Renal Drug Therapy: Comprehensive Practice
Test for Medical & Nursing Exam 150
Questions Answers and Rationale
2025/2026
1. Which class of diuretics acts on the ascending limb of the loop of
Henle?
A. Thiazide diuretics
B. Potassium-sparing diuretics
C. Loop diuretics
D. Carbonic anhydrase inhibitors
Answer: C. Loop diuretics
Rationale: Loop diuretics work in the thick ascending limb by
inhibiting the Na-K-2Cl cotransporter.
2. Which drug is considered a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Mannitol
Answer: C. Spironolactone
Rationale: Spironolactone blocks aldosterone receptors, reducing
potassium excretion.
3. What is the primary mechanism of thiazide diuretics?
A. Block sodium channels in the collecting duct
B. Inhibit carbonic anhydrase
C. Inhibit sodium-chloride reabsorption in the distal convoluted
tubule
D. Increase glomerular filtration rate
,Answer: C. Inhibit sodium-chloride reabsorption in the distal
convoluted tubule
Rationale: Thiazides act at the distal tubule Na-Cl transporter to
promote natriuresis.
4. Which diuretic is used to reduce cerebral edema?
A. Furosemide
B. Spironolactone
C. Acetazolamide
D. Mannitol
Answer: D. Mannitol
Rationale: Mannitol is an osmotic diuretic that reduces intracranial
pressure.
5. A major adverse effect of loop diuretics is:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Bradycardia
Answer: B. Hypokalemia
Rationale: Loop diuretics cause significant potassium loss due to
increased distal sodium delivery.
6. Which drug can cause ototoxicity at high doses?
A. Hydrochlorothiazide
B. Spironolactone
C. Furosemide
D. Triamterene
Answer: C. Furosemide
Rationale: High-dose loop diuretics, especially furosemide, can cause
reversible or irreversible ototoxicity.
, 7. Which diuretic is most likely to cause hyperuricemia?
A. Mannitol
B. Spironolactone
C. Thiazide diuretics
D. Acetazolamide
Answer: C. Thiazide diuretics
Rationale: Thiazides decrease uric acid excretion, increasing gout risk.
8. Which agent is used to treat nephrogenic diabetes insipidus?
A. Desmopressin
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
Answer: C. Hydrochlorothiazide
Rationale: Thiazides paradoxically reduce urine output in nephrogenic
diabetes insipidus.
9. Which medication treats benign prostatic hyperplasia (BPH) by
relaxing smooth muscle in the urinary tract?
A. Finasteride
B. Desmopressin
C. Furosemide
D. Tamsulosin
Answer: D. Tamsulosin
Rationale: Tamsulosin is an alpha-1 blocker that relaxes bladder neck
and prostate smooth muscle.
10. Which diuretic works by inhibiting aldosterone effects?
A. Furosemide
B. Spironolactone
, C. Acetazolamide
D. Mannitol
Answer: B. Spironolactone
Rationale: Spironolactone is an aldosterone antagonist in the distal
nephron.
11. Which diuretic increases calcium reabsorption?
A. Loop diuretics
B. Thiazide diuretics
C. Osmotic diuretics
D. Carbonic anhydrase inhibitors
Answer: B. Thiazide diuretics
Rationale: Thiazides reduce urinary calcium excretion and are useful in
kidney stone prevention.
12. The main site of action for acetazolamide is:
A. Loop of Henle
B. Distal tubule
C. Collecting duct
D. Proximal tubule
Answer: D. Proximal tubule
Rationale: Carbonic anhydrase is highly active in the proximal tubule.
13. Which intravenous diuretic is contraindicated in anuria?
A. Acetazolamide
B. Spironolactone
C. Mannitol
D. Hydrochlorothiazide
Test for Medical & Nursing Exam 150
Questions Answers and Rationale
2025/2026
1. Which class of diuretics acts on the ascending limb of the loop of
Henle?
A. Thiazide diuretics
B. Potassium-sparing diuretics
C. Loop diuretics
D. Carbonic anhydrase inhibitors
Answer: C. Loop diuretics
Rationale: Loop diuretics work in the thick ascending limb by
inhibiting the Na-K-2Cl cotransporter.
2. Which drug is considered a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Mannitol
Answer: C. Spironolactone
Rationale: Spironolactone blocks aldosterone receptors, reducing
potassium excretion.
3. What is the primary mechanism of thiazide diuretics?
A. Block sodium channels in the collecting duct
B. Inhibit carbonic anhydrase
C. Inhibit sodium-chloride reabsorption in the distal convoluted
tubule
D. Increase glomerular filtration rate
,Answer: C. Inhibit sodium-chloride reabsorption in the distal
convoluted tubule
Rationale: Thiazides act at the distal tubule Na-Cl transporter to
promote natriuresis.
4. Which diuretic is used to reduce cerebral edema?
A. Furosemide
B. Spironolactone
C. Acetazolamide
D. Mannitol
Answer: D. Mannitol
Rationale: Mannitol is an osmotic diuretic that reduces intracranial
pressure.
5. A major adverse effect of loop diuretics is:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Bradycardia
Answer: B. Hypokalemia
Rationale: Loop diuretics cause significant potassium loss due to
increased distal sodium delivery.
6. Which drug can cause ototoxicity at high doses?
A. Hydrochlorothiazide
B. Spironolactone
C. Furosemide
D. Triamterene
Answer: C. Furosemide
Rationale: High-dose loop diuretics, especially furosemide, can cause
reversible or irreversible ototoxicity.
, 7. Which diuretic is most likely to cause hyperuricemia?
A. Mannitol
B. Spironolactone
C. Thiazide diuretics
D. Acetazolamide
Answer: C. Thiazide diuretics
Rationale: Thiazides decrease uric acid excretion, increasing gout risk.
8. Which agent is used to treat nephrogenic diabetes insipidus?
A. Desmopressin
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
Answer: C. Hydrochlorothiazide
Rationale: Thiazides paradoxically reduce urine output in nephrogenic
diabetes insipidus.
9. Which medication treats benign prostatic hyperplasia (BPH) by
relaxing smooth muscle in the urinary tract?
A. Finasteride
B. Desmopressin
C. Furosemide
D. Tamsulosin
Answer: D. Tamsulosin
Rationale: Tamsulosin is an alpha-1 blocker that relaxes bladder neck
and prostate smooth muscle.
10. Which diuretic works by inhibiting aldosterone effects?
A. Furosemide
B. Spironolactone
, C. Acetazolamide
D. Mannitol
Answer: B. Spironolactone
Rationale: Spironolactone is an aldosterone antagonist in the distal
nephron.
11. Which diuretic increases calcium reabsorption?
A. Loop diuretics
B. Thiazide diuretics
C. Osmotic diuretics
D. Carbonic anhydrase inhibitors
Answer: B. Thiazide diuretics
Rationale: Thiazides reduce urinary calcium excretion and are useful in
kidney stone prevention.
12. The main site of action for acetazolamide is:
A. Loop of Henle
B. Distal tubule
C. Collecting duct
D. Proximal tubule
Answer: D. Proximal tubule
Rationale: Carbonic anhydrase is highly active in the proximal tubule.
13. Which intravenous diuretic is contraindicated in anuria?
A. Acetazolamide
B. Spironolactone
C. Mannitol
D. Hydrochlorothiazide
