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The most important long-term goal of treating hypertension 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
You start a patient with hypertension who is already receiving an ACEI on
spironolactone. You advise the patient to return in 4 weeks to check which of the
following laboratory parameters?
A. sodium
B. calcium
C. potassium
D. chloride - ANSWER✔️-C
A 68-year-old woman presents with hypertension and BP of 152-158/92-96 mm Hg
documented over 2 months on three different occasions. Electrocardiogram (ECG)
and creatinine are normal, and she has no proteinuria. Clinical findings include the
following: BMI 26.4 kg/m2; no S3, S4, or murmur; and point of maximal impulse
at fifth intercostal space, mid-clavicular line. Which of the following represents the
best intervention?
A. Initiate therapy with metoprolol.
B. Initiate therapy with hydrochlorothiazide.
C. Initiate therapy with methyldopa.
D. Continue to monitor BP, and start drug therapy if
evidence of target organ damage. - ANSWER✔️-B
Which of the following can have a favorable effect on a comorbid condition in a
person with hypertension?
,A. chlorthalidone in gout
B. propranolol with airway disease
C. aldosterone antagonist in heart failure
D. methyldopa in an older adult - ANSWER✔️-C
According to JNC-8 guidelines, all of the following medications are first-line
agents for use in a middle-aged white man without diabetes mellitus except:
A. lisinopril.
B. hydrochlorothiazide.
C. metoprolol.
D. amlodipine. - ANSWER✔️-C
You see a 59-year-old man with poorly controlled hypertension. On physical
examination, you note grade 1 hypertensive retinopathy. You anticipate all
of the following will be present except:
A. patient report of acute visual change.
B. narrowing of the terminal arterioles.
C. sharp optic disc borders.
D. absence of retinal hemorrhage. - ANSWER✔️-A
According to JNC-8, a 52-year-old well woman with a healthy BMI whose blood
pressure is consistently 130-135/82-86 mm Hg is considered to have:
A. normal blood pressure.
B. hypertension requiring therapy with a calcium channel blocker (CCB).
C. hypertension requiring therapy with an alpha blocker.
D. hypertension requiring therapy with a thiazide-type diuretic. - ANSWER✔️-A
Which of the following is associated with the highest risk of ischemic heart
disease?
A. presence of microalbuminuria plus heavy alcohol intake
B. absence of microalbuminuria plus use of a thiazolidinedione
C. absence of microalbuminuria plus chronic physical inactivity
D. presence of microalbuminuria plus cigarette
smoking - ANSWER✔️-D
When compared with Caucasians, African Americans tend to have a reduced effect
with monotherapy with all of the following blood pressure medications
except:
A. ACEs.
,B. ARBs.
C. CCB.
D. beta blockers. - ANSWER✔️-C
Match the recommended blood pressure goal for each patient according to JNC-8
guidelines. (Answer can be used more than once.)
A. <130/80 mm Hg
B. <140/80 mm Hg
C. <140/90 mm Hg
D. <150/90 mm
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. - ANSWER✔️-B
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. - ANSWER✔️-A
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. - ANSWER✔️-C
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. - ANSWER✔️-B
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. - ANSWER✔️-D
Match the antihypertension medication with its appropriate class.
_______6. amlodipine
_______7. diltiazem
_______8. trandolapril
_______9. telmisartan
_______10. pindolol
A. beta-adrenergic receptor antagonist
B. no dihydropyridine calcium channel blocker
C. dihydropyridine calcium channel blocker
D. angiotensin receptor antagonist
E. ACEI - ANSWER✔️-6. C.
7. B.
8. E.
9. D.
10. A.
You see a 38-year-old African American male with hypertension who is currently
being treated with thiazide-type diuretic. His current blood pressure reading is