CCRP AACVPR CORE EXAMS 2026 SET QUESTIONS AND
ANSWERS SURE A+
✔✔how does increased PVR happen - ✔✔structural changes in vascular wall -
remodeling of vessel walls and endothelial dysfunction
✔✔endothelium dependent vasodilation is impaired in ____ patients - ✔✔hypertensive
✔✔increased sympathetic tone in essential HTN - ✔✔resetting of peripheral and central
baroreceptors
✔✔elevated BP (one reading) - ✔✔greater than 130/80
d/t physiological stress, pain, acute illness, physiologic derangements
✔✔hypertension - ✔✔three consecutive readings of 130/80+ on different days
✔✔normal BP - ✔✔Systolic <120
Diastolic <80
✔✔Stage 1 HTN - ✔✔130-139/80-89
✔✔Stage 2 HTN - ✔✔>=140 or >=90
✔✔oversized BP cuff causes - ✔✔The low blood pressure reading
✔✔undersized BP cuff causes - ✔✔high BP reading
✔✔the center of the BP cuff should be at _____ level - ✔✔heart
✔✔width of the bladder cuff should equal _____% of arm circumference - ✔✔40
✔✔length of the cuff bladder should be enough to encircle ____% of the arm
circumference - ✔✔80
✔✔use arm with _____ reading if different - ✔✔higher
✔✔Ambulatory BP monitoring - ✔✔Indicated for evaluation of "white-coat" HTN.
Absence of 10-20% BP decrease during sleep may indicate increased CVD risk.
✔✔Pseudo-hypertension - ✔✔inaccurately high readings in the elderly due to stiff,
calcified arteries or in the obese due to a cuff that is too small
✔✔effect of hypertension on renal function - ✔✔angiotensin II raises BP by increasing
peripheral resistance and blood volume
,✔✔Home blood pressure monitoring - ✔✔improve patient compliance with meds
predictive of adverse outcomes - stroke, MI
can take multiple (not just related to caffeine, stress, smoking, exercise)
✔✔how many times should patients take their BP at home - ✔✔12-14 times per week
(two at night and two in evening for at least three days in a row)
✔✔BP meds with decrease BP how long after dose - ✔✔1-2 hours
✔✔BP highest before _____ of meds - ✔✔next dose
✔✔orthostatic hypotension - ✔✔Decrease in blood pressure related to positional or
postural changes from lying to sitting or standing positions
-common in elderly patients in CR with OCM, valvular stenosis, LV systolic dysfunction
and pts on multiple BP meds
✔✔orthostatic hypotension 2 - ✔✔a drop in over 20 mmHg and over 10 mmHg from
sitting to standing
-dizziness, weakness, postural unsteadiness, fainting
✔✔exercise induced hypotension - ✔✔ischemia, obstruction lesions (valvular stenosis,
obstructive CM, pulmonary HTN)
d/t RV or LV dysfunction during exercise
✔✔post exercise hypotension - ✔✔excessive peripheral vasodilation-working above
anaerobic threshold
-hot environment or clothing causing vasodilation in skin
-dehydration causing reduction in sweat and cooling
✔✔what to tell patients with orthostatic hypotension - ✔✔stand up slowly from laying
down
sit in bed a minute or two before standing up
orthostatic tolerance is lowest in the morning (raise head of bed by 10-20 degrees)
hydrate well throughout the day
with meals - lower CHO content, alcohol intake, large meals
✔✔orthostatic triggers - ✔✔COPD (coughing) and constipation
✔✔physical maneuvers for orthostatic hypotension - ✔✔tense lower body muscles and
abdomen for standing
cross legs in an X and voluntarily contract leg muscles while actively standing on both
legs
✔✔meds and OSHTN - ✔✔take HTN meds at night, well after meals, and after exercise
,✔✔post exercise HTN fixes - ✔✔timing of drugs - after exercise
adequate hydration
clothes that don't make you overheat
cool down after
✔✔HTN sodium intake - ✔✔2000-2300 mg
✔✔average daily American sodium intake - ✔✔3400 mg
✔✔alcohol intake and HTN - ✔✔two drinks a day for men
one drink a day for women
✔✔relationship of alcohol intake and HTN is ____ dependent - ✔✔dose
✔✔when to contact HCP about HTN - ✔✔resistant HTN - trends of HBP
make sure it's not pseudo hypertension
✔✔if BP is high, ask about - ✔✔NSAIDS, over the counter cold medicine (no Sudafed
or Nyquil), nutritional supplements
✔✔NSAIDs increase BP by - ✔✔altering the blood flow in the kidney and decrease
production of prostaglandins that are essential to maintain kidney blood flow (aka
makes you retain fluid)
✔✔Culprits of high bp - ✔✔Ma Huang, Ephedra, bitter orange
illicit drug use
oral contraceptives
post transplant meds - cyclosporine and tacrolimus, steroid hormones, and
erythropoietin
✔✔if patient cant pay for meds - ✔✔refer to social worker
✔✔if patient excessively consumes alcohol or sodium - ✔✔refer to dietician
✔✔psychosocial issues in HTN - ✔✔non-adherence to meds
cultural and economic barriers
resistance to lifestyle measures
✔✔elevated BP despite appropriate therapy - ✔✔bring in med list and prescriptions
taking pain meds?
comorbid conditions - depression or difficult life circumstances (difficult to comply with
med regimen)
, ✔✔cultural factors and HTN - ✔✔educate on value of taking meds, risk of silent illness,
acknowledge health care beliefs
✔✔economic struggle and HTN - ✔✔find generic brand
refer to social worker
✔✔diuretics - ✔✔medications that reduce fluid volume in the body and sodium
✔✔sympathoplegic agents - ✔✔beta blockers
decrease BP by vasodilation, inhibiting cardiac function or increasing venous pooling of
the blood
✔✔direct vasodilators - ✔✔Calcium channel blocker
decrease BP by decreasing vascular resistance the resistant vessels or by increasing
venous capacitance (decreased CO)
✔✔drugs that interrupt the RAAS - ✔✔ACE/ARB
decrease BP by countering the effect of angiotensin II on increasing peripheral vascular
resistance and increasing volume depletion
✔✔diuretics side effects - ✔✔hypokalemia
metabolic side effects that worsen hyperglycemia and dyslipidemia, cause uric acid
retention, gout, and ED (thiazides)
✔✔Beta blocker side effects - ✔✔bradycardia
worsening asthma or COPD
worsen hyperglycemia and dyslipidemia
cold feet
vivid dreams
rebound HTN on discontinuation
✔✔ACE inhibitors adverse effects - ✔✔dry cough
hypotension
hyperkalemia
rash
fever
altered taste
angioedema (rare but life-threatening)
acute renal failure (patients with bilateral renal artery stenosis)
✔✔ARB side effects - ✔✔lower incidence of dry cough and angioedema than ACE
✔✔CCBs adverse effects - ✔✔hypotension
flushing
nausea
ANSWERS SURE A+
✔✔how does increased PVR happen - ✔✔structural changes in vascular wall -
remodeling of vessel walls and endothelial dysfunction
✔✔endothelium dependent vasodilation is impaired in ____ patients - ✔✔hypertensive
✔✔increased sympathetic tone in essential HTN - ✔✔resetting of peripheral and central
baroreceptors
✔✔elevated BP (one reading) - ✔✔greater than 130/80
d/t physiological stress, pain, acute illness, physiologic derangements
✔✔hypertension - ✔✔three consecutive readings of 130/80+ on different days
✔✔normal BP - ✔✔Systolic <120
Diastolic <80
✔✔Stage 1 HTN - ✔✔130-139/80-89
✔✔Stage 2 HTN - ✔✔>=140 or >=90
✔✔oversized BP cuff causes - ✔✔The low blood pressure reading
✔✔undersized BP cuff causes - ✔✔high BP reading
✔✔the center of the BP cuff should be at _____ level - ✔✔heart
✔✔width of the bladder cuff should equal _____% of arm circumference - ✔✔40
✔✔length of the cuff bladder should be enough to encircle ____% of the arm
circumference - ✔✔80
✔✔use arm with _____ reading if different - ✔✔higher
✔✔Ambulatory BP monitoring - ✔✔Indicated for evaluation of "white-coat" HTN.
Absence of 10-20% BP decrease during sleep may indicate increased CVD risk.
✔✔Pseudo-hypertension - ✔✔inaccurately high readings in the elderly due to stiff,
calcified arteries or in the obese due to a cuff that is too small
✔✔effect of hypertension on renal function - ✔✔angiotensin II raises BP by increasing
peripheral resistance and blood volume
,✔✔Home blood pressure monitoring - ✔✔improve patient compliance with meds
predictive of adverse outcomes - stroke, MI
can take multiple (not just related to caffeine, stress, smoking, exercise)
✔✔how many times should patients take their BP at home - ✔✔12-14 times per week
(two at night and two in evening for at least three days in a row)
✔✔BP meds with decrease BP how long after dose - ✔✔1-2 hours
✔✔BP highest before _____ of meds - ✔✔next dose
✔✔orthostatic hypotension - ✔✔Decrease in blood pressure related to positional or
postural changes from lying to sitting or standing positions
-common in elderly patients in CR with OCM, valvular stenosis, LV systolic dysfunction
and pts on multiple BP meds
✔✔orthostatic hypotension 2 - ✔✔a drop in over 20 mmHg and over 10 mmHg from
sitting to standing
-dizziness, weakness, postural unsteadiness, fainting
✔✔exercise induced hypotension - ✔✔ischemia, obstruction lesions (valvular stenosis,
obstructive CM, pulmonary HTN)
d/t RV or LV dysfunction during exercise
✔✔post exercise hypotension - ✔✔excessive peripheral vasodilation-working above
anaerobic threshold
-hot environment or clothing causing vasodilation in skin
-dehydration causing reduction in sweat and cooling
✔✔what to tell patients with orthostatic hypotension - ✔✔stand up slowly from laying
down
sit in bed a minute or two before standing up
orthostatic tolerance is lowest in the morning (raise head of bed by 10-20 degrees)
hydrate well throughout the day
with meals - lower CHO content, alcohol intake, large meals
✔✔orthostatic triggers - ✔✔COPD (coughing) and constipation
✔✔physical maneuvers for orthostatic hypotension - ✔✔tense lower body muscles and
abdomen for standing
cross legs in an X and voluntarily contract leg muscles while actively standing on both
legs
✔✔meds and OSHTN - ✔✔take HTN meds at night, well after meals, and after exercise
,✔✔post exercise HTN fixes - ✔✔timing of drugs - after exercise
adequate hydration
clothes that don't make you overheat
cool down after
✔✔HTN sodium intake - ✔✔2000-2300 mg
✔✔average daily American sodium intake - ✔✔3400 mg
✔✔alcohol intake and HTN - ✔✔two drinks a day for men
one drink a day for women
✔✔relationship of alcohol intake and HTN is ____ dependent - ✔✔dose
✔✔when to contact HCP about HTN - ✔✔resistant HTN - trends of HBP
make sure it's not pseudo hypertension
✔✔if BP is high, ask about - ✔✔NSAIDS, over the counter cold medicine (no Sudafed
or Nyquil), nutritional supplements
✔✔NSAIDs increase BP by - ✔✔altering the blood flow in the kidney and decrease
production of prostaglandins that are essential to maintain kidney blood flow (aka
makes you retain fluid)
✔✔Culprits of high bp - ✔✔Ma Huang, Ephedra, bitter orange
illicit drug use
oral contraceptives
post transplant meds - cyclosporine and tacrolimus, steroid hormones, and
erythropoietin
✔✔if patient cant pay for meds - ✔✔refer to social worker
✔✔if patient excessively consumes alcohol or sodium - ✔✔refer to dietician
✔✔psychosocial issues in HTN - ✔✔non-adherence to meds
cultural and economic barriers
resistance to lifestyle measures
✔✔elevated BP despite appropriate therapy - ✔✔bring in med list and prescriptions
taking pain meds?
comorbid conditions - depression or difficult life circumstances (difficult to comply with
med regimen)
, ✔✔cultural factors and HTN - ✔✔educate on value of taking meds, risk of silent illness,
acknowledge health care beliefs
✔✔economic struggle and HTN - ✔✔find generic brand
refer to social worker
✔✔diuretics - ✔✔medications that reduce fluid volume in the body and sodium
✔✔sympathoplegic agents - ✔✔beta blockers
decrease BP by vasodilation, inhibiting cardiac function or increasing venous pooling of
the blood
✔✔direct vasodilators - ✔✔Calcium channel blocker
decrease BP by decreasing vascular resistance the resistant vessels or by increasing
venous capacitance (decreased CO)
✔✔drugs that interrupt the RAAS - ✔✔ACE/ARB
decrease BP by countering the effect of angiotensin II on increasing peripheral vascular
resistance and increasing volume depletion
✔✔diuretics side effects - ✔✔hypokalemia
metabolic side effects that worsen hyperglycemia and dyslipidemia, cause uric acid
retention, gout, and ED (thiazides)
✔✔Beta blocker side effects - ✔✔bradycardia
worsening asthma or COPD
worsen hyperglycemia and dyslipidemia
cold feet
vivid dreams
rebound HTN on discontinuation
✔✔ACE inhibitors adverse effects - ✔✔dry cough
hypotension
hyperkalemia
rash
fever
altered taste
angioedema (rare but life-threatening)
acute renal failure (patients with bilateral renal artery stenosis)
✔✔ARB side effects - ✔✔lower incidence of dry cough and angioedema than ACE
✔✔CCBs adverse effects - ✔✔hypotension
flushing
nausea
