2026/2027 | Verified Questions & Correct
Answers with Rationales | Advanced FNP
Hypertension Study Guide | A- Graded Exam
Prep
• This is a verified, A-graded FNP exam prep guide for NURS 5434 Family III HTN
(UTA 2026/2027), featuring 200 multiple-choice questions with highlighted correct
answers and detailed EXPERT RATIONALE.
• Study by reading each question carefully, attempting your answer before viewing
the correct option, and using the EXPERT RATIONALE to reinforce your clinical
reasoning for advanced hypertension management.
NURS 5434 FAMILY III — HYPERTENSION QUIZ UTA 2026/2027 | 200 VERIFIED
QUESTIONS WITH EXPERT RATIONALE
1. According to JNC 8 guidelines, what is the recommended blood pressure
target for a 65-year-old patient with no diabetes or chronic kidney disease?
A. Less than 120/80 mmHg
B. Less than 130/80 mmHg
C. Less than 140/90 mmHg
D. Less than 150/90 mmHg
E. Less than 160/100 mmHg
CORRECT ANSWER: D. Less than 150/90 mmHg
EXPERT RATIONALE: JNC 8 recommends a BP target of less than 150/90 mmHg for
patients aged 60 years and older who do not have diabetes or chronic kidney disease.
This is a relaxed target compared to younger populations, reflecting evidence that
aggressive lowering in this age group may not provide additional benefit and can
increase risk of adverse effects.
,2. A 55-year-old African American patient with hypertension and no other
comorbidities is being started on antihypertensive therapy. Which medication
is the MOST appropriate first-line choice?
A. ACE inhibitor
B. Beta-blocker
C. ARB
D. Thiazide diuretic
E. Alpha-blocker
CORRECT ANSWER: D. Thiazide diuretic
EXPERT RATIONALE: JNC 8 and ACC/AHA guidelines recommend thiazide diuretics or
calcium channel blockers as preferred first-line agents for African American patients
with hypertension without comorbidities. ACE inhibitors and ARBs are generally less
effective as monotherapy in this population due to lower renin activity.
3. Which of the following best defines Stage 2 hypertension according to the
2017 ACC/AHA guidelines?
A. Systolic BP 120–129 mmHg with diastolic less than 80 mmHg
B. Systolic BP 130–139 mmHg or diastolic 80–89 mmHg
C. Systolic BP 140–159 mmHg or diastolic 90–99 mmHg
D. Systolic BP ≥ 140 mmHg or diastolic ≥ 90 mmHg
E. Systolic BP ≥ 130 mmHg or diastolic ≥ 80 mmHg
CORRECT ANSWER: D. Systolic BP ≥ 140 mmHg or diastolic ≥ 90 mmHg
EXPERT RATIONALE: According to 2017 ACC/AHA guidelines, Stage 2 hypertension is
defined as systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. This category warrants
prompt initiation of antihypertensive medication in addition to lifestyle modifications.
,4. A patient with hypertension and type 2 diabetes presents to the clinic.
What is the recommended BP target for this patient per ACC/AHA 2017
guidelines?
A. Less than 150/90 mmHg
B. Less than 140/90 mmHg
C. Less than 130/80 mmHg
D. Less than 120/70 mmHg
E. Less than 135/85 mmHg
CORRECT ANSWER: C. Less than 130/80 mmHg
EXPERT RATIONALE: For patients with hypertension and diabetes, the 2017 ACC/AHA
guidelines recommend a BP target of less than 130/80 mmHg. Tighter control reduces
the risk of cardiovascular events, stroke, and diabetic nephropathy progression.
5. Which antihypertensive class is MOST appropriate as first-line therapy for a
hypertensive patient with chronic kidney disease and proteinuria?
A. Calcium channel blocker
B. Thiazide diuretic
C. Beta-blocker
D. ACE inhibitor
E. Alpha-blocker
CORRECT ANSWER: D. ACE inhibitor
EXPERT RATIONALE: ACE inhibitors are the drug of choice for hypertensive patients with
CKD and proteinuria. They reduce intraglomerular pressure by dilating the efferent
arteriole, thereby slowing the progression of nephropathy and reducing proteinuria.
ARBs are an acceptable alternative if ACE inhibitors are not tolerated.
, 6. A patient taking lisinopril develops a persistent dry cough. What is the BEST
alternative?
A. Amlodipine
B. Metoprolol
C. Losartan
D. Hydrochlorothiazide
E. Spironolactone
CORRECT ANSWER: C. Losartan
EXPERT RATIONALE: A dry, persistent cough is a well-known adverse effect of ACE
inhibitors, caused by bradykinin accumulation. ARBs, such as losartan, block the
angiotensin II receptor without affecting bradykinin metabolism and therefore do not
cause cough. They are the preferred alternative when ACE inhibitors are not tolerated.
7. Which electrolyte abnormality is most commonly associated with thiazide
diuretic use?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
E. Hypermagnesemia
CORRECT ANSWER: C. Hypokalemia
EXPERT RATIONALE: Thiazide diuretics promote sodium and water excretion in the
distal tubule, which secondarily increases potassium excretion, leading to hypokalemia.
Monitoring serum potassium levels is essential in patients on thiazide therapy,
particularly those also taking digoxin, as hypokalemia increases digoxin toxicity risk.