hypertension Flashcards
1
Q
- 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.
A
B. arrange for at least two additional BP measurements
during the next 2 weeks.
2
Q
- 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
A. prescribe an angiotensin-converting enzyme inhibitor (ACEI).
3
Q
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.
A
C. left ventricular hypertrophy.
4
Q
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.
A
B. uric acid.
5
Q
- 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.
A
D. consuming at least 1–2 servings of alcohol.
6
Q
6 to 10. Match the antihypertension medication with its
appropriate class.
6. amlodipine
A. beta-adrenergic receptor antagonist B. nondihydropyridine calcium channel blocker C. dihydropyridine calcium channel blocker D. angiotensin receptor antagonist E. ACEI
A
C. dihydropyridine calcium
channel blocker
7
Q
6 to 10. Match the antihypertension medication with its
appropriate class.
- diltiazem
A. beta-adrenergic receptor antagonist B. nondihydropyridine calcium channel blocker C. dihydropyridine calcium channel blocker D. angiotensin receptor antagonist E. ACEI
A
B. nondihydropyridine
calcium channel blocker
8
Q
6 to 10. Match the antihypertension medication with its
appropriate class.
- trandolapril
A. beta-adrenergic receptor antagonist B. nondihydropyridine calcium channel blocker C. dihydropyridine calcium channel blocker D. angiotensin receptor antagonist E. ACEI
A
E. ACEI
9
Q
6 to 10. Match the antihypertension medication with its
appropriate class.
- telmisartan
A. beta-adrenergic receptor antagonist B. nondihydropyridine calcium channel blocker C. dihydropyridine calcium channel blocker D. angiotensin receptor antagonist E. ACEI
A
D. angiotensin receptor
antagonist
10
Q
6 to 10. Match the antihypertension medication with its
appropriate class.
- pindolol
A. beta-adrenergic receptor antagonist B. nondihydropyridine calcium channel blocker C. dihydropyridine calcium channel blocker D. angiotensin receptor antagonist E. ACEI
A
A. beta-adrenergic receptor
antagonist
11
Q
- 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 156/94 mm Hg and he has no history of
diabetes mellitus or chronic kidney disease. Following
current best evidence, you consider adding which of
the following medications?
A. ACEI
B. angiotensin receptor blocker (ARBs)
C. beta-adrenergic receptor antagonist
D. calcium channel blocker
A
D. calcium channel blocker
12
Q
12. Nondihydropyridine calcium channel blockers are contraindicated in patients with: A. type 1 diabetes mellitus. B. a history of venous thromboembolism. C. severe left ventricular dysfunction. D. concomitant treatment with an ACEI.
A
C. severe left ventricular dysfunction.
13
Q
- 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 patient should sit on the edge of the examination table without arm support to enhance reading accuracy.
D. Obtaining the BP reading immediately after the
patient walks into the examination room is
recommended.
A
A. The patient should sit in a chair with feet flat on the
floor for at least 5 minutes before obtaining the
reading.
14
Q
14. A BP elevation noted only at an office visit is commonly known as \_\_\_\_\_ hypertension. A. provider-induced B. clinical C. white coat D. pseudo
A
C. white coat
15
Q
- 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.
A
B. avoid disease-related target organ damage.
