Adult Health II Examination: Clinical
Assessment and Diagnostic Reasoning
Question 1
Patient Case 1
Patient Profile: 57-year-old individual presenting for a follow-up
of high blood pressure detected at a community
screening. Biometrics:
Height: 175 cm (5' 9")
Weight: 88.6 kg (195.0 lb) Vital Signs:
Blood Pressure: 158/96 mmHg (Manual, right arm, seated)
Heart Rate: 78 bpm, regular
Respiratory Rate: 16 bpm
Temperature: 36.8∘ C36.8∘ C Clinical Context: The patient reports
occasional dull headaches in the morning but denies chest pain, shortness
of breath, or visual changes. Their social history includes a sedentary
lifestyle and a diet high in processed foods.
A
Using the biometric data provided for the 57-year-old patient,
what is the calculated Body Mass Index (BMI) and its corresponding
classification?
2 marks
,(a)24.5kg/m224.5kg/m2 (Normal weight)
(b)26.8kg/m226.8kg/m2 (Overweight)
(c)31.2kg/m231.2kg/m2 (Obese)
(d)28.9kg/m228.9kg/m2 (Overweight)
Expected answer
The BMI is calculated as weight in kilograms divided by height in
meters
squared: 88.6/(1.752)=88.6/3.0625=28.9388.6/(1.752)=88.6/
3.0625=28.93. According to WHO/CDC guidelines, a BMI between
25.0 and 29.9 is classified as overweight.
B
According to the AHA/ACC guidelines, how should the 57-year-old
patient's blood pressure of 158/96 mmHg be classified?
,2 marks
(a)Stage 1 Hypertension
(b)Stage 2 Hypertension
(c)Elevated
(d)Hypertensive Urgency
Expected answer
Stage 2 Hypertension is defined as a systolic BP of at least 140
mmHg or a diastolic BP of at least 90 mmHg. The patient's
reading of 158/96 mmHg meets both criteria.
C
Which initial laboratory test is most appropriate to screen for
target organ damage in the 57-year-old patient?
2 marks
, (a)Serum Creatinine and GFR
(b)C-reactive protein (CRP)
(c)Liver Function Tests (LFTs)
(d)Thyroid Stimulating Hormone (TSH)
Expected answer
Assessment of renal function (Creatinine/GFR) is essential in
hypertension to screen for hypertensive nephropathy, a form of
target organ damage.
D
What is the most recommended dietary intervention for the 57-
year-old patient to assist in blood pressure management?
2 marks
(a)Ketogenic Diet
Assessment and Diagnostic Reasoning
Question 1
Patient Case 1
Patient Profile: 57-year-old individual presenting for a follow-up
of high blood pressure detected at a community
screening. Biometrics:
Height: 175 cm (5' 9")
Weight: 88.6 kg (195.0 lb) Vital Signs:
Blood Pressure: 158/96 mmHg (Manual, right arm, seated)
Heart Rate: 78 bpm, regular
Respiratory Rate: 16 bpm
Temperature: 36.8∘ C36.8∘ C Clinical Context: The patient reports
occasional dull headaches in the morning but denies chest pain, shortness
of breath, or visual changes. Their social history includes a sedentary
lifestyle and a diet high in processed foods.
A
Using the biometric data provided for the 57-year-old patient,
what is the calculated Body Mass Index (BMI) and its corresponding
classification?
2 marks
,(a)24.5kg/m224.5kg/m2 (Normal weight)
(b)26.8kg/m226.8kg/m2 (Overweight)
(c)31.2kg/m231.2kg/m2 (Obese)
(d)28.9kg/m228.9kg/m2 (Overweight)
Expected answer
The BMI is calculated as weight in kilograms divided by height in
meters
squared: 88.6/(1.752)=88.6/3.0625=28.9388.6/(1.752)=88.6/
3.0625=28.93. According to WHO/CDC guidelines, a BMI between
25.0 and 29.9 is classified as overweight.
B
According to the AHA/ACC guidelines, how should the 57-year-old
patient's blood pressure of 158/96 mmHg be classified?
,2 marks
(a)Stage 1 Hypertension
(b)Stage 2 Hypertension
(c)Elevated
(d)Hypertensive Urgency
Expected answer
Stage 2 Hypertension is defined as a systolic BP of at least 140
mmHg or a diastolic BP of at least 90 mmHg. The patient's
reading of 158/96 mmHg meets both criteria.
C
Which initial laboratory test is most appropriate to screen for
target organ damage in the 57-year-old patient?
2 marks
, (a)Serum Creatinine and GFR
(b)C-reactive protein (CRP)
(c)Liver Function Tests (LFTs)
(d)Thyroid Stimulating Hormone (TSH)
Expected answer
Assessment of renal function (Creatinine/GFR) is essential in
hypertension to screen for hypertensive nephropathy, a form of
target organ damage.
D
What is the most recommended dietary intervention for the 57-
year-old patient to assist in blood pressure management?
2 marks
(a)Ketogenic Diet
