NURS 6013 Module 4 Quiz | Practice Questions and Answers with Rationales | 2026/2027 Updated –
Arkansas State University.
Section A – Diuretics and renal pharmacology
Question 1. Loop diuretic mechanism of action
Which transporter is primarily inhibited by furosemide in the thick ascending limb of the loop of
Henle?
A. Sodium-chloride cotransporter (NCC) B. Sodium-potassium-2 chloride cotransporter
(NKCC2) C. Epithelial sodium channel (ENaC) D. Sodium-glucose cotransporter 2 (SGLT2)
Correct Answer: B — NKCC2.
Rationale: Furosemide is a loop diuretic that inhibits the NKCC2 transporter in the thick
ascending limb of the loop of Henle. This reduces sodium, potassium, and chloride reabsorption,
increasing urinary electrolyte and water excretion.
Loop diuretics produce relatively powerful diuretic effects because this nephron segment
normally reabsorbs a substantial proportion of filtered sodium.
Question 2. Electrolyte disturbances
Which electrolyte abnormality is commonly associated with loop diuretic therapy?
A. Hyperkalemia B. Hypercalcemia C. Hypokalemia D. Hypermagnesemia
Correct Answer: C — Hypokalemia.
Rationale: Loop diuretics increase sodium delivery to more distal nephron segments, where
sodium reabsorption can promote potassium secretion.
Consequently, potassium loss and hypokalemia are recognized adverse effects. Loop diuretics
can also contribute to magnesium depletion.
Question 3. Loop diuretics and calcium
Which statement best describes the effect of loop diuretics on calcium handling?
A. They increase urinary calcium excretion. B. They completely prevent calcium filtration. C.
They stimulate calcium release from bone. D. They increase calcium reabsorption in the distal
convoluted tubule.
Correct Answer: A — They increase urinary calcium excretion.
, Rationale: Loop diuretics disrupt the lumen-positive electrical gradient in the thick ascending
limb, reducing paracellular calcium and magnesium reabsorption.
This increases urinary calcium excretion, distinguishing loop diuretics from thiazides.
Question 4. Thiazide diuretics
Where do thiazide diuretics primarily act?
A. Glomerulus B. Thick ascending limb of the loop of Henle C. Collecting duct through
aldosterone receptor blockade D. Early distal convoluted tubule
Correct Answer: D — Early distal convoluted tubule.
Rationale: Thiazide diuretics inhibit the sodium-chloride cotransporter in the early distal
convoluted tubule.
This reduces sodium-chloride reabsorption and promotes natriuresis. Their long-term
antihypertensive effects also involve a reduction in peripheral vascular resistance.
Question 5. Thiazides and calcium
Which effect on calcium balance is particularly associated with thiazide diuretics?
A. Increased urinary calcium elimination B. Increased renal calcium reabsorption C. Complete
suppression of calcium filtration D. Reduced calcium absorption through the intestines
Correct Answer: B — Increased renal calcium reabsorption.
Rationale: Thiazide diuretics tend to increase calcium reabsorption in the distal nephron,
reducing urinary calcium loss.
This is why thiazides and loop diuretics can have opposite effects on urinary calcium excretion.
Question 6. Carbonic anhydrase inhibitors
What is the principal renal mechanism of acetazolamide?
A. Direct inhibition of aldosterone receptors B. Blockade of NKCC2 transporters C. Inhibition of
carbonic anhydrase, reducing bicarbonate reabsorption D. Stimulation of antidiuretic hormone
secretion
Correct Answer: C
Rationale: Acetazolamide inhibits carbonic anhydrase, principally affecting processes in the
proximal convoluted tubule.
Arkansas State University.
Section A – Diuretics and renal pharmacology
Question 1. Loop diuretic mechanism of action
Which transporter is primarily inhibited by furosemide in the thick ascending limb of the loop of
Henle?
A. Sodium-chloride cotransporter (NCC) B. Sodium-potassium-2 chloride cotransporter
(NKCC2) C. Epithelial sodium channel (ENaC) D. Sodium-glucose cotransporter 2 (SGLT2)
Correct Answer: B — NKCC2.
Rationale: Furosemide is a loop diuretic that inhibits the NKCC2 transporter in the thick
ascending limb of the loop of Henle. This reduces sodium, potassium, and chloride reabsorption,
increasing urinary electrolyte and water excretion.
Loop diuretics produce relatively powerful diuretic effects because this nephron segment
normally reabsorbs a substantial proportion of filtered sodium.
Question 2. Electrolyte disturbances
Which electrolyte abnormality is commonly associated with loop diuretic therapy?
A. Hyperkalemia B. Hypercalcemia C. Hypokalemia D. Hypermagnesemia
Correct Answer: C — Hypokalemia.
Rationale: Loop diuretics increase sodium delivery to more distal nephron segments, where
sodium reabsorption can promote potassium secretion.
Consequently, potassium loss and hypokalemia are recognized adverse effects. Loop diuretics
can also contribute to magnesium depletion.
Question 3. Loop diuretics and calcium
Which statement best describes the effect of loop diuretics on calcium handling?
A. They increase urinary calcium excretion. B. They completely prevent calcium filtration. C.
They stimulate calcium release from bone. D. They increase calcium reabsorption in the distal
convoluted tubule.
Correct Answer: A — They increase urinary calcium excretion.
, Rationale: Loop diuretics disrupt the lumen-positive electrical gradient in the thick ascending
limb, reducing paracellular calcium and magnesium reabsorption.
This increases urinary calcium excretion, distinguishing loop diuretics from thiazides.
Question 4. Thiazide diuretics
Where do thiazide diuretics primarily act?
A. Glomerulus B. Thick ascending limb of the loop of Henle C. Collecting duct through
aldosterone receptor blockade D. Early distal convoluted tubule
Correct Answer: D — Early distal convoluted tubule.
Rationale: Thiazide diuretics inhibit the sodium-chloride cotransporter in the early distal
convoluted tubule.
This reduces sodium-chloride reabsorption and promotes natriuresis. Their long-term
antihypertensive effects also involve a reduction in peripheral vascular resistance.
Question 5. Thiazides and calcium
Which effect on calcium balance is particularly associated with thiazide diuretics?
A. Increased urinary calcium elimination B. Increased renal calcium reabsorption C. Complete
suppression of calcium filtration D. Reduced calcium absorption through the intestines
Correct Answer: B — Increased renal calcium reabsorption.
Rationale: Thiazide diuretics tend to increase calcium reabsorption in the distal nephron,
reducing urinary calcium loss.
This is why thiazides and loop diuretics can have opposite effects on urinary calcium excretion.
Question 6. Carbonic anhydrase inhibitors
What is the principal renal mechanism of acetazolamide?
A. Direct inhibition of aldosterone receptors B. Blockade of NKCC2 transporters C. Inhibition of
carbonic anhydrase, reducing bicarbonate reabsorption D. Stimulation of antidiuretic hormone
secretion
Correct Answer: C
Rationale: Acetazolamide inhibits carbonic anhydrase, principally affecting processes in the
proximal convoluted tubule.
