NRSG 220 PHARM W3 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026

NRSG 220 PHARM W3 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026 Roles of the kidney - Answers - Fluid balance - Electrolyte balance (The heart is extremely sensitive to K+ levels) - Acid-base balance (7.35-7.45) Lab values trick (35-45) - Answers pH: 7.35-7.45 Na: 135-145 K: 3.5-4.5 ~ 5.0 Mag: 0.65-1.05 Indications for Diuretic Therapy - Answers - Edema or pulmonary edema - Hypertension - Heart failure - Renal failure - Liver failure or cirrhosis Adverse Effects of Diuretic Therapy - Answers - Electrolyte imbalance - Dehydration - Hypotension Types of Diuretics - Answers 1. Loop or high-ceiling* 2. Thiazides* 3. Potassium-sparing* 4. Osmotic 5. Carbonic anhydrase inhibitors Action of Loop Diuretics - Answers Blocks Na+ reabsorption at the loop of Henle PO or Parenteral Furosemide (Lasix): Loop Diuretic - Answers Indications: Acute edema, HTN Action: Prevent reabsorption of Na and Cl Adverse Effects of Loop Diuretics - Answers - Ototoxicity - Electrolyte imbalance (hypokalemia) - Dysthymias - Tachycardia - Hypovolemia - Orthostatic hypotension Contraindications of Loop Diuretics - Answers - Hypersensitivity - Renal failure - Hepatic impairment - Dehydration Considerations for Loop Diuretics - Answers - Health history - Monitor vital signs - Safety - Older adults - Ready access to bathroom - Watch K+ levels - Admin. early in day Bumetanide (Bumex) - Answers Also a commonly seen loop diuretic ACE inhibitor often used first for pts. w/ heart or renal impairment - Answers What is an adverse effect that is not seen in Thiazide Diuretics - Answers Does not cause ototoxicity Hydrochlorothiazide (HCTZ) - Answers Indications: HTN, HF, edema (offlable: PMS, DI, nephrolithiasis) Action: Decrease reabsorption of Na+ in the distal tubule Adverse effects of Thiazide Diuretics - Answers Similar to Loop Diuretics (No ototoxicity) Also excretes K+ Contraindications of Thiazide Diuretics - Answers - Anuria - Hypersensitivity - Diabetes - Hypovolemia - Hypotension Drug Interactions with Thiazide Diuretics - Answers Decreased effect of coagulants, antidiabetic, and sulfonylurea drugs More risk of renal toxicity with NSAIDs (GFR 60 to give NSAIDs) What is an up and down side of K-Sparring Diuretics? - Answers Less effective BUT Help prevent hypokalemia Spironolactone (Aldactone) - Answers Indication: Mild HTN Action: Inhibits aldosterone in distal tubule and collecting ducts Adverse Effects of K-Sparring Diuretics - Answers Heart and muscle effects Do not give to pregnancy or breastfeeding people Drug interaction of K-Sparring Diuretic* - Answers - Acidosis with ammonium chloride - Decreased diuretic effects with aspirin and other salicylates - Decreased effects of digoxin Can cause hyperkalemia with potassium supplements, ACE inhibitors, ARB Additive hypotensive results with other antihypertensives Principles of Fluid Imbalance* - Answers - Intracellular fluid (ICF) makes up 2/3 of water in body - Extracellular fluid (ECF) makes up 1/3 of water in body