RVTI Level 1 Certification Exam Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
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[SECTION 1: Hypertension & Hyperlipidemia — Questions 1-8]
Q1: A nurse is caring for a client who has a blood pressure reading of 128/82 mm Hg. According
to the ACC/AHA guidelines, which of the following classifications should the nurse assign to
this client?
A. Normal
B. Elevated
C. Hypertension Stage 1
D. Hypertension Stage 2
Correct Answer: C
Rationale: According to the 2017 ACC/AHA guidelines, a blood pressure of 128/82 mm Hg falls
into the category of Hypertension Stage 1, which is defined as a systolic blood pressure of 130–
139 mm Hg or a diastolic blood pressure of 80–89 mm Hg. Option A (Normal) is incorrect
because normal BP is defined as less than 120/80 mm Hg. Option B (Elevated) is incorrect
because elevated BP is systolic 120–129 mm Hg and diastolic less than 80 mm Hg. Option D
(Stage 2) is incorrect because it requires a systolic of 140 mm Hg or higher, or a diastolic of 90
mm Hg or higher.
Q2: A nurse is providing teaching about dietary modifications to a client who has a new
diagnosis of hypertension. Which of the following client statements indicates an understanding
of the teaching?
A. "I should drink at least three glasses of wine each evening to help relax my blood vessels."
B. "I will aim to consume no more than 2,300 mg of sodium per day."
C. "I will increase my intake of potassium-rich foods like bananas and sweet potatoes."
D. "I should replace red meat with fatty fish like salmon only once a month."
,2
Correct Answer: C
Rationale: Increasing intake of potassium-rich foods helps counteract the effects of sodium and
lower blood pressure, making this statement correct. Option A is incorrect because alcohol
should be limited (men to 2 drinks, women to 1), as excessive alcohol raises BP. Option B is
partially correct for the general population but clients with hypertension are often advised to aim
for a lower limit of 1,500 mg/day per the DASH diet for optimal results; however, among the
choices, C is the most proactive nutritional intervention for BP control. Option D is incorrect
because fatty fish (omega-3s) should be consumed at least twice a week to improve
cardiovascular health.
Q3: A client prescribed lisinopril for hypertension reports a persistent, dry cough. The nurse
recognizes that this adverse effect is due to which of the following mechanisms?
A. Beta-blockade leading to bronchoconstriction
B. Calcium channel blockade causing irritation
C. Accumulation of bradykinin in the lungs
D. Angiotensin II receptor blockade in the throat
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor, which blocks the breakdown of bradykinin; the
accumulation of bradykinin in the lungs is the direct cause of the dry, non-productive cough.
Option A is incorrect because beta-blockers can cause bronchospasm, but not via this specific
mechanism for ACEIs. Option B is incorrect because calcium channel blockers do not typically
cause a cough. Option D refers to ARBs (losartan), which do not affect bradykinin and are
typically prescribed if a patient develops an ACEI cough.
Q4: A nurse is reviewing the laboratory results of a client taking hydrochlorothiazide (HCTZ).
Which of the following findings should the nurse report to the provider immediately?
A. Sodium of 138 mEq/L
B. Potassium of 3.1 mEq/L
C. Calcium of 10.2 mg/dL
D. Magnesium of 1.8 mg/dL
, 3
Correct Answer: B
Rationale: Thiazide diuretics like HCTZ cause sodium and water excretion but also potassium
excretion (hypokalemia). A potassium level of 3.1 mEq/L is low and requires intervention to
prevent cardiac dysrhythmias. Option A is a normal sodium level. Option C is incorrect because
thiazides typically cause calcium retention (hypercalcemia is a risk, but 10.2 is borderline high
compared to the immediate risk of arrhythmia from hypokalemia). Option D is a normal
magnesium level.
Q5: A client with hyperlipidemia is prescribed atorvastatin. Which of the following instructions
should the nurse include in the teaching plan?
A. "Take this medication in the morning on an empty stomach."
B. "Expect to see results in your cholesterol levels within 24 hours."
C. "Report any unexplained muscle pain or weakness to the provider."
D. "You may take this medication with grapefruit juice to enhance absorption."
Correct Answer: C
Rationale: Statins can cause myopathy and rarely rhabdomyolysis, so clients must report muscle
pain or weakness immediately so the provider can check CK levels. Option A is incorrect
because statins are usually taken in the evening (though some long-acting ones can be taken any
time) to coincide with the body's natural cholesterol synthesis cycle, but food does not strictly
prohibit absorption for all types. Option B is incorrect because lipid-lowering effects take weeks
to manifest. Option D is incorrect because grapefruit juice inhibits CYP3A4, increasing the risk
of statin toxicity.
Q6: A nurse is performing an assessment on a client who is at risk for hypertension. Which of the
following modifiable risk factors should the nurse prioritize during teaching?
A. Family history of cardiovascular disease
B. Age over 60 years
C. Sedentary lifestyle
D. African American ethnicity