NUR 641E FINAL EXAM 2026/2027 | NURSING STUDY GUIDE, PRACTICE
QUESTIONS, ANSWERS & EXAM REVIEW
Pharmacokinetics involves - ANS ✔✔a: Absorption: absorption from the administration site either
directly or indirectly into the blood/plasma.
b: Distribution: reversibly or irreversibly move from the bloodstream into the interstitial and intracellular
fluid.
c: Metabolism: bio transformed via hepatic metabolism or by other tissues.
d: Elimination: the drug and its metabolites are eliminated from the body
The route of administration with the highest bioavailability is - ANS ✔✔Intravenous, putting an entire
dose into a patient's vein and bypassing absorption
Intravenous route avoids - ANS ✔✔First-pass metabolism in the liver
Rectal administration has - ANS ✔✔variable and erratic absorption
Steady State (SS) is usually reached within - ANS ✔✔4-5 half-lives of a drug
Half-life of a drug is - ANS ✔✔How long it takes for the drug to be excreted from the body
- determines how frequently the drug must be administered
- predicts how long toxic effects can last
First-order (linear) pharmacokinetics means - ANS ✔✔The metabolism is directly proportional to the free
concentration of the drug
Zero-order (nonlinear) pharmacokinetics means - ANS ✔✔A drug is metabolized at a constant rate per
unit time
CYP3A4 substrate drugs may have a decreased activity if - ANS ✔✔Any CYP3A4 inducer drugs are used
along with it
Drug development process involves these steps according to the FDA - ANS ✔✔a: Discovery: laboratory
research to develop the new drugs
b: Preclinical research with animal testing for safety
c: Clinical research on healthy human subjects to assess medication pharmacokinetics (Phase 1)
d: Clinical research in humans primarily for medication safety, usually in a population for which the
treatment is intended (Phase 2)
, e: Clinical research in humans comparing the new drug to accept medications or placebo for efficacy and
safety (Phase 3)
f: FDA review of the results to determine approval
g: Post marketing study to identify adverse effects not found in earlier clinical studies (Phase 4)
Medication safety organizations include the Food and Drug Administration (FDA), the Institute for Safe
Medication Practices (ISMP), and the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) - ANS ✔✔a: The Institute for Safe Medication Practices (ISMP)
b: The Institute of Medicine (IOM)
c: The Joint Commission
d: The National Coordinating Counsil for Medication Error Reporting and Prevention (NCC MERP)
e: Food and Drug Administration (FDA) Safe Use Initiative
Two basic types of adverse drug reactions (ADRs) - ANS ✔✔Pharmacological and Idiosyncratic
Percent of adverse drug reactions that are pharmacological - ANS ✔✔85%-90%
Adverse drug reactions are usually - ANS ✔✔Preventable, frequently occur in a hospital or nursing home
setting, and include medication errors, adverse drug effects, and allergic and idiosyncratic type reactions
Are adverse drug reactions commonly reported - ANS ✔✔No, ADRs are not commonly reported, the FDA
does not mandate that ADRs be reported
Polypharmacy - ANS ✔✔Involves using multiple health care providers for care, using multiple
medications, and using several pharmacies for prescription filling
Angiotensin converting enzyme inhibitors (ACEIs) - ANS ✔✔Lisinopril, Captopril, Enalapril, Ramipril,
Benazepril, Fosinopril
How ACEI reduce blood pressure - ANS ✔✔ACEI reduce blood pressure by suppressing the release of
angiotensin-converting enzyme
Important side effects of ACEI include - ANS ✔✔Cough and angioedema, discontinue the ACEI if
angioedema occur
Angiotensin II receptor blocking agents (ARBs) - ANS ✔✔Candesartan (Atacand), Eprosartan (Teveten),
Irbesartan (Avapro), Losartan (Cozaar), Telmisartan (Micardis) and Valsartan (Diovan).
How ARBs reduce blood pressure - ANS ✔✔ARBs reduce blood pressure by blocking angiotensin II
receptors
Essential (primary) hypertension accounts for - ANS ✔✔accounts for 90% of cases
QUESTIONS, ANSWERS & EXAM REVIEW
Pharmacokinetics involves - ANS ✔✔a: Absorption: absorption from the administration site either
directly or indirectly into the blood/plasma.
b: Distribution: reversibly or irreversibly move from the bloodstream into the interstitial and intracellular
fluid.
c: Metabolism: bio transformed via hepatic metabolism or by other tissues.
d: Elimination: the drug and its metabolites are eliminated from the body
The route of administration with the highest bioavailability is - ANS ✔✔Intravenous, putting an entire
dose into a patient's vein and bypassing absorption
Intravenous route avoids - ANS ✔✔First-pass metabolism in the liver
Rectal administration has - ANS ✔✔variable and erratic absorption
Steady State (SS) is usually reached within - ANS ✔✔4-5 half-lives of a drug
Half-life of a drug is - ANS ✔✔How long it takes for the drug to be excreted from the body
- determines how frequently the drug must be administered
- predicts how long toxic effects can last
First-order (linear) pharmacokinetics means - ANS ✔✔The metabolism is directly proportional to the free
concentration of the drug
Zero-order (nonlinear) pharmacokinetics means - ANS ✔✔A drug is metabolized at a constant rate per
unit time
CYP3A4 substrate drugs may have a decreased activity if - ANS ✔✔Any CYP3A4 inducer drugs are used
along with it
Drug development process involves these steps according to the FDA - ANS ✔✔a: Discovery: laboratory
research to develop the new drugs
b: Preclinical research with animal testing for safety
c: Clinical research on healthy human subjects to assess medication pharmacokinetics (Phase 1)
d: Clinical research in humans primarily for medication safety, usually in a population for which the
treatment is intended (Phase 2)
, e: Clinical research in humans comparing the new drug to accept medications or placebo for efficacy and
safety (Phase 3)
f: FDA review of the results to determine approval
g: Post marketing study to identify adverse effects not found in earlier clinical studies (Phase 4)
Medication safety organizations include the Food and Drug Administration (FDA), the Institute for Safe
Medication Practices (ISMP), and the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) - ANS ✔✔a: The Institute for Safe Medication Practices (ISMP)
b: The Institute of Medicine (IOM)
c: The Joint Commission
d: The National Coordinating Counsil for Medication Error Reporting and Prevention (NCC MERP)
e: Food and Drug Administration (FDA) Safe Use Initiative
Two basic types of adverse drug reactions (ADRs) - ANS ✔✔Pharmacological and Idiosyncratic
Percent of adverse drug reactions that are pharmacological - ANS ✔✔85%-90%
Adverse drug reactions are usually - ANS ✔✔Preventable, frequently occur in a hospital or nursing home
setting, and include medication errors, adverse drug effects, and allergic and idiosyncratic type reactions
Are adverse drug reactions commonly reported - ANS ✔✔No, ADRs are not commonly reported, the FDA
does not mandate that ADRs be reported
Polypharmacy - ANS ✔✔Involves using multiple health care providers for care, using multiple
medications, and using several pharmacies for prescription filling
Angiotensin converting enzyme inhibitors (ACEIs) - ANS ✔✔Lisinopril, Captopril, Enalapril, Ramipril,
Benazepril, Fosinopril
How ACEI reduce blood pressure - ANS ✔✔ACEI reduce blood pressure by suppressing the release of
angiotensin-converting enzyme
Important side effects of ACEI include - ANS ✔✔Cough and angioedema, discontinue the ACEI if
angioedema occur
Angiotensin II receptor blocking agents (ARBs) - ANS ✔✔Candesartan (Atacand), Eprosartan (Teveten),
Irbesartan (Avapro), Losartan (Cozaar), Telmisartan (Micardis) and Valsartan (Diovan).
How ARBs reduce blood pressure - ANS ✔✔ARBs reduce blood pressure by blocking angiotensin II
receptors
Essential (primary) hypertension accounts for - ANS ✔✔accounts for 90% of cases
