COMSAE Form 110 Exam Study Guide 2026 |
Comprehensive Practice Questions & Verified
Answers | A+ Review Resource
1. According to the 2017 ACC/AHA guidelines, which of the following blood
pressure readings defines Stage 1 hypertension?
a) SBP < 120 and DBP < 80
b) SBP 120-129 and DBP < 80
c) SBP 130-139 or DBP 80-89
d) SBP ≥ 140 or DBP ≥ 90
Answer: c) SBP 130-139 or DBP 80-89
Rationale: The 2017 ACC/AHA guidelines define Stage 1 hypertension as a systolic
BP of 130-139 mmHg OR a diastolic BP of 80-89 mmHg. This lower threshold was
established to promote earlier intervention and prevent cardiovascular
complications. [User Notes]
2. A 45-year-old patient has a blood pressure reading of 118/76 mmHg.
According to the 2017 ACC/AHA guidelines, how should this be classified?
a) Elevated blood pressure
b) Normal blood pressure
c) Stage 1 hypertension
d) Stage 2 hypertension
Answer: b) Normal blood pressure
Rationale: Normal blood pressure is defined as SBP < 120 mmHg AND DBP < 80
mmHg. This patient's reading of 118/76 falls within this range. [User Notes]
3. A 52-year-old patient presents with a blood pressure of 125/78 mmHg. How
would you classify this reading?
a) Normal
b) Elevated
c) Stage 1 hypertension
d) Stage 2 hypertension
,Answer: b) Elevated
Rationale: Elevated blood pressure is defined as SBP 120-129 mmHg AND DBP <
80 mmHg. This patient's SBP of 125 with DBP of 78 meets these criteria. Lifestyle
modification is typically recommended at this stage. [User Notes]
4. A 60-year-old patient with no other comorbidities has a blood pressure of
145/92 mmHg on three separate occasions. What is the diagnosis?
a) Normal blood pressure
b) Elevated blood pressure
c) Stage 1 hypertension
d) Stage 2 hypertension
Answer: d) Stage 2 hypertension
Rationale: Stage 2 hypertension is defined as SBP ≥ 140 mmHg OR DBP ≥ 90
mmHg. This patient's readings consistently exceed both thresholds, indicating
Stage 2 hypertension requiring pharmacologic intervention. [User Notes]
5. How is hypertensive urgency different from hypertensive emergency?
a) Hypertensive urgency involves evidence of end-organ damage, while
hypertensive emergency does not
b) Hypertensive emergency involves evidence of acute end-organ damage, while
hypertensive urgency does not
c) Hypertensive urgency has higher blood pressure readings than hypertensive
emergency
d) They are the same condition with different names
Answer: b) Hypertensive emergency involves evidence of acute end-organ
damage, while hypertensive urgency does not
Rationale: The key distinction is the presence of acute target organ damage.
Hypertensive emergency presents with severely elevated BP (often >180/120)
accompanied by acute end-organ damage such as encephalopathy, intracranial
hemorrhage, acute myocardial infarction, acute renal failure, or aortic dissection.
Hypertensive urgency is severely elevated BP without evidence of acute end-
organ damage. [User Notes]
6. A 65-year-old patient presents with BP 210/120 mmHg, severe headache,
confusion, and papilledema on fundoscopic exam. What is the most appropriate
diagnosis and management?
, a) Hypertensive urgency; oral antihypertensives and outpatient follow-up
b) Hypertensive emergency; immediate admission to ICU with intravenous
antihypertensives
c) Stage 2 hypertension; start oral lisinopril and recheck in 2 weeks
d) Panic attack; observe and reassess
Answer: b) Hypertensive emergency; immediate admission to ICU with
intravenous antihypertensives
Rationale: This patient has severely elevated BP with evidence of acute end-organ
damage (hypertensive encephalopathy evidenced by confusion and papilledema).
This constitutes a hypertensive emergency requiring immediate hospitalization,
ICU-level care, and carefully controlled reduction of BP with IV antihypertensives
like nicardipine or labetalol.
7. Which of the following intravenous antihypertensives is a calcium channel
blocker commonly used in hypertensive emergencies?
a) Labetalol
b) Sodium nitroprusside
c) Nicardipine
d) Nitroglycerin
Answer: c) Nicardipine
Rationale: Nicardipine is a dihydropyridine calcium channel blocker that is
administered intravenously for hypertensive emergencies. It provides predictable,
titratable BP reduction with a favorable safety profile. Labetalol is a combined
alpha/beta blocker, sodium nitroprusside is a direct vasodilator, and nitroglycerin
is primarily a venodilator.
8. A 55-year-old African American male with Stage 1 hypertension and no
comorbidities is started on lifestyle modifications. After 6 months, his BP
remains 135/85 mmHg. According to guidelines, what is the next best step?
a) Continue lifestyle modifications alone for another 6 months
b) Initiate monotherapy with a thiazide diuretic or calcium channel blocker
c) Start an ACE inhibitor as first-line therapy
d) Add a beta-blocker
Answer: b) Initiate monotherapy with a thiazide diuretic or calcium channel
blocker
Comprehensive Practice Questions & Verified
Answers | A+ Review Resource
1. According to the 2017 ACC/AHA guidelines, which of the following blood
pressure readings defines Stage 1 hypertension?
a) SBP < 120 and DBP < 80
b) SBP 120-129 and DBP < 80
c) SBP 130-139 or DBP 80-89
d) SBP ≥ 140 or DBP ≥ 90
Answer: c) SBP 130-139 or DBP 80-89
Rationale: The 2017 ACC/AHA guidelines define Stage 1 hypertension as a systolic
BP of 130-139 mmHg OR a diastolic BP of 80-89 mmHg. This lower threshold was
established to promote earlier intervention and prevent cardiovascular
complications. [User Notes]
2. A 45-year-old patient has a blood pressure reading of 118/76 mmHg.
According to the 2017 ACC/AHA guidelines, how should this be classified?
a) Elevated blood pressure
b) Normal blood pressure
c) Stage 1 hypertension
d) Stage 2 hypertension
Answer: b) Normal blood pressure
Rationale: Normal blood pressure is defined as SBP < 120 mmHg AND DBP < 80
mmHg. This patient's reading of 118/76 falls within this range. [User Notes]
3. A 52-year-old patient presents with a blood pressure of 125/78 mmHg. How
would you classify this reading?
a) Normal
b) Elevated
c) Stage 1 hypertension
d) Stage 2 hypertension
,Answer: b) Elevated
Rationale: Elevated blood pressure is defined as SBP 120-129 mmHg AND DBP <
80 mmHg. This patient's SBP of 125 with DBP of 78 meets these criteria. Lifestyle
modification is typically recommended at this stage. [User Notes]
4. A 60-year-old patient with no other comorbidities has a blood pressure of
145/92 mmHg on three separate occasions. What is the diagnosis?
a) Normal blood pressure
b) Elevated blood pressure
c) Stage 1 hypertension
d) Stage 2 hypertension
Answer: d) Stage 2 hypertension
Rationale: Stage 2 hypertension is defined as SBP ≥ 140 mmHg OR DBP ≥ 90
mmHg. This patient's readings consistently exceed both thresholds, indicating
Stage 2 hypertension requiring pharmacologic intervention. [User Notes]
5. How is hypertensive urgency different from hypertensive emergency?
a) Hypertensive urgency involves evidence of end-organ damage, while
hypertensive emergency does not
b) Hypertensive emergency involves evidence of acute end-organ damage, while
hypertensive urgency does not
c) Hypertensive urgency has higher blood pressure readings than hypertensive
emergency
d) They are the same condition with different names
Answer: b) Hypertensive emergency involves evidence of acute end-organ
damage, while hypertensive urgency does not
Rationale: The key distinction is the presence of acute target organ damage.
Hypertensive emergency presents with severely elevated BP (often >180/120)
accompanied by acute end-organ damage such as encephalopathy, intracranial
hemorrhage, acute myocardial infarction, acute renal failure, or aortic dissection.
Hypertensive urgency is severely elevated BP without evidence of acute end-
organ damage. [User Notes]
6. A 65-year-old patient presents with BP 210/120 mmHg, severe headache,
confusion, and papilledema on fundoscopic exam. What is the most appropriate
diagnosis and management?
, a) Hypertensive urgency; oral antihypertensives and outpatient follow-up
b) Hypertensive emergency; immediate admission to ICU with intravenous
antihypertensives
c) Stage 2 hypertension; start oral lisinopril and recheck in 2 weeks
d) Panic attack; observe and reassess
Answer: b) Hypertensive emergency; immediate admission to ICU with
intravenous antihypertensives
Rationale: This patient has severely elevated BP with evidence of acute end-organ
damage (hypertensive encephalopathy evidenced by confusion and papilledema).
This constitutes a hypertensive emergency requiring immediate hospitalization,
ICU-level care, and carefully controlled reduction of BP with IV antihypertensives
like nicardipine or labetalol.
7. Which of the following intravenous antihypertensives is a calcium channel
blocker commonly used in hypertensive emergencies?
a) Labetalol
b) Sodium nitroprusside
c) Nicardipine
d) Nitroglycerin
Answer: c) Nicardipine
Rationale: Nicardipine is a dihydropyridine calcium channel blocker that is
administered intravenously for hypertensive emergencies. It provides predictable,
titratable BP reduction with a favorable safety profile. Labetalol is a combined
alpha/beta blocker, sodium nitroprusside is a direct vasodilator, and nitroglycerin
is primarily a venodilator.
8. A 55-year-old African American male with Stage 1 hypertension and no
comorbidities is started on lifestyle modifications. After 6 months, his BP
remains 135/85 mmHg. According to guidelines, what is the next best step?
a) Continue lifestyle modifications alone for another 6 months
b) Initiate monotherapy with a thiazide diuretic or calcium channel blocker
c) Start an ACE inhibitor as first-line therapy
d) Add a beta-blocker
Answer: b) Initiate monotherapy with a thiazide diuretic or calcium channel
blocker
