NUR 641 E FINAL EXAM STUDY GUIDE GRAND CANYON UNIVERSITY
EXPECTED QUESTIONS AND VERIFIED ANSWERS 2026 TO 2027
1. absorption, distribution, metabolism, excretion
Pharmacokinetics involves
2. absorption from the administration site either directly or indirectly in the blood plasma
Pharmacokinetic absorption
3. reversibly or irreversibly move from the bloodstream into the interstitial and intracellular fluid
Parmacokinetic distribution
4. biotransformed via hepatic metabolism or by other tissue
Pharmacokinetics metabolism
5. 1. highest bioavailability 2. places entire does into venin thus bypassing absorption 3. avoids
hepatic first pass metabolism in the liver
Intravenous medications
6. usually reached within 4-5 half lives of the drug
steady state medication
7. 1.the time required for the elimination process to reduce 2.the concentration of the drug to one
half what it was at initial administration 3.determines drug frequency 4. predicts length of toxic
effects 5. constant first order pharmacokinetics of a drug
drug half life
8. drug is metabolized at a constant rate per unit
zero order (nonlinear)
9. metabolizes 50% drugs inhibit: grapefruit juice - increase drug -> adverse effects may have
enhanced activity with any other CYP3A4
CYP3A4
10. 1. discovery or laboratory for development 2. Phase 1 begins with animal testing 3. phase 2 human
subjects 4. compare drug to placebo or other drug that is effective 5.FDA then reviews result and
determines approval 6. Post market study to determine other side effects that were not seen while lab
testing
Six steps in drug development process
11. 1.Institute of Safe mediation Practice 2. Institute of Medicine 3. Joint commission 4.National
Coordinating Council form mediation error reporting and prevention 5. Food and Drug Administration
(safe use initiative)
organizations for medication safety
12. 1.Also known as a side effect, an undesirable reaction that accompanies the principal response for
which the drug was taken include allergic reactions and adverse drug effects 2. Either
pharmacological or idiosyncratic 3. 85-90% of ADRs are pharmacological 4. Reporting is not mandated
by FDA thus are not commonly reported 5. usually preventable occur in hospital and nursing homes
due to med errors 6. Polypharmacy, multiple doctors and multiple pharmacies increase risk
Adverse Drug Reaction (ADR)
1
, 13. 1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril and fosinopril 2. suppress release
of angiotensin converting enzyme 3. side effects include cough and angioedema, with angioedema
the medication should be discontinued
Angiotensin-converting enzyme (ACE) inhibitors
14. 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan 2.block
angiotensin 11 receptors
Angiotensin II Receptor Blockers (ARBs)
15. Essential HTN accounts for 90% of cases and is also called primary, secondary may be caused by
CKD
Essential vs Secondary HTN
16. use: angina pectoris action: dilate veins and arteries and thereby reducing ischemia and relieving
pain by decreasing myocardial O2 consumption Side effects: throbbing HA, flushing, hypotension
tachycardia available: IV, SL, topical ointment and transdermal patch contraindicated with PDE-5
(sildanfil and vardenafil)
Nitroglycerin (Nitrate)
17. 1. antiarrhythmic of choice when there is coexisting heart failure 2. can cause thyroid and
pulmonary toxicity
Amiodarone
18. vasoconstriction and increased blood pressure
Alpha 1 adrenergic stimulation results
19. Decrease sympathetic stimulation causing vasodilation and decreased blood pressure
alpha 1 blockade
20. stimulation by beta agonists (isoproterenol) result in increased heart rate, blood pressure and
cardiac output 2. blockade results in decreased heart rate, bp, and cardiac output
beta 1 adrenergic
21. The heart does not adequately circulate blood to systemic system. Due to pressure overload or
volume overload causing a reduction of oxygenated blood to body tissue
left heart failure
22. 1.Associated with pulmonary disease and increased pulmonary vascular resistance 2.The heart
does not adequately circulate blood to the pulmonic system. Can be due to volume overload or
regurgitation in Tricuspid Valve or Pulmonic Valve. Can lead to systemic edema, back up of blood in
liver and lower extremities
Right heart failure
23. 1.Inhibit water transport across Loop of Henle work on receptors in ascending renal loop 2.inhibit
reabsorption of NaCL at site in kidney 3. potent diuretic (Lasix) can cause hypokalemia
Loop diuretics MOA
24. spironolactone, triamterene, amiloride
Potassium sparing diuretics
25. phosphodiesterase inhibitor used to treat acute heart failure
Milrinone (Primacor)
2
EXPECTED QUESTIONS AND VERIFIED ANSWERS 2026 TO 2027
1. absorption, distribution, metabolism, excretion
Pharmacokinetics involves
2. absorption from the administration site either directly or indirectly in the blood plasma
Pharmacokinetic absorption
3. reversibly or irreversibly move from the bloodstream into the interstitial and intracellular fluid
Parmacokinetic distribution
4. biotransformed via hepatic metabolism or by other tissue
Pharmacokinetics metabolism
5. 1. highest bioavailability 2. places entire does into venin thus bypassing absorption 3. avoids
hepatic first pass metabolism in the liver
Intravenous medications
6. usually reached within 4-5 half lives of the drug
steady state medication
7. 1.the time required for the elimination process to reduce 2.the concentration of the drug to one
half what it was at initial administration 3.determines drug frequency 4. predicts length of toxic
effects 5. constant first order pharmacokinetics of a drug
drug half life
8. drug is metabolized at a constant rate per unit
zero order (nonlinear)
9. metabolizes 50% drugs inhibit: grapefruit juice - increase drug -> adverse effects may have
enhanced activity with any other CYP3A4
CYP3A4
10. 1. discovery or laboratory for development 2. Phase 1 begins with animal testing 3. phase 2 human
subjects 4. compare drug to placebo or other drug that is effective 5.FDA then reviews result and
determines approval 6. Post market study to determine other side effects that were not seen while lab
testing
Six steps in drug development process
11. 1.Institute of Safe mediation Practice 2. Institute of Medicine 3. Joint commission 4.National
Coordinating Council form mediation error reporting and prevention 5. Food and Drug Administration
(safe use initiative)
organizations for medication safety
12. 1.Also known as a side effect, an undesirable reaction that accompanies the principal response for
which the drug was taken include allergic reactions and adverse drug effects 2. Either
pharmacological or idiosyncratic 3. 85-90% of ADRs are pharmacological 4. Reporting is not mandated
by FDA thus are not commonly reported 5. usually preventable occur in hospital and nursing homes
due to med errors 6. Polypharmacy, multiple doctors and multiple pharmacies increase risk
Adverse Drug Reaction (ADR)
1
, 13. 1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril and fosinopril 2. suppress release
of angiotensin converting enzyme 3. side effects include cough and angioedema, with angioedema
the medication should be discontinued
Angiotensin-converting enzyme (ACE) inhibitors
14. 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan 2.block
angiotensin 11 receptors
Angiotensin II Receptor Blockers (ARBs)
15. Essential HTN accounts for 90% of cases and is also called primary, secondary may be caused by
CKD
Essential vs Secondary HTN
16. use: angina pectoris action: dilate veins and arteries and thereby reducing ischemia and relieving
pain by decreasing myocardial O2 consumption Side effects: throbbing HA, flushing, hypotension
tachycardia available: IV, SL, topical ointment and transdermal patch contraindicated with PDE-5
(sildanfil and vardenafil)
Nitroglycerin (Nitrate)
17. 1. antiarrhythmic of choice when there is coexisting heart failure 2. can cause thyroid and
pulmonary toxicity
Amiodarone
18. vasoconstriction and increased blood pressure
Alpha 1 adrenergic stimulation results
19. Decrease sympathetic stimulation causing vasodilation and decreased blood pressure
alpha 1 blockade
20. stimulation by beta agonists (isoproterenol) result in increased heart rate, blood pressure and
cardiac output 2. blockade results in decreased heart rate, bp, and cardiac output
beta 1 adrenergic
21. The heart does not adequately circulate blood to systemic system. Due to pressure overload or
volume overload causing a reduction of oxygenated blood to body tissue
left heart failure
22. 1.Associated with pulmonary disease and increased pulmonary vascular resistance 2.The heart
does not adequately circulate blood to the pulmonic system. Can be due to volume overload or
regurgitation in Tricuspid Valve or Pulmonic Valve. Can lead to systemic edema, back up of blood in
liver and lower extremities
Right heart failure
23. 1.Inhibit water transport across Loop of Henle work on receptors in ascending renal loop 2.inhibit
reabsorption of NaCL at site in kidney 3. potent diuretic (Lasix) can cause hypokalemia
Loop diuretics MOA
24. spironolactone, triamterene, amiloride
Potassium sparing diuretics
25. phosphodiesterase inhibitor used to treat acute heart failure
Milrinone (Primacor)
2
