TEST BANK FOR NURSE PRACTITIONER CERTIFICATION EXAM
PREP 6TH FITZGERALD | 9780803677128 | ALL CHAPTERS
WITH ANSWERS AND RATIONALS .
You examine a 38 year old woman who has presented for an initial examination and Papanicolaou
test. She has no complaint. Her BP is 154/98 mm Hg bilaterally and her BMI is 31 kg/m2. The rest of
her physical exam 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 BUN, creatinine, and potassium ion measurements and UA
D. advise her to reduce her sodium intake - ANSWER: B. arrange for at least two additional BP
measurements during the next 2 weeks
You see a 68 year old woman as a pt who is transferring care into your practice. She has a 10y history
of HTN, diabetes mellitus, and hyperlipidemia. Current medications include HCTZ, glipizide,
metformin, simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92mm Hg and the rest
of her history and exam 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 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 - ANSWER: A. prescribe an ACEI
You examine a 78 y/o woman with long-standing poorly controlled hHTN. When evaluating her for
HTN target organ damage, you look for evidence of:
A. lipid abnormalities
B. insulin resistance
C. left ventricular hypertrophy
D. clotting disorders - ANSWER: C. left ventricular hypertrophy
Diagnostic testing for a pt with newly diagnosed primary hHTN should include all of the following
except:
A. hematocrit
B. uric acid
C. creatinine
D. potassium - ANSWER: B. uric acid
In the person w/HTN, the nurse practitioner recommends all of the following to potentially reduce BP
in a patient with a BMI of 30 kg/m2 except:
A. 10kg weight loss
B. dietary sodium restriction to 2.4g 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 - ANSWER: D. consuming at least 1-2 servings of alcohol
what class of antihypertension medication is amlodipine? - ANSWER: dihydropyridine calcium channel
blocker
what class of antihypertension medication is diltiazem? - ANSWER: nondihydropyridine calcium
channel blocker
what class of antihypertension medication is trandolapril? - ANSWER: ACEI
what class of antihypertension medication is telmisartan? - ANSWER: angiotensin receptor antagonist
, what class of antihypertension medication is pindolol? - ANSWER: beta-adrenergic receptor
antagonist
You see a 38-year old African American male with HTN who is currently being treated with thiazide-
type diuretic. His current BP reading is 156/94mm HG and he has no history of DM or CKD. Following
current best evidence, you consider adding which of the following medications?
A. ACEI
B. ARBs
C. beta-adrenergic receptor antagonist
D. calcium channel blocker - ANSWER: D. calcium channel blocker
nondihydropyridine calcium channel blockers are contraindicated in pts with:
A. type 1 DM
B. a history of venous thromboembolism
C. severe left ventricular dysfunction
D. concomitant treatment with an ACEI - ANSWER: C. severe left ventricular dysfunction
In obtaining an office BP measurement, which of the following is most reflective of the best practice?
A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the
reading
B. the BP cuff should not cover more than 50% of the upper arm
C. the pt should sit on the edge of the exam table w/o arm support to enhance reading accuracy
D. obtaining the BP reading immediately after the pt walks into the exam room is recommended -
ANSWER: A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before
obtaining the reading
A BP elevation noted only at an office visit is commonly known as ____________ hypertension
A. provider-induced
B. clinical
C. white coat
D. pseudo - ANSWER: C. white coat
The most important long-term goal of treating HTN is to:
A. strive to reach recommended numeric BP measurement
B. avoid disease-related target organ damage
C. develop a plan of care with minimal adverse effects
D. treat concomitant health problems often noted in the person with this condition - ANSWER: B.
avoid disease-related target organ damage
You start a pt with HTN who is already receiving an ACEI on spironolactone. You advise pt to return in
4 weeks to check which of the following lab parameters?
A. sodium
B. calcium
C. potassium
D. chloride - ANSWER: C. potassium
A 68yo woman presents with HTN and BP of 152-158/92-96mmHg documented over 2 months on
three different occasions. ECG and creatinine are normal, and she has no proteinuria. Clinical findings
include the following: BMI 26.4, no 23 24 or murmur, and point of maximal impulse at 5th intercostal
space, mid-clavicular line. Which of the following represents the best intervention?
A. initiate therapy with metoprolol
B. initiate therapy w/hydrochlorothiazide
C. Initiate therapy with methyldopa
D. Continue to monitor BP, and start drug therapy if evidence of target organ damage - ANSWER: B.
initiate therapy w/hydrochlorothiazide
PREP 6TH FITZGERALD | 9780803677128 | ALL CHAPTERS
WITH ANSWERS AND RATIONALS .
You examine a 38 year old woman who has presented for an initial examination and Papanicolaou
test. She has no complaint. Her BP is 154/98 mm Hg bilaterally and her BMI is 31 kg/m2. The rest of
her physical exam 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 BUN, creatinine, and potassium ion measurements and UA
D. advise her to reduce her sodium intake - ANSWER: B. arrange for at least two additional BP
measurements during the next 2 weeks
You see a 68 year old woman as a pt who is transferring care into your practice. She has a 10y history
of HTN, diabetes mellitus, and hyperlipidemia. Current medications include HCTZ, glipizide,
metformin, simvastatin, and daily low-dose aspirin. Today's BP reading is 158/92mm Hg and the rest
of her history and exam 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 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 - ANSWER: A. prescribe an ACEI
You examine a 78 y/o woman with long-standing poorly controlled hHTN. When evaluating her for
HTN target organ damage, you look for evidence of:
A. lipid abnormalities
B. insulin resistance
C. left ventricular hypertrophy
D. clotting disorders - ANSWER: C. left ventricular hypertrophy
Diagnostic testing for a pt with newly diagnosed primary hHTN should include all of the following
except:
A. hematocrit
B. uric acid
C. creatinine
D. potassium - ANSWER: B. uric acid
In the person w/HTN, the nurse practitioner recommends all of the following to potentially reduce BP
in a patient with a BMI of 30 kg/m2 except:
A. 10kg weight loss
B. dietary sodium restriction to 2.4g 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 - ANSWER: D. consuming at least 1-2 servings of alcohol
what class of antihypertension medication is amlodipine? - ANSWER: dihydropyridine calcium channel
blocker
what class of antihypertension medication is diltiazem? - ANSWER: nondihydropyridine calcium
channel blocker
what class of antihypertension medication is trandolapril? - ANSWER: ACEI
what class of antihypertension medication is telmisartan? - ANSWER: angiotensin receptor antagonist
, what class of antihypertension medication is pindolol? - ANSWER: beta-adrenergic receptor
antagonist
You see a 38-year old African American male with HTN who is currently being treated with thiazide-
type diuretic. His current BP reading is 156/94mm HG and he has no history of DM or CKD. Following
current best evidence, you consider adding which of the following medications?
A. ACEI
B. ARBs
C. beta-adrenergic receptor antagonist
D. calcium channel blocker - ANSWER: D. calcium channel blocker
nondihydropyridine calcium channel blockers are contraindicated in pts with:
A. type 1 DM
B. a history of venous thromboembolism
C. severe left ventricular dysfunction
D. concomitant treatment with an ACEI - ANSWER: C. severe left ventricular dysfunction
In obtaining an office BP measurement, which of the following is most reflective of the best practice?
A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before obtaining the
reading
B. the BP cuff should not cover more than 50% of the upper arm
C. the pt should sit on the edge of the exam table w/o arm support to enhance reading accuracy
D. obtaining the BP reading immediately after the pt walks into the exam room is recommended -
ANSWER: A. the patient should sit in a chair with feet flat on the floor for at least 5 minutes before
obtaining the reading
A BP elevation noted only at an office visit is commonly known as ____________ hypertension
A. provider-induced
B. clinical
C. white coat
D. pseudo - ANSWER: C. white coat
The most important long-term goal of treating HTN is to:
A. strive to reach recommended numeric BP measurement
B. avoid disease-related target organ damage
C. develop a plan of care with minimal adverse effects
D. treat concomitant health problems often noted in the person with this condition - ANSWER: B.
avoid disease-related target organ damage
You start a pt with HTN who is already receiving an ACEI on spironolactone. You advise pt to return in
4 weeks to check which of the following lab parameters?
A. sodium
B. calcium
C. potassium
D. chloride - ANSWER: C. potassium
A 68yo woman presents with HTN and BP of 152-158/92-96mmHg documented over 2 months on
three different occasions. ECG and creatinine are normal, and she has no proteinuria. Clinical findings
include the following: BMI 26.4, no 23 24 or murmur, and point of maximal impulse at 5th intercostal
space, mid-clavicular line. Which of the following represents the best intervention?
A. initiate therapy with metoprolol
B. initiate therapy w/hydrochlorothiazide
C. Initiate therapy with methyldopa
D. Continue to monitor BP, and start drug therapy if evidence of target organ damage - ANSWER: B.
initiate therapy w/hydrochlorothiazide
