NSG 533 Advanced Pharmacology | Wilkes University | Academic Year 2026/2027 | Test
1 Week 4 Comprehensive Examination | Verified Questions and Correct Answer
Rationales
1. Define metaplasia in cell adaptation - ANSWERS-response to chronic irritation in which
a cell that is better able to survive replaces the original cell
2. Define dysplasia in cell adapatation - ANSWERS-maladaptation; deranged cell growth
and differentiation within a specific tissue; precursor of cancer
3. Define hypertrophy in cell adaptations - ANSWERS-when there are increased work
demands, the cell increases in size
4. Define hyperplasia in cell adaptation - ANSWERS-an increase in the number of cells in an
organ or tissue that is capable of mitotic division
5. Aging is thought to be the result of: - ANSWERS-1. Faulty DNA repair mechanisms
2. Reduced antioxidants
6. Define intracellular fluid - ANSWERS-all the fluid within the cells (2/3 of total body water)
7. Define extracellular fluid - ANSWERS-all the fluid outside of the cells (1/3 of total body
water)
8. What makes up extracellular fluid - ANSWERS-1. Interstitial fluid (3/4)
2. Intravascular fluid (blood plasma) (1/4)
9. Define interstitial fluid - ANSWERS-component of extracellular fluid that is the fluid
surrounding the cells and found in the spaces between cells, but not within the blood
vessels
10. Define intravascular fluid - ANSWERS-component of extracellular fluid that is the fluid
within the blood vessels (aka blood plasma)
11. Define transcellular fluid - ANSWERS-component of extracellular fluid that is the fluid
contained within epithelial-lined cavities of the body
12. Isotonic alterations - ANSWERS-aka fluid volume deficit; Total body water change with
proportional electrolyte and water change (most common)
13. What does isotonic fluid loss cause? - ANSWERS-dehydration and hypovolemia
14. S/s isotonic fluid loss - ANSWERS-- rapid HR
- normal or dec BP
15. Isotonic fluid excess - ANSWERS-aka hypervolemia; caused by excessive administration
of IV fluids
,16. Define hypovolemic hypernatremia - ANSWERS-loss of total body water with loss of total
body sodium (but ECF sodium increases)
Causes: loop diuretics, hyperglycemia, GI losses
17. Define euvolemic hypernatremia - ANSWERS-loss of water with normal sodium
concentration (most common)
Causes: inadequate water intake, excessive sweating, burns
18. Define hypervolemic hypernatremia - ANSWERS-increased TBW and a greater increase
in total body sodium (rare)
Causes: infusion of hypertonic saline solutions; over-secretion of aldosterone; near
salt-water drowning
19. S/s isotonic fluid excess - ANSWERS-- distended neck veins
- elevated BP
- edema
20. S/s hypernatremia (Na >145 meq/L) - ANSWERS-muscle twitching, weakness,
hyperactive reflexes
21. Treatment for hypernatremia - ANSWERS-- oral fluids or isotonic solutions
- give slowly to prevent cerebral edema
- diuretics to enhance sodium excretion
22. Define hypovolemic hyponatremia - ANSWERS-loss of total body fluid with a greater loss
of total body sodium
Causes: prolonged vomiting/diarrhea, inadequate secretion of aldosterone
23. Define euvolemic hyponatremia - ANSWERS-loss of sodium without significant loss of
water
Causes: SIADH, hypothyroidism
24. Define dilutional hypotonic hyponatremia - ANSWERS-aka water intoxication
25. Define hypervolemic hyponatremia - ANSWERS-both TBW and sodium are increased, but
TBW is more
Causes: CHF, cirrhosis of liver, nephrotic syndrome
26. Treatment for hyponatremia (Na < 135meq/L) - ANSWERS-fluid restriction
27. Causes of hyperkalemia - ANSWERS-
28. S/s hyperkalemia (K> 5.0 meq/L) - ANSWERS-- bradycardia
- muscle weakness
- anxiety
- peaked T waves
, - oliguria
29. Treatment for hyperkalemia - ANSWERS-- Kayexalate
- glucose to stimulate insulin secretion (pushes K back to ICF)
- dialysis
30. Causes of hypokalemia - ANSWERS-mostly GI and renal
- GI (diarrhea/vomiting)
- renal (diuretic use, low plasma Mg, excessive aldosterone secretion)
31. S/s hypokalemia (K < 3.5meq/L) - ANSWERS-- lethargy
- n/v
- Flat T wave
32. Treatment for hypokalemia - ANSWERS-Potassium replacement 40-80meq/day if renal
function normal
33. Causes of hypercalcemia - ANSWERS-CHED
Calcium ingestion, Hyperparathyroid, excess Vitamin D
34. S/s hypercalcemia (Ca > 10.5mg/dl) - ANSWERS-- loss of membrane excitability
- lethargy
- depressed T waves
35. Treatment for hypercalcemia - ANSWERS-- phosphate
- calcitonin
36. Causes of hypocalcemia - ANSWERS-- inadequate internal absorption
- decreased levels of PTH
- decreased levels of Vitamin D
37. S/s hypocalcemia (Ca < 9.0mg/dl) - ANSWERS-Convulsions (Chvostek/Trousseau)
Arrhythmias (long QT)
Tetany
Stridor
38. Treatment for hypocalcemia - ANSWERS-- 10% calcium gluconate
- decrease phosphate intake
39. Difference between local vs generalized edema - ANSWERS-local edema is limited to the
site of injury (cerebral, pulmonary and can be life threatening)
Generalized edema has a more uniform distribution of fluid in the interstitial spaces
40. Define dependent edema - ANSWERS-fluid accumulates in gravity-dependent areas of
the body(feet, legs, butt)
1 Week 4 Comprehensive Examination | Verified Questions and Correct Answer
Rationales
1. Define metaplasia in cell adaptation - ANSWERS-response to chronic irritation in which
a cell that is better able to survive replaces the original cell
2. Define dysplasia in cell adapatation - ANSWERS-maladaptation; deranged cell growth
and differentiation within a specific tissue; precursor of cancer
3. Define hypertrophy in cell adaptations - ANSWERS-when there are increased work
demands, the cell increases in size
4. Define hyperplasia in cell adaptation - ANSWERS-an increase in the number of cells in an
organ or tissue that is capable of mitotic division
5. Aging is thought to be the result of: - ANSWERS-1. Faulty DNA repair mechanisms
2. Reduced antioxidants
6. Define intracellular fluid - ANSWERS-all the fluid within the cells (2/3 of total body water)
7. Define extracellular fluid - ANSWERS-all the fluid outside of the cells (1/3 of total body
water)
8. What makes up extracellular fluid - ANSWERS-1. Interstitial fluid (3/4)
2. Intravascular fluid (blood plasma) (1/4)
9. Define interstitial fluid - ANSWERS-component of extracellular fluid that is the fluid
surrounding the cells and found in the spaces between cells, but not within the blood
vessels
10. Define intravascular fluid - ANSWERS-component of extracellular fluid that is the fluid
within the blood vessels (aka blood plasma)
11. Define transcellular fluid - ANSWERS-component of extracellular fluid that is the fluid
contained within epithelial-lined cavities of the body
12. Isotonic alterations - ANSWERS-aka fluid volume deficit; Total body water change with
proportional electrolyte and water change (most common)
13. What does isotonic fluid loss cause? - ANSWERS-dehydration and hypovolemia
14. S/s isotonic fluid loss - ANSWERS-- rapid HR
- normal or dec BP
15. Isotonic fluid excess - ANSWERS-aka hypervolemia; caused by excessive administration
of IV fluids
,16. Define hypovolemic hypernatremia - ANSWERS-loss of total body water with loss of total
body sodium (but ECF sodium increases)
Causes: loop diuretics, hyperglycemia, GI losses
17. Define euvolemic hypernatremia - ANSWERS-loss of water with normal sodium
concentration (most common)
Causes: inadequate water intake, excessive sweating, burns
18. Define hypervolemic hypernatremia - ANSWERS-increased TBW and a greater increase
in total body sodium (rare)
Causes: infusion of hypertonic saline solutions; over-secretion of aldosterone; near
salt-water drowning
19. S/s isotonic fluid excess - ANSWERS-- distended neck veins
- elevated BP
- edema
20. S/s hypernatremia (Na >145 meq/L) - ANSWERS-muscle twitching, weakness,
hyperactive reflexes
21. Treatment for hypernatremia - ANSWERS-- oral fluids or isotonic solutions
- give slowly to prevent cerebral edema
- diuretics to enhance sodium excretion
22. Define hypovolemic hyponatremia - ANSWERS-loss of total body fluid with a greater loss
of total body sodium
Causes: prolonged vomiting/diarrhea, inadequate secretion of aldosterone
23. Define euvolemic hyponatremia - ANSWERS-loss of sodium without significant loss of
water
Causes: SIADH, hypothyroidism
24. Define dilutional hypotonic hyponatremia - ANSWERS-aka water intoxication
25. Define hypervolemic hyponatremia - ANSWERS-both TBW and sodium are increased, but
TBW is more
Causes: CHF, cirrhosis of liver, nephrotic syndrome
26. Treatment for hyponatremia (Na < 135meq/L) - ANSWERS-fluid restriction
27. Causes of hyperkalemia - ANSWERS-
28. S/s hyperkalemia (K> 5.0 meq/L) - ANSWERS-- bradycardia
- muscle weakness
- anxiety
- peaked T waves
, - oliguria
29. Treatment for hyperkalemia - ANSWERS-- Kayexalate
- glucose to stimulate insulin secretion (pushes K back to ICF)
- dialysis
30. Causes of hypokalemia - ANSWERS-mostly GI and renal
- GI (diarrhea/vomiting)
- renal (diuretic use, low plasma Mg, excessive aldosterone secretion)
31. S/s hypokalemia (K < 3.5meq/L) - ANSWERS-- lethargy
- n/v
- Flat T wave
32. Treatment for hypokalemia - ANSWERS-Potassium replacement 40-80meq/day if renal
function normal
33. Causes of hypercalcemia - ANSWERS-CHED
Calcium ingestion, Hyperparathyroid, excess Vitamin D
34. S/s hypercalcemia (Ca > 10.5mg/dl) - ANSWERS-- loss of membrane excitability
- lethargy
- depressed T waves
35. Treatment for hypercalcemia - ANSWERS-- phosphate
- calcitonin
36. Causes of hypocalcemia - ANSWERS-- inadequate internal absorption
- decreased levels of PTH
- decreased levels of Vitamin D
37. S/s hypocalcemia (Ca < 9.0mg/dl) - ANSWERS-Convulsions (Chvostek/Trousseau)
Arrhythmias (long QT)
Tetany
Stridor
38. Treatment for hypocalcemia - ANSWERS-- 10% calcium gluconate
- decrease phosphate intake
39. Difference between local vs generalized edema - ANSWERS-local edema is limited to the
site of injury (cerebral, pulmonary and can be life threatening)
Generalized edema has a more uniform distribution of fluid in the interstitial spaces
40. Define dependent edema - ANSWERS-fluid accumulates in gravity-dependent areas of
the body(feet, legs, butt)
