Page 1 of 489
HCA100 FINAL EXAM – 100 FULLY SOLVED
QUESTIONS WITH ANSWERS GRADED A+
ASSURED SUCCESS
1. A 62-year-old male with a history of hypertension and type
2 diabetes presents for a follow-up. His blood pressure is
144/88 mm Hg. He is adherent to lisinopril 20 mg daily. What
is the most appropriate next step?
A) Increase lisinopril to 40 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Switch to losartan 50 mg daily
Answer: B) Add amlodipine 5 mg daily
Rationale: The patient’s BP is above goal (<130/80 for
diabetes). Adding a calcium channel blocker is a standard next
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step. ACE inhibitors can be increased, but combination therapy
often provides better control. Thiazides may be added later, but
CCBs are a common second agent.
2. A 55-year-old female presents with episodes of substernal
chest pressure when walking uphill, relieved by rest. She has
a 20-year smoking history. What is the most appropriate
initial diagnostic test?
A) Exercise treadmill test
B) Coronary computed tomography angiography
C) Resting ECG
D) Echocardiogram
Answer: A) Exercise treadmill test
Rationale: The patient has stable angina symptoms and is able
to exercise. An exercise ECG is a reasonable initial test for
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diagnosis of coronary artery disease in a patient with
intermediate pretest probability.
3. A 70-year-old male with heart failure with reduced ejection
fraction (HFrEF) is on carvedilol, lisinopril, and furosemide. He
reports a weight gain of 5 pounds in 3 days and increased
dyspnea. What is the priority action?
A) Increase furosemide dose
B) Add spironolactone
C) Hospitalize for intravenous diuresis
D) Order an echocardiogram
Answer: C) Hospitalize for intravenous diuresis
Rationale: Rapid weight gain with worsening symptoms indicates
acute decompensated heart failure. Hospitalization is warranted
for intravenous diuretics and monitoring.
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4. A 68-year-old female with chronic atrial fibrillation is on
warfarin. Her INR today is 3.8. She has no bleeding. What
should the nurse practitioner do?
A) Administer vitamin K 2.5 mg orally
B) Hold warfarin for 1 day and recheck INR
C) Decrease warfarin dose and recheck in 1 week
D) No change
Answer: B) Hold warfarin for 1 day and recheck INR
Rationale: For an INR of 3.8 (target 2-3), holding one dose is
appropriate. Vitamin K is reserved for INR >10 or bleeding. A
dose reduction may follow after reassessment.
5. A 45-year-old male presents with a blood pressure of
152/96 mm Hg on two separate visits. He has no other
HCA100 FINAL EXAM – 100 FULLY SOLVED
QUESTIONS WITH ANSWERS GRADED A+
ASSURED SUCCESS
1. A 62-year-old male with a history of hypertension and type
2 diabetes presents for a follow-up. His blood pressure is
144/88 mm Hg. He is adherent to lisinopril 20 mg daily. What
is the most appropriate next step?
A) Increase lisinopril to 40 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Switch to losartan 50 mg daily
Answer: B) Add amlodipine 5 mg daily
Rationale: The patient’s BP is above goal (<130/80 for
diabetes). Adding a calcium channel blocker is a standard next
,Page 2 of 489
step. ACE inhibitors can be increased, but combination therapy
often provides better control. Thiazides may be added later, but
CCBs are a common second agent.
2. A 55-year-old female presents with episodes of substernal
chest pressure when walking uphill, relieved by rest. She has
a 20-year smoking history. What is the most appropriate
initial diagnostic test?
A) Exercise treadmill test
B) Coronary computed tomography angiography
C) Resting ECG
D) Echocardiogram
Answer: A) Exercise treadmill test
Rationale: The patient has stable angina symptoms and is able
to exercise. An exercise ECG is a reasonable initial test for
,Page 3 of 489
diagnosis of coronary artery disease in a patient with
intermediate pretest probability.
3. A 70-year-old male with heart failure with reduced ejection
fraction (HFrEF) is on carvedilol, lisinopril, and furosemide. He
reports a weight gain of 5 pounds in 3 days and increased
dyspnea. What is the priority action?
A) Increase furosemide dose
B) Add spironolactone
C) Hospitalize for intravenous diuresis
D) Order an echocardiogram
Answer: C) Hospitalize for intravenous diuresis
Rationale: Rapid weight gain with worsening symptoms indicates
acute decompensated heart failure. Hospitalization is warranted
for intravenous diuretics and monitoring.
, Page 4 of 489
4. A 68-year-old female with chronic atrial fibrillation is on
warfarin. Her INR today is 3.8. She has no bleeding. What
should the nurse practitioner do?
A) Administer vitamin K 2.5 mg orally
B) Hold warfarin for 1 day and recheck INR
C) Decrease warfarin dose and recheck in 1 week
D) No change
Answer: B) Hold warfarin for 1 day and recheck INR
Rationale: For an INR of 3.8 (target 2-3), holding one dose is
appropriate. Vitamin K is reserved for INR >10 or bleeding. A
dose reduction may follow after reassessment.
5. A 45-year-old male presents with a blood pressure of
152/96 mm Hg on two separate visits. He has no other
