NUR 354 Pharmacology II — Exam 2 Comprehensive Review | Full Questions and Correct Answers
with Rationales | 2026/2027 Updated | 100% Correct - Arizona College of Nursing.
Arizona College of Nursing
Modules 3–4: Renal Pharmacology • Hypertension • Angina • ACS/MI
75 Questions With Correct Answers and Rationales
PART I — RENAL PHARMACOLOGY
Questions 1–22
1. Which function is performed by the kidneys?
A. Production of insulin
B. Regulation of fluid and electrolyte balance
C. Production of bile
D. Storage of glycogen
Answer: B
Rationale: The kidneys regulate fluid volume, electrolytes, acid-base status, blood pressure,
waste elimination, and several endocrine functions. Current NUR 354 materials specifically
emphasize renal regulation of fluid/electrolytes and secretion of renin, erythropoietin, and
activated vitamin D. Studocu
2. Which hormone released by the kidney contributes directly to regulation of blood
pressure?
A. Insulin
B. Renin
C. Thyroxine
D. Calcitonin
Answer: B
Rationale: Renin initiates the renin-angiotensin-aldosterone system when renal perfusion is
decreased.
,3. Which finding generally indicates declining renal filtration?
A. Increasing GFR
B. Decreasing serum creatinine
C. Decreasing GFR
D. Decreasing BUN with oliguria
Answer: C
Rationale: GFR estimates filtration capacity. Progressive reduction in GFR generally indicates
worsening renal function.
4. Furosemide primarily acts at which portion of the nephron?
A. Proximal convoluted tubule
B. Thick ascending loop of Henle
C. Collecting duct only
D. Glomerulus
Answer: B
Rationale: Loop diuretics inhibit the Na⁺-K⁺-2Cl⁻ cotransporter in the thick ascending limb,
producing powerful natriuresis and diuresis.
5. Which electrolyte abnormality is a major concern for a client receiving furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B
Rationale: Furosemide increases urinary potassium loss. Hypokalemia may lead to muscle
weakness and cardiac dysrhythmias.
6. A patient receiving high-dose IV furosemide reports ringing in the ears. Which action is
most appropriate?
, A. Document this as an expected therapeutic effect.
B. Assess the patient and notify the provider because ototoxicity is possible.
C. Give an additional dose.
D. Encourage increased sodium intake.
Answer: B
Rationale: Tinnitus or hearing changes can indicate loop-diuretic-associated ototoxicity,
especially with rapid IV administration or high doses. NUR 354 material specifically highlights
ototoxicity as a major loop-diuretic adverse effect. [studocu.com] - NUR 354 Exam 2 …
7. Which instruction is most appropriate for a patient prescribed a once-daily diuretic?
A. Take it immediately before bedtime.
B. Take it earlier in the day.
C. Increase dietary sodium.
D. Restrict all oral fluid.
Answer: B
Rationale: Taking diuretics earlier in the day reduces nocturia and sleep disruption. The NUR
354 guide explicitly emphasizes avoiding late-day doses. [studocu.com] - NUR 354 Exam 2 …
8. Hydrochlorothiazide decreases blood pressure primarily by:
A. Blocking sodium and chloride reabsorption in the distal convoluted tubule
B. Blocking beta-1 receptors
C. Directly inhibiting renin
D. Increasing aldosterone activity
Answer: A
Rationale: Thiazides inhibit the Na⁺/Cl⁻ cotransporter in the distal convoluted tubule, increasing
sodium and water excretion.
9. Which laboratory result should concern the nurse in a patient receiving
hydrochlorothiazide?
A. Potassium 2.9 mEq/L
B. Potassium 4.0 mEq/L
with Rationales | 2026/2027 Updated | 100% Correct - Arizona College of Nursing.
Arizona College of Nursing
Modules 3–4: Renal Pharmacology • Hypertension • Angina • ACS/MI
75 Questions With Correct Answers and Rationales
PART I — RENAL PHARMACOLOGY
Questions 1–22
1. Which function is performed by the kidneys?
A. Production of insulin
B. Regulation of fluid and electrolyte balance
C. Production of bile
D. Storage of glycogen
Answer: B
Rationale: The kidneys regulate fluid volume, electrolytes, acid-base status, blood pressure,
waste elimination, and several endocrine functions. Current NUR 354 materials specifically
emphasize renal regulation of fluid/electrolytes and secretion of renin, erythropoietin, and
activated vitamin D. Studocu
2. Which hormone released by the kidney contributes directly to regulation of blood
pressure?
A. Insulin
B. Renin
C. Thyroxine
D. Calcitonin
Answer: B
Rationale: Renin initiates the renin-angiotensin-aldosterone system when renal perfusion is
decreased.
,3. Which finding generally indicates declining renal filtration?
A. Increasing GFR
B. Decreasing serum creatinine
C. Decreasing GFR
D. Decreasing BUN with oliguria
Answer: C
Rationale: GFR estimates filtration capacity. Progressive reduction in GFR generally indicates
worsening renal function.
4. Furosemide primarily acts at which portion of the nephron?
A. Proximal convoluted tubule
B. Thick ascending loop of Henle
C. Collecting duct only
D. Glomerulus
Answer: B
Rationale: Loop diuretics inhibit the Na⁺-K⁺-2Cl⁻ cotransporter in the thick ascending limb,
producing powerful natriuresis and diuresis.
5. Which electrolyte abnormality is a major concern for a client receiving furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B
Rationale: Furosemide increases urinary potassium loss. Hypokalemia may lead to muscle
weakness and cardiac dysrhythmias.
6. A patient receiving high-dose IV furosemide reports ringing in the ears. Which action is
most appropriate?
, A. Document this as an expected therapeutic effect.
B. Assess the patient and notify the provider because ototoxicity is possible.
C. Give an additional dose.
D. Encourage increased sodium intake.
Answer: B
Rationale: Tinnitus or hearing changes can indicate loop-diuretic-associated ototoxicity,
especially with rapid IV administration or high doses. NUR 354 material specifically highlights
ototoxicity as a major loop-diuretic adverse effect. [studocu.com] - NUR 354 Exam 2 …
7. Which instruction is most appropriate for a patient prescribed a once-daily diuretic?
A. Take it immediately before bedtime.
B. Take it earlier in the day.
C. Increase dietary sodium.
D. Restrict all oral fluid.
Answer: B
Rationale: Taking diuretics earlier in the day reduces nocturia and sleep disruption. The NUR
354 guide explicitly emphasizes avoiding late-day doses. [studocu.com] - NUR 354 Exam 2 …
8. Hydrochlorothiazide decreases blood pressure primarily by:
A. Blocking sodium and chloride reabsorption in the distal convoluted tubule
B. Blocking beta-1 receptors
C. Directly inhibiting renin
D. Increasing aldosterone activity
Answer: A
Rationale: Thiazides inhibit the Na⁺/Cl⁻ cotransporter in the distal convoluted tubule, increasing
sodium and water excretion.
9. Which laboratory result should concern the nurse in a patient receiving
hydrochlorothiazide?
A. Potassium 2.9 mEq/L
B. Potassium 4.0 mEq/L
