NSG 533 (Exams 4) Wilkes Advanced
Pharmacology | Advanced/Hard | 100% Pass
Guaranteed | Graded A+
[1] What is the primary cause of edema in a patient with right-sided heart failure?
A. Decreased plasma oncotic pressure from liver congestion
B. Increased capillary hydrostatic pressure from venous congestion
C. Increased capillary permeability from inflammation
D. Lymphatic obstruction from impaired venous return
Correct Answer: B
Explanation: Right-sided heart failure causes venous congestion, elevating capillary
hydrostatic pressure. This pressure gradient favors fluid movement from the capillaries into the
interstitial space, leading to dependent edema .
[2] Which electrolyte imbalance is most commonly associated with diuretic therapy that blocks
sodium reabsorption in the distal tubule?
A. Hyperkalemia
,B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C
Explanation: Diuretics that block sodium reabsorption in the distal tubule (such as thiazides
and loop diuretics) increase sodium delivery to the distal tubule, promoting potassium secretion
and leading to hypokalemia .
[3] A patient with acute kidney injury (AKI) has a fractional excretion of sodium (FENa) <1%. This
finding is most consistent with which type of AKI?
A. Intrinsic AKI (acute tubular necrosis)
B. Post-renal AKI
C. Prerenal AKI
D. Chronic kidney disease
Correct Answer: C
Explanation: In prerenal AKI, the kidneys retain sodium and water to preserve volume,
resulting in FENa <1% and urine osmolality >500 mOsm/kg. This contrasts with intrinsic AKI
,(e.g., acute tubular necrosis), where FENa >2% and urine osmolality is low, reflecting tubular
damage and impaired concentrating ability .
[4] Which stage of chronic kidney disease (CKD) is defined by a glomerular filtration rate (GFR)
of 15–29 mL/min/1.73m²?
A. Stage 2
B. Stage 3
C. Stage 4
D. Stage 5
Correct Answer: C
Explanation: CKD staging is based on GFR: Stage 1 (≥90), Stage 2 (60–89), Stage 3 (30–59),
Stage 4 (15–29), and Stage 5 (<15 or dialysis). Stage 4 represents severe reduction in kidney
function, requiring preparation for renal replacement therapy .
[5] Which mechanism of cell injury involves the accumulation of oxygen-derived free radicals
and is a key feature of ischemia-reperfusion injury?
A. ATP depletion
, B. Mitochondrial damage
C. Membrane permeability defects
D. Intracellular calcium accumulation
Correct Answer: B
Explanation: Ischemia-reperfusion injury involves mitochondrial damage from reactive
oxygen species generated upon reoxygenation. Damaged mitochondria release pro-apoptotic
factors and fail to produce ATP, exacerbating injury. This mechanism is particularly relevant in
myocardial infarction and stroke, where reperfusion can paradoxically worsen tissue damage .
[6] In the context of drug therapy, what does the term "pharmacodynamics" refer to?
A. The movement of drugs through the body (absorption, distribution, metabolism, excretion)
B. The effects of drugs on the body and their mechanism of action
C. The genetic factors influencing drug response
D. The process of drug development and clinical trials
Correct Answer: B
Explanation: Pharmacodynamics describes what the drug does to the body, including
Pharmacology | Advanced/Hard | 100% Pass
Guaranteed | Graded A+
[1] What is the primary cause of edema in a patient with right-sided heart failure?
A. Decreased plasma oncotic pressure from liver congestion
B. Increased capillary hydrostatic pressure from venous congestion
C. Increased capillary permeability from inflammation
D. Lymphatic obstruction from impaired venous return
Correct Answer: B
Explanation: Right-sided heart failure causes venous congestion, elevating capillary
hydrostatic pressure. This pressure gradient favors fluid movement from the capillaries into the
interstitial space, leading to dependent edema .
[2] Which electrolyte imbalance is most commonly associated with diuretic therapy that blocks
sodium reabsorption in the distal tubule?
A. Hyperkalemia
,B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C
Explanation: Diuretics that block sodium reabsorption in the distal tubule (such as thiazides
and loop diuretics) increase sodium delivery to the distal tubule, promoting potassium secretion
and leading to hypokalemia .
[3] A patient with acute kidney injury (AKI) has a fractional excretion of sodium (FENa) <1%. This
finding is most consistent with which type of AKI?
A. Intrinsic AKI (acute tubular necrosis)
B. Post-renal AKI
C. Prerenal AKI
D. Chronic kidney disease
Correct Answer: C
Explanation: In prerenal AKI, the kidneys retain sodium and water to preserve volume,
resulting in FENa <1% and urine osmolality >500 mOsm/kg. This contrasts with intrinsic AKI
,(e.g., acute tubular necrosis), where FENa >2% and urine osmolality is low, reflecting tubular
damage and impaired concentrating ability .
[4] Which stage of chronic kidney disease (CKD) is defined by a glomerular filtration rate (GFR)
of 15–29 mL/min/1.73m²?
A. Stage 2
B. Stage 3
C. Stage 4
D. Stage 5
Correct Answer: C
Explanation: CKD staging is based on GFR: Stage 1 (≥90), Stage 2 (60–89), Stage 3 (30–59),
Stage 4 (15–29), and Stage 5 (<15 or dialysis). Stage 4 represents severe reduction in kidney
function, requiring preparation for renal replacement therapy .
[5] Which mechanism of cell injury involves the accumulation of oxygen-derived free radicals
and is a key feature of ischemia-reperfusion injury?
A. ATP depletion
, B. Mitochondrial damage
C. Membrane permeability defects
D. Intracellular calcium accumulation
Correct Answer: B
Explanation: Ischemia-reperfusion injury involves mitochondrial damage from reactive
oxygen species generated upon reoxygenation. Damaged mitochondria release pro-apoptotic
factors and fail to produce ATP, exacerbating injury. This mechanism is particularly relevant in
myocardial infarction and stroke, where reperfusion can paradoxically worsen tissue damage .
[6] In the context of drug therapy, what does the term "pharmacodynamics" refer to?
A. The movement of drugs through the body (absorption, distribution, metabolism, excretion)
B. The effects of drugs on the body and their mechanism of action
C. The genetic factors influencing drug response
D. The process of drug development and clinical trials
Correct Answer: B
Explanation: Pharmacodynamics describes what the drug does to the body, including
