NURS 5434/ NURS5434 HTN Quiz –
Family III (FNP 3) Review| UTA (Latest
2026 Update) 100% Verified Questions &
Answers | Grade A+
Question 1
A 48-year-old Black male with a BP of 138/88 mmHg on two separate visits has no
diabetes or CKD. According to the 2024 ACC/AHA guidelines, which of the following is
the most appropriate next step?
• A. Start hydrochlorothiazide 12.5 mg daily
• B. Start amlodipine 5 mg daily
• C. Recommend lifestyle modifications and recheck in 3–6 months
• D. Start lisinopril 10 mg daily
✅ Answer: C – This patient has Elevated BP (120–129/<80) or Stage 1 HTN (130–
139/80–89) with low ASCVD risk (<10%). Non-pharmacologic therapy is first-line. In
Black patients with Stage 1 HTN, if drug therapy is indicated, a CCB or thiazide is
preferred (not ACEi as monotherapy), but here drug therapy is not yet indicated.
Question 2
A 62-year-old female with diabetes (eGFR 55 mL/min) and BP 148/90 mmHg. What is
the goal BP per 2025 ISH guidelines for high-risk patients?
• A. <140/90 mmHg
• B. <135/85 mmHg
• C. <130/80 mmHg
• D. <120/80 mmHg
,✅ Answer: C – High-risk patients (CKD, diabetes, CAD, or 10-year ASCVD risk ≥10%)
have a goal BP of <130/80 mmHg (2024 ACC/AHA and 2025 ISH).
Question 3
A 55-year-old patient is on lisinopril 40 mg daily and amlodipine 10 mg daily. BP today
is 152/94 mmHg. Heart rate is 72 bpm. Which of the following is the best third agent to
add?
• A. Clonidine
• B. Hydralazine
• C. Chlorthalidone 12.5 mg
• D. Metoprolol succinate 50 mg
✅ Answer: C – The patient is already on an ACEi and CCB. Adding a thiazide-like
diuretic (chlorthalidone) is the recommended 3rd agent for resistant HTN per the “A +
C + D” regimen. Beta-blockers are not first-line unless specific indications (HF, angina,
post-MI).
Question 4
A 30-year-old pregnant female (12 weeks gestation) has BP 150/96 mmHg on two visits.
She has no proteinuria. What is the preferred initial antihypertensive?
• A. Lisinopril
• B. Losartan
• C. Labetalol
• D. Hydrochlorothiazide
✅ Answer: C – In pregnancy, safe agents include labetalol, nifedipine (ER), and
methyldopa. ACEis (lisinopril) and ARBs (losartan) are contraindicated due to
fetotoxicity. Thiazides are not first-line.
, Question 5
A 72-year-old male with orthostatic hypotension, falls history, and BP 162/88 mmHg in
clinic. Which of the following is most appropriate?
• A. Start amlodipine 10 mg daily
• B. Start losartan 50 mg daily
• C. Start amlodipine 2.5 mg daily and check standing BP
• D. No treatment due to age
✅ Answer: C – Older adults with HTN benefit from treatment, but start low dose (e.g.,
amlodipine 2.5 mg) and monitor for orthostasis. Goal BP is <130/80 if tolerates; avoid
aggressive lowering in frail elderly.
Question 6
Which of the following medication classes has been shown to reduce cardiovascular
events in hypertensive patients with heart failure with reduced ejection fraction
(HFrEF) but is not recommended as monotherapy for uncomplicated hypertension?
• A. Thiazide diuretics
• B. Dihydropyridine CCBs (amlodipine)
• C. Beta-blockers (carvedilol, metoprolol succinate)
• D. Alpha-blockers (doxazosin)
✅ Answer: D – Alpha-blockers (doxazosin) are not first-line for HTN due to increased
risk of HF and lack of CV outcome benefit. They are used for BPH. Beta-blockers are not
first-line for uncomplicated HTN but are indicated in HFrEF.
Question 7
A patient’s home BP log averages 145/90 mmHg. Clinic BP is 160/92 mmHg. No target
organ damage. This is most consistent with:
• A. Masked hypertension
Family III (FNP 3) Review| UTA (Latest
2026 Update) 100% Verified Questions &
Answers | Grade A+
Question 1
A 48-year-old Black male with a BP of 138/88 mmHg on two separate visits has no
diabetes or CKD. According to the 2024 ACC/AHA guidelines, which of the following is
the most appropriate next step?
• A. Start hydrochlorothiazide 12.5 mg daily
• B. Start amlodipine 5 mg daily
• C. Recommend lifestyle modifications and recheck in 3–6 months
• D. Start lisinopril 10 mg daily
✅ Answer: C – This patient has Elevated BP (120–129/<80) or Stage 1 HTN (130–
139/80–89) with low ASCVD risk (<10%). Non-pharmacologic therapy is first-line. In
Black patients with Stage 1 HTN, if drug therapy is indicated, a CCB or thiazide is
preferred (not ACEi as monotherapy), but here drug therapy is not yet indicated.
Question 2
A 62-year-old female with diabetes (eGFR 55 mL/min) and BP 148/90 mmHg. What is
the goal BP per 2025 ISH guidelines for high-risk patients?
• A. <140/90 mmHg
• B. <135/85 mmHg
• C. <130/80 mmHg
• D. <120/80 mmHg
,✅ Answer: C – High-risk patients (CKD, diabetes, CAD, or 10-year ASCVD risk ≥10%)
have a goal BP of <130/80 mmHg (2024 ACC/AHA and 2025 ISH).
Question 3
A 55-year-old patient is on lisinopril 40 mg daily and amlodipine 10 mg daily. BP today
is 152/94 mmHg. Heart rate is 72 bpm. Which of the following is the best third agent to
add?
• A. Clonidine
• B. Hydralazine
• C. Chlorthalidone 12.5 mg
• D. Metoprolol succinate 50 mg
✅ Answer: C – The patient is already on an ACEi and CCB. Adding a thiazide-like
diuretic (chlorthalidone) is the recommended 3rd agent for resistant HTN per the “A +
C + D” regimen. Beta-blockers are not first-line unless specific indications (HF, angina,
post-MI).
Question 4
A 30-year-old pregnant female (12 weeks gestation) has BP 150/96 mmHg on two visits.
She has no proteinuria. What is the preferred initial antihypertensive?
• A. Lisinopril
• B. Losartan
• C. Labetalol
• D. Hydrochlorothiazide
✅ Answer: C – In pregnancy, safe agents include labetalol, nifedipine (ER), and
methyldopa. ACEis (lisinopril) and ARBs (losartan) are contraindicated due to
fetotoxicity. Thiazides are not first-line.
, Question 5
A 72-year-old male with orthostatic hypotension, falls history, and BP 162/88 mmHg in
clinic. Which of the following is most appropriate?
• A. Start amlodipine 10 mg daily
• B. Start losartan 50 mg daily
• C. Start amlodipine 2.5 mg daily and check standing BP
• D. No treatment due to age
✅ Answer: C – Older adults with HTN benefit from treatment, but start low dose (e.g.,
amlodipine 2.5 mg) and monitor for orthostasis. Goal BP is <130/80 if tolerates; avoid
aggressive lowering in frail elderly.
Question 6
Which of the following medication classes has been shown to reduce cardiovascular
events in hypertensive patients with heart failure with reduced ejection fraction
(HFrEF) but is not recommended as monotherapy for uncomplicated hypertension?
• A. Thiazide diuretics
• B. Dihydropyridine CCBs (amlodipine)
• C. Beta-blockers (carvedilol, metoprolol succinate)
• D. Alpha-blockers (doxazosin)
✅ Answer: D – Alpha-blockers (doxazosin) are not first-line for HTN due to increased
risk of HF and lack of CV outcome benefit. They are used for BPH. Beta-blockers are not
first-line for uncomplicated HTN but are indicated in HFrEF.
Question 7
A patient’s home BP log averages 145/90 mmHg. Clinic BP is 160/92 mmHg. No target
organ damage. This is most consistent with:
• A. Masked hypertension
