Cardiac Questions and Answers 2022 from Fitzgerald
1. You examine a 38-year-old woman who has presented for an initial examination
and Papanicolaou test. She has no complaint. Her blood pressure (BP) is 154/98 mm
Hg bilaterally and her body mass index (BMI) is 31 kg/m2. The rest of her physical
examination is unremarkable. Your next best action is to:
A. initiate antihypertensive therapy.
B. arrange for at least two additional BP measurements during the next 2 weeks.
C. order blood urea nitrogen, creatinine, and potassium ion measurements and
urinalysis.
D. advise her to reduce her sodium intake.
B. arrange for at least two additional BP measurements during the next 2 weeks.
Per ACC/AHA 2017 guideline: Because individual BP measurements tend to vary in an
unpredictable or random fashion, a single reading is inadequate for clinical decision-
making. An average of 2 to 3 BP measurements obtained on 2 to 3 separate occasions
will minimize random error and provide a more accurate basis for estimation of BP.
2. You see a 68-year-old woman as a patient who is transferring care into your
practice. She has a 10-year history of hypertension, diabetes mellitus, and
hyperlipidemia.
Current medications include hydrochlorothiazide (HCTZ), glipizide, metformin,
simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92 mm Hg, and
the rest of her history and examination are unremarkable. Documentation from her
former healthcare provider indicates that her BP has been in the range for the past 12
months. Your next best action is to:
A. prescribe an angiotensin-converting enzyme inhibitor (ACEI).
B. have her return for a BP check in 1 week.
C. advise that her current therapy is adequate.
D. add therapy with an aldosterone antagonist.
A. prescribe an angiotensin-converting enzyme inhibitor (ACEI).
,Per ACC/AHA 2017 guideline:
patient is Stage 2 Hypertension (BP ≥ 140/90 mm Hg) ...
goal is >130/80
In adults with DM and hypertension, all first-line classes of antihypertensive agents (i.e.,
diuretics, ACE inhibitors, ARBs, and CCBs) are useful and effective.
*** multiple medications are usually required to control hypertension in persons with
diabetes.
3. You examine a 78-year-old woman with long-standing, poorly controlled
hypertension. When evaluating her for hypertensive target organ damage, you look
for evidence of:
A. lipid abnormalities.
B. insulin resistance.
C. left ventricular hypertrophy.
D. clotting disorders.
C. left ventricular hypertrophy.
4. Diagnostic testing for a patient with newly diagnosed primary hypertension should
include all of the following except:
A. hematocrit.
B. uric acid.
C. creatinine.
D. potassium.
B. uric acid.
,clinical and laboratory findings are mainly referable to involvement of the target organs:
heart, brain, kidneys, eyes, and peripheral arteries.
5. In the person with hypertension, the nurse practitioner (NP) recommends all of the
following to potentially reduce BP in a patient with a BMI of 30 kg/m2 except:
A. 10-kg (22-lb) weight loss.
B. dietary sodium restriction to 2.4 g (6 g NaCl) per day.
C. regular aerobic physical activity, such as 30-40 minutes of brisk walking most days of
the week.
D. consuming at least 1-2 servings of alcohol.
D. consuming at least 1-2 servings of alcohol.
6. amlodipine -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
C. dihydropyridine calcium channel blocker
7. diltiazem -- which medication class
A. beta-adrenergic receptor antagonist
, B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
B. nondihydropyridine calcium channel blocker
7. diltiazem -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
B. nondihydropyridine calcium channel blocker
10. pindolol -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
A. beta-adrenergic receptor antagonist
1. You examine a 38-year-old woman who has presented for an initial examination
and Papanicolaou test. She has no complaint. Her blood pressure (BP) is 154/98 mm
Hg bilaterally and her body mass index (BMI) is 31 kg/m2. The rest of her physical
examination is unremarkable. Your next best action is to:
A. initiate antihypertensive therapy.
B. arrange for at least two additional BP measurements during the next 2 weeks.
C. order blood urea nitrogen, creatinine, and potassium ion measurements and
urinalysis.
D. advise her to reduce her sodium intake.
B. arrange for at least two additional BP measurements during the next 2 weeks.
Per ACC/AHA 2017 guideline: Because individual BP measurements tend to vary in an
unpredictable or random fashion, a single reading is inadequate for clinical decision-
making. An average of 2 to 3 BP measurements obtained on 2 to 3 separate occasions
will minimize random error and provide a more accurate basis for estimation of BP.
2. You see a 68-year-old woman as a patient who is transferring care into your
practice. She has a 10-year history of hypertension, diabetes mellitus, and
hyperlipidemia.
Current medications include hydrochlorothiazide (HCTZ), glipizide, metformin,
simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92 mm Hg, and
the rest of her history and examination are unremarkable. Documentation from her
former healthcare provider indicates that her BP has been in the range for the past 12
months. Your next best action is to:
A. prescribe an angiotensin-converting enzyme inhibitor (ACEI).
B. have her return for a BP check in 1 week.
C. advise that her current therapy is adequate.
D. add therapy with an aldosterone antagonist.
A. prescribe an angiotensin-converting enzyme inhibitor (ACEI).
,Per ACC/AHA 2017 guideline:
patient is Stage 2 Hypertension (BP ≥ 140/90 mm Hg) ...
goal is >130/80
In adults with DM and hypertension, all first-line classes of antihypertensive agents (i.e.,
diuretics, ACE inhibitors, ARBs, and CCBs) are useful and effective.
*** multiple medications are usually required to control hypertension in persons with
diabetes.
3. You examine a 78-year-old woman with long-standing, poorly controlled
hypertension. When evaluating her for hypertensive target organ damage, you look
for evidence of:
A. lipid abnormalities.
B. insulin resistance.
C. left ventricular hypertrophy.
D. clotting disorders.
C. left ventricular hypertrophy.
4. Diagnostic testing for a patient with newly diagnosed primary hypertension should
include all of the following except:
A. hematocrit.
B. uric acid.
C. creatinine.
D. potassium.
B. uric acid.
,clinical and laboratory findings are mainly referable to involvement of the target organs:
heart, brain, kidneys, eyes, and peripheral arteries.
5. In the person with hypertension, the nurse practitioner (NP) recommends all of the
following to potentially reduce BP in a patient with a BMI of 30 kg/m2 except:
A. 10-kg (22-lb) weight loss.
B. dietary sodium restriction to 2.4 g (6 g NaCl) per day.
C. regular aerobic physical activity, such as 30-40 minutes of brisk walking most days of
the week.
D. consuming at least 1-2 servings of alcohol.
D. consuming at least 1-2 servings of alcohol.
6. amlodipine -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
C. dihydropyridine calcium channel blocker
7. diltiazem -- which medication class
A. beta-adrenergic receptor antagonist
, B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
B. nondihydropyridine calcium channel blocker
7. diltiazem -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
B. nondihydropyridine calcium channel blocker
10. pindolol -- which medication class
A. beta-adrenergic receptor antagonist
B. nondihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI
A. beta-adrenergic receptor antagonist
