ANSERS 2025
Benazepril should be discontinued immediately if:
1. dry cough
2. pregnancy occurs
3. potassium levels decrease
4. gout develops - CORRECT ANSWER -2. pregnancy occurs
Benzapril is an ACEI and this class of drugs is contraindicated during pregnancy because of teratoge
nic effects on the renal system of the developing fetus. Dry cough is an aggravating side effect that
occurs in some patients who take ACEI, but discontinuation is elective. ACEI use is associated with
increased potassium levels, not decreased levels. Gout is not exacerbated by ACEI use.
A characteristic of an ACEI iduced cough is that it:
1. is mildly productive
2. is worse at nightime
3. usually begins within 2 weeks of starting therapy
4. is more common in men - CORRECT ANSWER -
3. usually begins within 2 weeks of starting therapy
A patient taking atorvastatin for newly diagnosed dyslipidemia complains of fatigue, weakness, and
muscle aches in his lower back, arms, and legs for the past three days. It has not improved with r
est. How should this be evaluated?
1. stop the atorvastatin immediately
2. check liver enzymes first
3. order a CPK level
4. ask about nighttime muscle cramps - CORRECT ANSWER -1. stop the atorvastatin immediately
,This patient has complaints highly suggestive of rhabdomyolysis. The atorvastatin should be stoppe
d immediately and a CPK should be ordered. Liver enzymes would not assess for the etiology of m
yalgias. They assess tolernce of statins in the liver. Nighttime muscle cramps are not usually associa
ted with statin use. Myalgias are common but are not ypically associated with an elevated CPK. Rh
abdomyolysis is a rare side effect of the statins.
Which patient could be expected to have the highest systolic BP?
1. a 21 year old male
2. a 50 year old perimenopausal female
3. a 35 year old with T2DM
4. a 75 year old male - CORRECT ANSWER -4. a 75 year old male
Nearly 25% of the US population has HTN. The greatest incidence is in older adults because of cha
nges in the intima of vessels as aging and calcium deposition occur. Males of any age are more lik
ely than females, with AA adults having the highest incidence.
A 50 year old patient with HTN has taken hydrochlorthiazide 25mg daily for the past 4 weeks. Her
BP has decreased from 155/95 to 145/90. How should the NP proceed?
1. Wait another 4 weeks before making a dosage change
2. Increase the HCTZ to 50mg daily
3. Add a drug from another class to the daily 25mg HCTZ
4. Stop the HCTZ and start a drug from a different class - CORRECT ANSWER -
3. Add a drug from another class to the daily 25mg HCTZ
The recommended target BP is <140/90. The current plan has not allowed this patient to meet this
goal, so it is not acceptable to continue this current dose. Increasing the HCTZ to 50mg/daily will
not result in a decrease in BP, only and increase in potassium loss. Adding a drug from a different
med class is a good choice because the combined effects of antihypertensive medication is a good
choice because the combined effects of antihypertensive medication nearly always produce a decre
ase in BP and both drugs can be maintained in low doses.
,Which of the following HTN meds should not be used in pregnant women?
a. CCBs
b. TZDs
c. ARBs and ACEIs
d. BBs - CORRECT ANSWER -c. ARBs and ACEIs
A 52 year old man presents to your office for a health maintenance exam, and initial vital signs sh
ow a BP of 154/94. Previous BP measurements were normal. What is the next step in managemen
t?
a. start an anti-HTN med
b. repeat the BP measurement
c. Look for causes of secondary HTN
d. Perform a urine drug screen - CORRECT ANSWER -b. repeat the BP measurement
Which of the following states is correct regarding BP evaluation?
a. the patient should be lying quietly on the exam table for 5 mins prior to obtaining a BP
b. arm should be below heart level during BP
c. the bladder of the BP cuff should encircle 80% of the forearm
d. HTN can be dx by the average of 2 elevated BP readings on a single occasion -
CORRECT ANSWER -c. the bladder of the BP cuff should encircle 80% of the forearm
Which of the following anti-HTN medications should be avoided in patients with gout?
a. losartan
b. HCTZ
c. nifedipine
d. atenolol - CORRECT ANSWER -b. HCTZ
, Which of the following antihypertensive meds should be avoided in patients with poorly controlled
asthma?
a. losartan
b. HCTZ
c. nifedipine
d. atenolol - CORRECT ANSWER -d. atenolol
Which of the following antihypertensive meds should not be used as a first-
line treatment for a person with essential HTN and no other other medical conditions?
a. ACEI
b. BB
c. CCB
d. diuretic - CORRECT ANSWER -b. BB
Which of the following medications should be d/c in a woman with essential HTN who is trying to
get pregnant?
a. methyldopa
b. labetalol
c. nifedipine
d. losartan - CORRECT ANSWER -d. losartan
Which of the following lab values are the most likely to be affected by eating within an hour of la
b draw?
a. LDL
b. total LDL