NUR 521
Exam 2
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Q1
A patient on furosemide reports hearing loss. What is the most likely cause?
A. Hypokalemia
B. Ototoxicity
C. Hypernatremia
D. Metabolic alkalosis
Answer: B
Rationale:
Loop diuretics like furosemide inhibit the Na⁺-K⁺-2Cl⁻ transporter in the thick
ascending limb. This mechanism disrupts ionic gradients in the inner ear, leading to
ototoxicity, especially at high IV doses or with concurrent aminoglycosides. Hearing
loss is a critical toxicity requiring immediate evaluation.
Q2
Which diuretic is most appropriate for a patient with hypercalcemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B
Rationale:
Loop diuretics increase calcium excretion by inhibiting paracellular Ca²⁺ reabsorption.
In contrast, thiazides increase calcium retention. Therefore, furosemide is preferred in
managing hypercalcemia due to its calciuric effect.
Q3
A patient on spironolactone develops muscle weakness. What electrolyte imbalance is
likely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale:
Spironolactone is a potassium-sparing diuretic that antagonizes aldosterone receptors.
This reduces potassium excretion, increasing the risk of hyperkalemia, which can
present with muscle weakness and life-threatening arrhythmias.
2
,Q4
Which diuretic works at the distal convoluted tubule?
A. Furosemide
B. Mannitol
C. Hydrochlorothiazide
D. Spironolactone
Answer: C
Rationale:
Thiazide diuretics act at the distal convoluted tubule by inhibiting the Na⁺/Cl⁻
transporter. This leads to moderate diuresis and increased calcium reabsorption,
making them useful in hypertension and kidney stone prevention.
Q5
Which diuretic is contraindicated in severe renal failure?
A. Furosemide
B. Hydrochlorothiazide
C. Bumetanide
D. Ethacrynic acid
Answer: B
Rationale:
Thiazides require adequate renal function to reach their site of action. In severe renal
failure (low GFR), they are ineffective, whereas loop diuretics remain active due to
different pharmacokinetics.
Q6
Mannitol is primarily used for:
A. Hypertension
B. Edema
C. Increased intracranial pressure
D. Heart failure
Answer: C
Rationale:
Mannitol is an osmotic diuretic that increases plasma osmolarity, drawing fluid out of
tissues. It is used to reduce intracranial and intraocular pressure, not for routine
hypertension management.
3
, Q7
Which electrolyte imbalance is most common with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B
Rationale:
Loop diuretics increase urinary excretion of potassium, sodium, calcium, and
magnesium. Hypokalemia is the most clinically significant due to arrhythmia risk.
Q8
Spironolactone is especially useful in which condition?
A. Acute kidney injury
B. Hyperaldosteronism
C. Dehydration
D. Hypotension
Answer: B
Rationale:
Spironolactone directly blocks aldosterone receptors, making it highly effective in
primary hyperaldosteronism and resistant hypertension.
Q9
Which diuretic can cause gynecomastia?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
Answer: B
Rationale:
Spironolactone has antiandrogen effects due to steroid receptor binding, leading to
gynecomastia and endocrine disturbances.
Q10
Which diuretic is safest in sulfa allergy?
A. Furosemide
4
Exam 2
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Q1
A patient on furosemide reports hearing loss. What is the most likely cause?
A. Hypokalemia
B. Ototoxicity
C. Hypernatremia
D. Metabolic alkalosis
Answer: B
Rationale:
Loop diuretics like furosemide inhibit the Na⁺-K⁺-2Cl⁻ transporter in the thick
ascending limb. This mechanism disrupts ionic gradients in the inner ear, leading to
ototoxicity, especially at high IV doses or with concurrent aminoglycosides. Hearing
loss is a critical toxicity requiring immediate evaluation.
Q2
Which diuretic is most appropriate for a patient with hypercalcemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B
Rationale:
Loop diuretics increase calcium excretion by inhibiting paracellular Ca²⁺ reabsorption.
In contrast, thiazides increase calcium retention. Therefore, furosemide is preferred in
managing hypercalcemia due to its calciuric effect.
Q3
A patient on spironolactone develops muscle weakness. What electrolyte imbalance is
likely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale:
Spironolactone is a potassium-sparing diuretic that antagonizes aldosterone receptors.
This reduces potassium excretion, increasing the risk of hyperkalemia, which can
present with muscle weakness and life-threatening arrhythmias.
2
,Q4
Which diuretic works at the distal convoluted tubule?
A. Furosemide
B. Mannitol
C. Hydrochlorothiazide
D. Spironolactone
Answer: C
Rationale:
Thiazide diuretics act at the distal convoluted tubule by inhibiting the Na⁺/Cl⁻
transporter. This leads to moderate diuresis and increased calcium reabsorption,
making them useful in hypertension and kidney stone prevention.
Q5
Which diuretic is contraindicated in severe renal failure?
A. Furosemide
B. Hydrochlorothiazide
C. Bumetanide
D. Ethacrynic acid
Answer: B
Rationale:
Thiazides require adequate renal function to reach their site of action. In severe renal
failure (low GFR), they are ineffective, whereas loop diuretics remain active due to
different pharmacokinetics.
Q6
Mannitol is primarily used for:
A. Hypertension
B. Edema
C. Increased intracranial pressure
D. Heart failure
Answer: C
Rationale:
Mannitol is an osmotic diuretic that increases plasma osmolarity, drawing fluid out of
tissues. It is used to reduce intracranial and intraocular pressure, not for routine
hypertension management.
3
, Q7
Which electrolyte imbalance is most common with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B
Rationale:
Loop diuretics increase urinary excretion of potassium, sodium, calcium, and
magnesium. Hypokalemia is the most clinically significant due to arrhythmia risk.
Q8
Spironolactone is especially useful in which condition?
A. Acute kidney injury
B. Hyperaldosteronism
C. Dehydration
D. Hypotension
Answer: B
Rationale:
Spironolactone directly blocks aldosterone receptors, making it highly effective in
primary hyperaldosteronism and resistant hypertension.
Q9
Which diuretic can cause gynecomastia?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
Answer: B
Rationale:
Spironolactone has antiandrogen effects due to steroid receptor binding, leading to
gynecomastia and endocrine disturbances.
Q10
Which diuretic is safest in sulfa allergy?
A. Furosemide
4
