NURS 5434/ NURS5434 HTN Quiz – Family III
(FNP 3) Review | UTA (Latest 2026 Update)
100% Verified Questions & Answers | Grade A+
Question 1
A 55-year-old male with a BMI of 32 kg/m² presents with BP readings of 128/78
mmHg on two separate visits. He has no diabetes, CKD, or known cardiovascular
disease. His 10-year ASCVD risk is 6%. 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 1 year
• D. Start lisinopril 10 mg daily
Answer: C – This patient has Elevated BP (120–129/<80) with low ASCVD
risk (<10%). Non-pharmacologic therapy including weight loss, DASH diet,
and sodium restriction is first-line. Pharmacologic therapy is not indicated at
this stage.
Question 2
A 68-year-old female with type 2 diabetes (HbA1c 7.2%), eGFR 48 mL/min, and
urine albumin-to-creatinine ratio of 300 mg/g has a BP of 142/86 mmHg. What is
the goal BP per 2024 ACC/AHA guidelines for this patient?
• A. <140/90 mmHg
• B. <135/85 mmHg
• C. <130/80 mmHg
• D. <120/80 mmHg
,Answer: C – High-risk patients with CKD, diabetes, or established CVD have
a goal BP of <130/80 mmHg. The presence of albuminuria further increases
cardiovascular risk, supporting intensive BP control.
Question 3
A 45-year-old White male with Stage 1 hypertension (BP 136/84 mmHg) and a 10-
year ASCVD risk of 12% has failed 6 months of lifestyle modifications. Which of
the following is the most appropriate initial pharmacologic agent?
• A. Hydrochlorothiazide 12.5 mg daily
• B. Amlodipine 5 mg daily
• C. Lisinopril 10 mg daily
• D. Metoprolol tartrate 25 mg twice daily
Answer: C – For non-Black patients with Stage 1 HTN and ASCVD risk
≥10%, first-line agents include ACE inhibitors (lisinopril), ARBs, CCBs, or
thiazides. ACE inhibitors are preferred in patients with diabetes or CKD, but
any first-line agent is appropriate. Beta-blockers are not first-line for
uncomplicated HTN.
Question 4
A 60-year-old Black female with a BP of 142/90 mmHg on three separate visits
has no comorbidities. Her 10-year ASCVD risk is 8%. She has been adherent to
lifestyle modifications for 4 months. What is the most appropriate initial
antihypertensive medication?
• A. Lisinopril 10 mg daily
• B. Losartan 50 mg daily
• C. Amlodipine 5 mg daily
• D. Metoprolol succinate 50 mg daily
Answer: C – In Black patients with hypertension (without CKD or heart
failure), initial therapy should be a CCB (amlodipine) or thiazide diuretic.
,ACE inhibitors and ARBs are less effective as monotherapy in Black patients
due to lower renin profiles.
Question 5
A 72-year-old male with a history of coronary artery disease and prior MI presents
with BP of 148/84 mmHg. He is currently on aspirin, atorvastatin, and metoprolol
succinate. What is the most appropriate next step?
• A. Add amlodipine 5 mg daily
• B. Add lisinopril 5 mg daily
• C. Increase metoprolol succinate to 100 mg daily
• D. Add hydrochlorothiazide 12.5 mg daily
Answer: B – Patients with CAD and hypertension benefit from ACE
inhibitors (or ARBs) for secondary prevention, regardless of BP. Adding
lisinopril provides both BP control and cardiovascular protection. Beta-
blocker is already on board.
Question 6
A 35-year-old pregnant female at 28 weeks gestation has BP readings of 158/96
mmHg and 160/94 mmHg on two visits 1 week apart. She has no proteinuria.
Which of the following is the preferred initial antihypertensive agent?
• A. Lisinopril
• B. Valsartan
• C. Methyldopa
• D. Hydrochlorothiazide
Answer: C – Methyldopa, labetalol, and nifedipine ER are first-line agents for
hypertension in pregnancy. ACE inhibitors (lisinopril) and ARBs (valsartan)
are contraindicated due to fetal renal agenesis, oligohydramnios, and neonatal
death.
, Question 7
A 50-year-old male with BP 152/94 mmHg is started on lisinopril 10 mg daily. He
returns 4 weeks later with BP 148/90 mmHg and complaints of a dry, annoying
cough that started 2 weeks ago. What is the most appropriate next step?
• A. Continue lisinopril and add amlodipine
• B. Add a thiazide diuretic
• C. Switch to losartan 50 mg daily
• D. Switch to amlodipine 5 mg daily
Answer: C – ACE inhibitor-induced cough (5-20% of patients) is a class
effect. Switching to an ARB (losartan) is recommended, as ARBs have a much
lower incidence of cough while providing similar cardiovascular benefits.
Question 8
A 65-year-old female with heart failure with preserved ejection fraction (HFpEF)
and hypertension has a BP of 144/82 mmHg. She is currently on furosemide 40 mg
daily. Which medication class should be added for optimal BP and heart failure
management?
• A. Amlodipine
• B. Spironolactone
• C. Hydralazine
• D. Doxazosin
Answer: B – In patients with HFpEF and hypertension, mineralocorticoid
receptor antagonists (spironolactone) improve outcomes. Amlodipine is not
beneficial in HFpEF. Hydralazine and doxazosin are not first-line.
Question 9
A 58-year-old male with resistant hypertension is on maximal doses of lisinopril
(40 mg), amlodipine (10 mg), and chlorthalidone (25 mg). BP remains 156/92
(FNP 3) Review | UTA (Latest 2026 Update)
100% Verified Questions & Answers | Grade A+
Question 1
A 55-year-old male with a BMI of 32 kg/m² presents with BP readings of 128/78
mmHg on two separate visits. He has no diabetes, CKD, or known cardiovascular
disease. His 10-year ASCVD risk is 6%. 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 1 year
• D. Start lisinopril 10 mg daily
Answer: C – This patient has Elevated BP (120–129/<80) with low ASCVD
risk (<10%). Non-pharmacologic therapy including weight loss, DASH diet,
and sodium restriction is first-line. Pharmacologic therapy is not indicated at
this stage.
Question 2
A 68-year-old female with type 2 diabetes (HbA1c 7.2%), eGFR 48 mL/min, and
urine albumin-to-creatinine ratio of 300 mg/g has a BP of 142/86 mmHg. What is
the goal BP per 2024 ACC/AHA guidelines for this patient?
• A. <140/90 mmHg
• B. <135/85 mmHg
• C. <130/80 mmHg
• D. <120/80 mmHg
,Answer: C – High-risk patients with CKD, diabetes, or established CVD have
a goal BP of <130/80 mmHg. The presence of albuminuria further increases
cardiovascular risk, supporting intensive BP control.
Question 3
A 45-year-old White male with Stage 1 hypertension (BP 136/84 mmHg) and a 10-
year ASCVD risk of 12% has failed 6 months of lifestyle modifications. Which of
the following is the most appropriate initial pharmacologic agent?
• A. Hydrochlorothiazide 12.5 mg daily
• B. Amlodipine 5 mg daily
• C. Lisinopril 10 mg daily
• D. Metoprolol tartrate 25 mg twice daily
Answer: C – For non-Black patients with Stage 1 HTN and ASCVD risk
≥10%, first-line agents include ACE inhibitors (lisinopril), ARBs, CCBs, or
thiazides. ACE inhibitors are preferred in patients with diabetes or CKD, but
any first-line agent is appropriate. Beta-blockers are not first-line for
uncomplicated HTN.
Question 4
A 60-year-old Black female with a BP of 142/90 mmHg on three separate visits
has no comorbidities. Her 10-year ASCVD risk is 8%. She has been adherent to
lifestyle modifications for 4 months. What is the most appropriate initial
antihypertensive medication?
• A. Lisinopril 10 mg daily
• B. Losartan 50 mg daily
• C. Amlodipine 5 mg daily
• D. Metoprolol succinate 50 mg daily
Answer: C – In Black patients with hypertension (without CKD or heart
failure), initial therapy should be a CCB (amlodipine) or thiazide diuretic.
,ACE inhibitors and ARBs are less effective as monotherapy in Black patients
due to lower renin profiles.
Question 5
A 72-year-old male with a history of coronary artery disease and prior MI presents
with BP of 148/84 mmHg. He is currently on aspirin, atorvastatin, and metoprolol
succinate. What is the most appropriate next step?
• A. Add amlodipine 5 mg daily
• B. Add lisinopril 5 mg daily
• C. Increase metoprolol succinate to 100 mg daily
• D. Add hydrochlorothiazide 12.5 mg daily
Answer: B – Patients with CAD and hypertension benefit from ACE
inhibitors (or ARBs) for secondary prevention, regardless of BP. Adding
lisinopril provides both BP control and cardiovascular protection. Beta-
blocker is already on board.
Question 6
A 35-year-old pregnant female at 28 weeks gestation has BP readings of 158/96
mmHg and 160/94 mmHg on two visits 1 week apart. She has no proteinuria.
Which of the following is the preferred initial antihypertensive agent?
• A. Lisinopril
• B. Valsartan
• C. Methyldopa
• D. Hydrochlorothiazide
Answer: C – Methyldopa, labetalol, and nifedipine ER are first-line agents for
hypertension in pregnancy. ACE inhibitors (lisinopril) and ARBs (valsartan)
are contraindicated due to fetal renal agenesis, oligohydramnios, and neonatal
death.
, Question 7
A 50-year-old male with BP 152/94 mmHg is started on lisinopril 10 mg daily. He
returns 4 weeks later with BP 148/90 mmHg and complaints of a dry, annoying
cough that started 2 weeks ago. What is the most appropriate next step?
• A. Continue lisinopril and add amlodipine
• B. Add a thiazide diuretic
• C. Switch to losartan 50 mg daily
• D. Switch to amlodipine 5 mg daily
Answer: C – ACE inhibitor-induced cough (5-20% of patients) is a class
effect. Switching to an ARB (losartan) is recommended, as ARBs have a much
lower incidence of cough while providing similar cardiovascular benefits.
Question 8
A 65-year-old female with heart failure with preserved ejection fraction (HFpEF)
and hypertension has a BP of 144/82 mmHg. She is currently on furosemide 40 mg
daily. Which medication class should be added for optimal BP and heart failure
management?
• A. Amlodipine
• B. Spironolactone
• C. Hydralazine
• D. Doxazosin
Answer: B – In patients with HFpEF and hypertension, mineralocorticoid
receptor antagonists (spironolactone) improve outcomes. Amlodipine is not
beneficial in HFpEF. Hydralazine and doxazosin are not first-line.
Question 9
A 58-year-old male with resistant hypertension is on maximal doses of lisinopril
(40 mg), amlodipine (10 mg), and chlorthalidone (25 mg). BP remains 156/92
