PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
CHAPTERg5
ASSESSMENTgQUESTIONS
StudentgQuestionsg(10gquestions)
1.gAg55-year-
oldgwhitegmangwithgseatedgofficegbloodgpressureg(BP)greadingsgofg138/89gmmgHggandg136/84gmmgHggisgaskedg
togreturnging2gweeksgforgrepeatgmeasurements,gwhichgareg138/88gmmgHggandg134/82gmmgHg.gWhichgofgthegfoll
owinggclassifiesghisgBPgpergtheg2017gACC/AHAgguidelines?
A. Stageg2ghypertension
B. Stageg1ghypertension
C. ElevatedgBP
D. OptimalgBP
2.gAg34-year-
oldgblackgmangpresentsgtogyourgclinicgwithgagBPgofg160/94gmmgHg.gRepeatgreadingsgovergthegpastg2gweeksgave
rageg156/92gmmgHg.gThegpatientghasgnogpastgmedicalghistorygwithgthegexceptiongofgCrohngdisease,gwhichgisgc
urrentlygtreatedgwithgchronicgsteroidgtherapy.gHegisgalsogtakinggangover-the-
countergNSAIDgforgongoinggbackgpain.gPhysicalgexaminationgandglaboratorygtestsgaregunremarkable.gAppropri
ateginterventionsgatgthisgtimeginclude:
A. Noginterventiongbecausegpatientgmostglikelyghasgdrug-inducedghypertension
B. NSAIDgisgappropriategasglonggasghegfollowsgtheginstructionsgongthegpackageginsert
C. Reassessmentgofgthegdosegandgneedgforglong-termgoralgsteroids
D. Initiationgofgantihypertensivegtherapy
3.gAg45-year-oldgAfrican-
Americangwomangwhoghasgresistantghypertension,gheartgfailuregwithgreducedgejectiongfraction,gtypeg2gdiabetes,g
andgdyslipidemiagcomesgtogthegclinicgforgagmedicationgmanagementgvisit.gHergcurrentgmedicationsgincludegenal
april/hydrochlorothiazideg(Vaseretic),gmetoprololgsuccinate,ghydralazine,gisosorbidegdinitrate,gmetformin,gandga
torvastatin.gSheghasgbeengadherentgtogallghergmedications.gShegcomplainsgofgrecentlygdevelopedgfatigue,garthral
gia,gandgmildgperipheralgedema,gandgagbutterflygrashgacrossghergnosegandguppergcheeks.gWhichgofgthegfollowingg
statementsgisgcorrect?
A. Thegmostglikelygmedicationgcausinggthisgadversegreactiongisgthegangiotensin-
convertinggenzymeginhibitor,genalapril
B. Thisgisglikelygtogbegagdose-independentgadversegdruggreaction
C. TestinggforgN-acetyltransferase-1g(NAT-1)gandgNAT-2ggenesgmayghelpgtogpreventgthisgadversegeffect
D. Discontinuegallgmedicationsgduegtogunknowngetiologygofgthisgreaction
4.gAg52-year-
oldgAsiangmalegisgnewlygdiagnosedgwithgstageg1ghypertension.gSignificantglabgvaluesgaregpotassiumglevelgofg4.5g
mEq/Lg(mmol/L)gandgangestimatedgGFRgofg25gmL/min/1.73gm2.gHisgpastgmedicalghistorygincludesgtypeg2gdiabe
tes,gchronicgkidneygdiseaseg(stagegG4,gA1),ghyperlipidemia,gandggout.gHisg10-
yeargASCVDgriskgisgestimatedgatg10.8%.gWhichgofgthegfollowinggmedicationsgwouldgbegpreferredgforgthisgpatie
nt?
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
A. Chlorthalidone
B. Amlodipine
C. Losartan
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
D. Metoprololgtartrate
5. Ag55-year-
oldgblackgwomanghasgaghistorygofgleftgventricularghypertrophygwithgagleftgventriculargejectiongfractiongofg
55%g(0.55).gSheghasghadghypertensiongforg10gyearsgandgisgcurrentlygtakinggchlorthalidoneg25gmg
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
daily,gmetoprololgsuccinateg50gmggdaily,gandgamlodipineg2.5gmggdaily.gHergaveragedgBPgisg152/94gmmgHggwithg
agheartgrategofg54gbeats/min.gHergphysicalgexaminationgisgunremarkablegandgbasicgmetabolicgpanelgrevealsgseru
mgcreatininegofg0.8gmg/dLg(71gµmol/L)gandgpotassiumgofg3.9gmEq/Lg(mmol/L).gShegreportsgallergiesgtogfosino
prilgandgaspirin.gWhichgofgthegfollowinggrepresentsgthegoptimalgcoursegofgaction?
A. Increasegamlodipinegtog5gmggandghaveghergtakegitgatgbedtime
B. Increasegmetoprololgsuccinategtog100gmggdaily
C. Addglisinoprilg5gmggdaily
D. Addgspironolactoneg50gmggdaily
6. Ag65-year-
oldgblackgmalegpresentsgtogthegclinicgtodaygwithgaveragegBPgofg148/88gmmgHggandgheartgrategofg70gbeats/min.g
Heghasgpastgmedicalghistorygofgtypeg2gdiabetesgandgchronicgobstructivegpulmonarygdiseaseg(groupgB).gHisgmost
grecentgserumgpotassiumgisg3.6gmEq/Lg(mmol/L),gserumgcreatininegisg0.9gmg/dLg(80gµmol/L),gcalculatedgcreatin
inegclearancegisg92gmL/ming(1.54gmL/s)gandgurinegalbumingisgwithingnormalglimits.gHisgcurrentgmedicationglistg
includesgatorvastatin,gmetformin,gandginhaledgtiotropium.gWhichgofgthegfollowinggantihypertensivesgwouldgbegt
hegmostgappropriateginitialgtherapy?
A. Amlodipine
B. Chlorthalidone
C. Atenolol
D. Lisinopril
7. Ag67-year-oldgAsiangmangwithgagrecentgnon-
STgsegmentgelevationgmyocardialginfarctiong(MI)g(2gweeksgago)ghasgangaveragegBPgofg138/86gmmgHggandgag
heartgrategofg76gbeats/min.gWhichgofgthegfollowinggantihypertensivegagentsgisgpreferredgingthisgsetting?
A. Metoprololgtartrate
B. Acebutolol
C. Hydrochlorothiazide
D. Spironolactone
8. Ag58-
yeargoldgIndiangAmericangmalegpresentsgtogurgentgcaregwithgchiefgcomplaintsgofgseveregheadache,gconfusion
,gandgblurredgvision.gUpongexamination,ghisgvitalgsignsgandgrelevantglabgvaluesginclude:gBPg218/124gmmgHg
;gHRg92gbeats/min;gRRg18gbreaths/min;gserumgpotassiumg4.8gmEq/Lg(mmol/L);gserumgcreatinineg2.4gmg/dL
g(212gµmol/L);gbloodgureagnitrogeng45gmg/dLg(16.1gmmol/L);gserumgglucoseg145gmg/dLg(8.0gmmol/L);
hemoglobingA1Cg6.4%g(0.064;g46gmmol/molgHb);gASTg28gU/Lg(0.47gµkat/L);gALTg20gU/Lg(0.33gµkat/L);gurin
alysisgshowsgpositivegofgproteinsgandgnegativegofgketones.gHeghasgmedicalghistorygofghypertensiongbutgnoghistor
ygofgrenalgorghepaticgimpairment.gAccordinggtogthegpharmacists,ghisgantihypertensivegmedicationsgaregoverduegf
orgagrefillgbyg2gmonths.gWhichgofgthegfollowinggstatementsgisgmostgaccurate?
A. Hegisgexperiencingghypertensivegurgency
B. Goalgisgtogreducegsystolicgbloodgpressuregbygupgtog25%gwithinganghour
C. Goalgisgtogreducegsystolicgbloodgpressuregbyg25%gtog50%gwithinganghour
D. Administrationgofgshort-actinggoralgantihypertensivegsuchgasglabetalolgorgclonidinegisgappropriate
g g g g g g gg
ANSWERED
CHAPTERg5
ASSESSMENTgQUESTIONS
StudentgQuestionsg(10gquestions)
1.gAg55-year-
oldgwhitegmangwithgseatedgofficegbloodgpressureg(BP)greadingsgofg138/89gmmgHggandg136/84gmmgHggisgaskedg
togreturnging2gweeksgforgrepeatgmeasurements,gwhichgareg138/88gmmgHggandg134/82gmmgHg.gWhichgofgthegfoll
owinggclassifiesghisgBPgpergtheg2017gACC/AHAgguidelines?
A. Stageg2ghypertension
B. Stageg1ghypertension
C. ElevatedgBP
D. OptimalgBP
2.gAg34-year-
oldgblackgmangpresentsgtogyourgclinicgwithgagBPgofg160/94gmmgHg.gRepeatgreadingsgovergthegpastg2gweeksgave
rageg156/92gmmgHg.gThegpatientghasgnogpastgmedicalghistorygwithgthegexceptiongofgCrohngdisease,gwhichgisgc
urrentlygtreatedgwithgchronicgsteroidgtherapy.gHegisgalsogtakinggangover-the-
countergNSAIDgforgongoinggbackgpain.gPhysicalgexaminationgandglaboratorygtestsgaregunremarkable.gAppropri
ateginterventionsgatgthisgtimeginclude:
A. Noginterventiongbecausegpatientgmostglikelyghasgdrug-inducedghypertension
B. NSAIDgisgappropriategasglonggasghegfollowsgtheginstructionsgongthegpackageginsert
C. Reassessmentgofgthegdosegandgneedgforglong-termgoralgsteroids
D. Initiationgofgantihypertensivegtherapy
3.gAg45-year-oldgAfrican-
Americangwomangwhoghasgresistantghypertension,gheartgfailuregwithgreducedgejectiongfraction,gtypeg2gdiabetes,g
andgdyslipidemiagcomesgtogthegclinicgforgagmedicationgmanagementgvisit.gHergcurrentgmedicationsgincludegenal
april/hydrochlorothiazideg(Vaseretic),gmetoprololgsuccinate,ghydralazine,gisosorbidegdinitrate,gmetformin,gandga
torvastatin.gSheghasgbeengadherentgtogallghergmedications.gShegcomplainsgofgrecentlygdevelopedgfatigue,garthral
gia,gandgmildgperipheralgedema,gandgagbutterflygrashgacrossghergnosegandguppergcheeks.gWhichgofgthegfollowingg
statementsgisgcorrect?
A. Thegmostglikelygmedicationgcausinggthisgadversegreactiongisgthegangiotensin-
convertinggenzymeginhibitor,genalapril
B. Thisgisglikelygtogbegagdose-independentgadversegdruggreaction
C. TestinggforgN-acetyltransferase-1g(NAT-1)gandgNAT-2ggenesgmayghelpgtogpreventgthisgadversegeffect
D. Discontinuegallgmedicationsgduegtogunknowngetiologygofgthisgreaction
4.gAg52-year-
oldgAsiangmalegisgnewlygdiagnosedgwithgstageg1ghypertension.gSignificantglabgvaluesgaregpotassiumglevelgofg4.5g
mEq/Lg(mmol/L)gandgangestimatedgGFRgofg25gmL/min/1.73gm2.gHisgpastgmedicalghistorygincludesgtypeg2gdiabe
tes,gchronicgkidneygdiseaseg(stagegG4,gA1),ghyperlipidemia,gandggout.gHisg10-
yeargASCVDgriskgisgestimatedgatg10.8%.gWhichgofgthegfollowinggmedicationsgwouldgbegpreferredgforgthisgpatie
nt?
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
A. Chlorthalidone
B. Amlodipine
C. Losartan
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
D. Metoprololgtartrate
5. Ag55-year-
oldgblackgwomanghasgaghistorygofgleftgventricularghypertrophygwithgagleftgventriculargejectiongfractiongofg
55%g(0.55).gSheghasghadghypertensiongforg10gyearsgandgisgcurrentlygtakinggchlorthalidoneg25gmg
, PATHOPHYSI NSG 530 Exam 3 Study Questions
g g g g g g gg
ANSWERED
daily,gmetoprololgsuccinateg50gmggdaily,gandgamlodipineg2.5gmggdaily.gHergaveragedgBPgisg152/94gmmgHggwithg
agheartgrategofg54gbeats/min.gHergphysicalgexaminationgisgunremarkablegandgbasicgmetabolicgpanelgrevealsgseru
mgcreatininegofg0.8gmg/dLg(71gµmol/L)gandgpotassiumgofg3.9gmEq/Lg(mmol/L).gShegreportsgallergiesgtogfosino
prilgandgaspirin.gWhichgofgthegfollowinggrepresentsgthegoptimalgcoursegofgaction?
A. Increasegamlodipinegtog5gmggandghaveghergtakegitgatgbedtime
B. Increasegmetoprololgsuccinategtog100gmggdaily
C. Addglisinoprilg5gmggdaily
D. Addgspironolactoneg50gmggdaily
6. Ag65-year-
oldgblackgmalegpresentsgtogthegclinicgtodaygwithgaveragegBPgofg148/88gmmgHggandgheartgrategofg70gbeats/min.g
Heghasgpastgmedicalghistorygofgtypeg2gdiabetesgandgchronicgobstructivegpulmonarygdiseaseg(groupgB).gHisgmost
grecentgserumgpotassiumgisg3.6gmEq/Lg(mmol/L),gserumgcreatininegisg0.9gmg/dLg(80gµmol/L),gcalculatedgcreatin
inegclearancegisg92gmL/ming(1.54gmL/s)gandgurinegalbumingisgwithingnormalglimits.gHisgcurrentgmedicationglistg
includesgatorvastatin,gmetformin,gandginhaledgtiotropium.gWhichgofgthegfollowinggantihypertensivesgwouldgbegt
hegmostgappropriateginitialgtherapy?
A. Amlodipine
B. Chlorthalidone
C. Atenolol
D. Lisinopril
7. Ag67-year-oldgAsiangmangwithgagrecentgnon-
STgsegmentgelevationgmyocardialginfarctiong(MI)g(2gweeksgago)ghasgangaveragegBPgofg138/86gmmgHggandgag
heartgrategofg76gbeats/min.gWhichgofgthegfollowinggantihypertensivegagentsgisgpreferredgingthisgsetting?
A. Metoprololgtartrate
B. Acebutolol
C. Hydrochlorothiazide
D. Spironolactone
8. Ag58-
yeargoldgIndiangAmericangmalegpresentsgtogurgentgcaregwithgchiefgcomplaintsgofgseveregheadache,gconfusion
,gandgblurredgvision.gUpongexamination,ghisgvitalgsignsgandgrelevantglabgvaluesginclude:gBPg218/124gmmgHg
;gHRg92gbeats/min;gRRg18gbreaths/min;gserumgpotassiumg4.8gmEq/Lg(mmol/L);gserumgcreatinineg2.4gmg/dL
g(212gµmol/L);gbloodgureagnitrogeng45gmg/dLg(16.1gmmol/L);gserumgglucoseg145gmg/dLg(8.0gmmol/L);
hemoglobingA1Cg6.4%g(0.064;g46gmmol/molgHb);gASTg28gU/Lg(0.47gµkat/L);gALTg20gU/Lg(0.33gµkat/L);gurin
alysisgshowsgpositivegofgproteinsgandgnegativegofgketones.gHeghasgmedicalghistorygofghypertensiongbutgnoghistor
ygofgrenalgorghepaticgimpairment.gAccordinggtogthegpharmacists,ghisgantihypertensivegmedicationsgaregoverduegf
orgagrefillgbyg2gmonths.gWhichgofgthegfollowinggstatementsgisgmostgaccurate?
A. Hegisgexperiencingghypertensivegurgency
B. Goalgisgtogreducegsystolicgbloodgpressuregbygupgtog25%gwithinganghour
C. Goalgisgtogreducegsystolicgbloodgpressuregbyg25%gtog50%gwithinganghour
D. Administrationgofgshort-actinggoralgantihypertensivegsuchgasglabetalolgorgclonidinegisgappropriate
