PHARMACOLOGY NURSING LEHNES
PHARMACOTHERAPEUTICS ACTUAL EXAM
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ The kidney produces effects on the ECF through three processes:
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?
,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)
Answer: Hypovolemia
Acid-Base Imbalances
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?
Answer: They are classed as diuretics but are employed primarily to
lower intraocular pressure (IOP) - they do not increase urine
production.
◉ Lasix (furosemide)
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
Nursing Implications & teaching:
-DIURESIS BEGINS WITHIN 30 MINUTES - drug to be taken early in
the day! Usually administered for situations that require massive
mobilization of fluid (pulmonary edema associated with HF, edema
of hepatic cardiac or renal origin unresponsive to other diuretics and
hypertension that is unaffected by other diuretics).
-Is more useful in patients with severe renal impairment because
when renal blood flow and GFR are low, it can still promote diuresis
(unlike thiazide diuretics)
-Monitor for unusual thirst, dry mouth, lethargy, hypotension
(weakness, dizziness, lightheadedness, fainting; combated by rising
slowly), oliguria and hearing impairment (ototoxicity-is transient
unless formed by ethacrynic acid which causes irreversible damage;
risk is increased if patient is on other ototoxic drugs such as
aminoglycoside antibiotics such as gentamicin)
PHARMACOTHERAPEUTICS ACTUAL EXAM
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉ The kidney produces effects on the ECF through three processes:
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?
,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)
Answer: Hypovolemia
Acid-Base Imbalances
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?
Answer: They are classed as diuretics but are employed primarily to
lower intraocular pressure (IOP) - they do not increase urine
production.
◉ Lasix (furosemide)
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
Nursing Implications & teaching:
-DIURESIS BEGINS WITHIN 30 MINUTES - drug to be taken early in
the day! Usually administered for situations that require massive
mobilization of fluid (pulmonary edema associated with HF, edema
of hepatic cardiac or renal origin unresponsive to other diuretics and
hypertension that is unaffected by other diuretics).
-Is more useful in patients with severe renal impairment because
when renal blood flow and GFR are low, it can still promote diuresis
(unlike thiazide diuretics)
-Monitor for unusual thirst, dry mouth, lethargy, hypotension
(weakness, dizziness, lightheadedness, fainting; combated by rising
slowly), oliguria and hearing impairment (ototoxicity-is transient
unless formed by ethacrynic acid which causes irreversible damage;
risk is increased if patient is on other ototoxic drugs such as
aminoglycoside antibiotics such as gentamicin)
