme. *Important side effects of ACE inhibitors
include cough and angioedema; discontinue the ACEI if angioedema occurs.
Question 12: Angiotensin II receptor blocking agents (ARBs):
Answer: Candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), telmisartan
(Micardis) and valsartan (Diovan). ARBs reduce blood pressure by blocking angiotensin II receptors.
Question 13: Cardiovascular-Essential (primary) hypertension
Answer: Accounts for 90% of cases; secondary hypertension may be caused by chronic renal failure.
Question 14: Nitroglycerin
Answer: nitrate drug used in the treatment of angina; a nitrate drug that can be administered IV, SL, a
topical ointment and as a transdermal patch
Page 2
Nurse Educator Questions with Correct Answers (Grade A+)
Question 1: Pharmacokinetics
Answer: Involves ADME (absorption, distribution, metabolism and elimination). Absorption: absorption
from the administration site either directly or indirectly into the blood/plasma. Distribution: reversibly or
irreversibly move from the bloodstream into the interstitial and intracellular fluid. Metabolism:
bio-transformed via hepatic metabolism or by other tissues. Elimination: lastly, the drug & its metabolites
are eliminated from the body
Question 2: The route of administration with the highest bio-availability is
Answer: Intravenous; putting entire dose into a patient's vein and bypassing absorption. Intravenous route
avoids first-pass metabolism in the liver.
Question 3: rectal administration disadvantages
Answer: variable and erratic absorption
Question 4: Steady state (SS)
Answer: is usually reached within 4-5 half-lives of a drug
Question 5: The half-life of a drug is defined as
Answer: how long it takes for half the drug to be excreted from the body
Question 6: Half-life of a drug
Answer: Determines how frequently the drug must be administered Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug Zero-order (nonlinear) pharmacokinetics
means a drug is metabolized at a constant rate per unit time.
Question 7: CYP3A4 substrate drugs
Answer: May have enhanced activity if any CYP3A4 inducer drugs are used along with it.
Question 8: Drug development steps (according to the FDA)
Answer: Discovery: laboratory research to develop the new drug Pre-clinical research with animal testing
Page 1
, Question 8 (continued)
for safety (Phase I) Clinical research on human subjects for medication safety (Phase II) Clinical research
in humans comparing the new drug to accepted medications or placebo depending on the study (Phase III)
FDA review of the results to determine approval Post-marketing study to identify adverse effects not found
in earlier clinical studies (Phase IV)
Question 9: Medication safety organizations
Answer: The Institute for Safe Medication Practices (ISMP) The Institute of Medicine (IOM) The Joint
Commission The National Coordinating Council for Medication Error Reporting and Prevention
(NCCMERP) Food and Drug Administration (FDA) Safe Use Initiative
Question 10: Adverse Drug Reactions (ADRs)
Answer: Two basic type of ADRs: pharmacological and idiosyncratic. 85% to 90% of ADRs are
pharmacological. Adverse drug reactions are usually preventable, frequently occur in a hospital or nursing
home setting, and include medication errors, adverse drug effects, allergic and idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate that ADRs be reported. Polypharmacy
involves using multiple healthcare providers for care, using multiple medications, and using several
pharmacies for prescription filling.
Question 11: Cardiovascular-Angiotensin converting enzyme inhibitors (ACEIs):
Answer: Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril; *ACEIs reduce blood pressure by
suppressing the release of angiotensin-converting enzyme. *Important side effects of ACE inhibitors
include cough and angioedema; discontinue the ACEI if angioedema occurs.
Question 12: Angiotensin II receptor blocking agents (ARBs):
Answer: Candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), telmisartan
(Micardis) and valsartan (Diovan). ARBs reduce blood pressure by blocking angiotensin II receptors.
Question 13: Cardiovascular-Essential (primary) hypertension
Answer: Accounts for 90% of cases; secondary hypertension may be caused by chronic renal failure.
Question 14: Nitroglycerin
Answer: nitrate drug used in the treatment of angina; a nitrate drug that can be administered IV, SL, a
topical ointment and as a transdermal patch
Page 2
