Lehne Pharmacotherapeutics for
Advanced Practice Nurses and Physician
Assistants - Ch 37-47 Exam 2026
Questions and Answers Graded A+
Three functions of the kidneys - Correct answer-1. Cleansing of extracellular fluid
(ECF) including the maintenance of ECF volume + composition
2. Maintenance of Acid-Base balance
3. Excretion of metabolic wastes and foreign substances (drugs, toxins)
Of the 3 functions, diuretics affect ECF composition and volume the most
(function one)
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,The kidney produces effects on the ECF through three processes: - Correct answer-
1. Filtration - occurring at the glomerulus (for small molecules like electrolytes and
glucose; large molecules like lipids and proteins remain in the blood)
2. Reabsorption - takes place by way of active transport across water soluble
osmotic gradient; determines the contents of urine; diuretics work to interfere with
this process by blockading mainly sodium and chloride reabsorption which
prevents the passive reabsorption of water causing water and these electrolytes to
stay within the nephron and become excreted together
3. Active Secretion - located at pumps in the proximal convoluted tubule
How does aldosterone act on the nephrons? - Correct answer-As a principal
mineralocoticoid of the adrenal cortex, it stimulates reabsorption of sodium from
the distal nephron. Simultaneously, it causes potassium to be secreted.
Adverse effects of diuretics (as an overall drug class) - Correct answer-
Hypovolemia
Acid-Base Imbalances
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, Altered Electrolyte Levels
Combat these by using short-acting diuretics and by timing dosing so that the
kidney has periods of operation unaffected by drug-induced diuresis
What is the function of carbonic anhydrase inhibitors? - Correct answer-They are
classed as diuretics but are employed primarily to lower intraocular pressure (IOP)
- they do not increase urine production.
Lasix (furosemide) - Correct answer-Classification: Loop Diuretic
Therapeutic Effects: Lowering of blood pressure by creating large volume loss and
substantial relaxation of venous smooth muscle contractions which reduces venous
return to the heart; Acts in loop of Henle to block sodium and chloride reabsorption
(which is usually a 20% reabsorption rate) so creates major DIURESIS
Adverse Reactions & side effects: Dehydration, hypochloremia, hypokalemia,
hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis, oliguria,
hyperglycemia, reduction of HDL cholesterol, increase in LDL and triglycerides
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
Advanced Practice Nurses and Physician
Assistants - Ch 37-47 Exam 2026
Questions and Answers Graded A+
Three functions of the kidneys - Correct answer-1. Cleansing of extracellular fluid
(ECF) including the maintenance of ECF volume + composition
2. Maintenance of Acid-Base balance
3. Excretion of metabolic wastes and foreign substances (drugs, toxins)
Of the 3 functions, diuretics affect ECF composition and volume the most
(function one)
©COPYRIGHT 2026, ALL RIGHTS RESERVED 1
,The kidney produces effects on the ECF through three processes: - Correct answer-
1. Filtration - occurring at the glomerulus (for small molecules like electrolytes and
glucose; large molecules like lipids and proteins remain in the blood)
2. Reabsorption - takes place by way of active transport across water soluble
osmotic gradient; determines the contents of urine; diuretics work to interfere with
this process by blockading mainly sodium and chloride reabsorption which
prevents the passive reabsorption of water causing water and these electrolytes to
stay within the nephron and become excreted together
3. Active Secretion - located at pumps in the proximal convoluted tubule
How does aldosterone act on the nephrons? - Correct answer-As a principal
mineralocoticoid of the adrenal cortex, it stimulates reabsorption of sodium from
the distal nephron. Simultaneously, it causes potassium to be secreted.
Adverse effects of diuretics (as an overall drug class) - Correct answer-
Hypovolemia
Acid-Base Imbalances
©COPYRIGHT 2026, ALL RIGHTS RESERVED 2
, Altered Electrolyte Levels
Combat these by using short-acting diuretics and by timing dosing so that the
kidney has periods of operation unaffected by drug-induced diuresis
What is the function of carbonic anhydrase inhibitors? - Correct answer-They are
classed as diuretics but are employed primarily to lower intraocular pressure (IOP)
- they do not increase urine production.
Lasix (furosemide) - Correct answer-Classification: Loop Diuretic
Therapeutic Effects: Lowering of blood pressure by creating large volume loss and
substantial relaxation of venous smooth muscle contractions which reduces venous
return to the heart; Acts in loop of Henle to block sodium and chloride reabsorption
(which is usually a 20% reabsorption rate) so creates major DIURESIS
Adverse Reactions & side effects: Dehydration, hypochloremia, hypokalemia,
hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis, oliguria,
hyperglycemia, reduction of HDL cholesterol, increase in LDL and triglycerides
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
