NURS 5434 FAMILY III HTN QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027 NURS
5434 FAMILY III HTN QUIZ (LATEST 2026/2027 UPDATE)
SECTION ONE: QUESTIONS 1-100
1. A 55-year-old Black male patient with a new diagnosis of hypertension has a blood
pressure of 148/92 mmHg. According to the JNC 8 guidelines, what is the most
appropriate initial pharmacological therapy for this patient?
A. Hydrochlorothiazide
B. Lisinopril
C. Amlodipine
D. Metoprolol
🟢 C. Amlodipine
🔴 RATIONALE: JNC 8 guidelines recommend initial antihypertensive therapy for Black
patients, including those with diabetes, to include a thiazide-type diuretic or a calcium
channel blocker (CCB). Amlodipine is a CCB and is preferred in this population due to its
proven efficacy in reducing cardiovascular events.
,2. A nurse is evaluating a patient's 24-hour ambulatory blood pressure monitoring
report. The average daytime reading is 145/90 mmHg, and the average nighttime
reading is 130/80 mmHg. How would this pattern be classified?
A. Normal diurnal variation
B. Dipper pattern
C. Non-dipper pattern
D. Reverse dipper pattern
🟢 C. Non-dipper pattern
🔴 RATIONALE: A normal blood pressure pattern shows a 10-20% drop in nighttime BP
(dipper). A non-dipper pattern has a less than 10% drop in nocturnal systolic and
diastolic BP, which is associated with increased cardiovascular risk. This patient's
nighttime BP did not drop sufficiently.
3. Which of the following lifestyle modifications has the most significant and direct
impact on reducing systolic blood pressure in patients with stage 1 hypertension?
A. Reducing dietary sodium intake to <2.4 g per day
B. Limiting alcohol consumption to two drinks per day for men
C. Achieving a body mass index (BMI) of less than 25 kg/m²
D. Engaging in regular aerobic physical activity for 90 minutes per week
🟢 C. Achieving a body mass index (BMI) of less than 25 kg/m²
,🔴 RATIONALE: While all listed are important, weight loss has a near-linear relationship
with blood pressure reduction. A 1 kg/m² reduction in BMI is associated with a 1 mmHg
reduction in BP, and achieving a normal BMI can lower systolic BP by 5-20 mmHg per 10
kg of weight loss, making it the most impactful single intervention among the options.
4. A 68-year-old patient with a history of heart failure with reduced ejection fraction
(HFrEF) is started on a new antihypertensive. Which class of medication is
contraindicated in this patient population?
A. Angiotensin-converting enzyme inhibitors (ACEIs)
B. Angiotensin receptor blockers (ARBs)
C. Beta-blockers (e.g., carvedilol)
D. Dihydropyridine calcium channel blockers (e.g., amlodipine)
🟢 D. Dihydropyridine calcium channel blockers (e.g., amlodipine)
🔴 RATIONALE: Dihydropyridine CCBs like amlodipine have negative inotropic effects
and can worsen heart failure symptoms. ACEIs, ARBs, and beta-blockers are a
cornerstone of HFrEF therapy and have been shown to reduce mortality and
hospitalization.
5. A patient presents with a blood pressure of 210/120 mmHg and reports a severe
headache, chest pain, and dyspnea. What is the priority nursing action?
, A. Administer a sublingual nifedipine capsule
B. Obtain a 12-lead electrocardiogram (ECG)
C. Prepare for the administration of intravenous (IV) antihypertensives
D. Begin a continuous nicardipine infusion
🟢 C. Prepare for the administration of intravenous (IV) antihypertensives
🔴 RATIONALE: This patient is in a hypertensive emergency with evidence of target
organ damage. The priority is to reduce BP using a titratable intravenous agent to
prevent further damage. While an ECG is important, it should not delay the initiation of
IV therapy.
6. During a community health screening, a 42-year-old patient has a blood pressure
of 138/86 mmHg on two separate occasions. According to the 2017 ACC/AHA
guideline, this patient's blood pressure is classified as:
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
🟢 C. Stage 1 Hypertension
🔴 RATIONALE: The 2017 ACC/AHA guidelines define Stage 1 hypertension as a systolic
BP of 130-139 mmHg OR a diastolic BP of 80-89 mmHg. The patient's BP of 138/86 falls
ANSWERS) PLUS RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027 NURS
5434 FAMILY III HTN QUIZ (LATEST 2026/2027 UPDATE)
SECTION ONE: QUESTIONS 1-100
1. A 55-year-old Black male patient with a new diagnosis of hypertension has a blood
pressure of 148/92 mmHg. According to the JNC 8 guidelines, what is the most
appropriate initial pharmacological therapy for this patient?
A. Hydrochlorothiazide
B. Lisinopril
C. Amlodipine
D. Metoprolol
🟢 C. Amlodipine
🔴 RATIONALE: JNC 8 guidelines recommend initial antihypertensive therapy for Black
patients, including those with diabetes, to include a thiazide-type diuretic or a calcium
channel blocker (CCB). Amlodipine is a CCB and is preferred in this population due to its
proven efficacy in reducing cardiovascular events.
,2. A nurse is evaluating a patient's 24-hour ambulatory blood pressure monitoring
report. The average daytime reading is 145/90 mmHg, and the average nighttime
reading is 130/80 mmHg. How would this pattern be classified?
A. Normal diurnal variation
B. Dipper pattern
C. Non-dipper pattern
D. Reverse dipper pattern
🟢 C. Non-dipper pattern
🔴 RATIONALE: A normal blood pressure pattern shows a 10-20% drop in nighttime BP
(dipper). A non-dipper pattern has a less than 10% drop in nocturnal systolic and
diastolic BP, which is associated with increased cardiovascular risk. This patient's
nighttime BP did not drop sufficiently.
3. Which of the following lifestyle modifications has the most significant and direct
impact on reducing systolic blood pressure in patients with stage 1 hypertension?
A. Reducing dietary sodium intake to <2.4 g per day
B. Limiting alcohol consumption to two drinks per day for men
C. Achieving a body mass index (BMI) of less than 25 kg/m²
D. Engaging in regular aerobic physical activity for 90 minutes per week
🟢 C. Achieving a body mass index (BMI) of less than 25 kg/m²
,🔴 RATIONALE: While all listed are important, weight loss has a near-linear relationship
with blood pressure reduction. A 1 kg/m² reduction in BMI is associated with a 1 mmHg
reduction in BP, and achieving a normal BMI can lower systolic BP by 5-20 mmHg per 10
kg of weight loss, making it the most impactful single intervention among the options.
4. A 68-year-old patient with a history of heart failure with reduced ejection fraction
(HFrEF) is started on a new antihypertensive. Which class of medication is
contraindicated in this patient population?
A. Angiotensin-converting enzyme inhibitors (ACEIs)
B. Angiotensin receptor blockers (ARBs)
C. Beta-blockers (e.g., carvedilol)
D. Dihydropyridine calcium channel blockers (e.g., amlodipine)
🟢 D. Dihydropyridine calcium channel blockers (e.g., amlodipine)
🔴 RATIONALE: Dihydropyridine CCBs like amlodipine have negative inotropic effects
and can worsen heart failure symptoms. ACEIs, ARBs, and beta-blockers are a
cornerstone of HFrEF therapy and have been shown to reduce mortality and
hospitalization.
5. A patient presents with a blood pressure of 210/120 mmHg and reports a severe
headache, chest pain, and dyspnea. What is the priority nursing action?
, A. Administer a sublingual nifedipine capsule
B. Obtain a 12-lead electrocardiogram (ECG)
C. Prepare for the administration of intravenous (IV) antihypertensives
D. Begin a continuous nicardipine infusion
🟢 C. Prepare for the administration of intravenous (IV) antihypertensives
🔴 RATIONALE: This patient is in a hypertensive emergency with evidence of target
organ damage. The priority is to reduce BP using a titratable intravenous agent to
prevent further damage. While an ECG is important, it should not delay the initiation of
IV therapy.
6. During a community health screening, a 42-year-old patient has a blood pressure
of 138/86 mmHg on two separate occasions. According to the 2017 ACC/AHA
guideline, this patient's blood pressure is classified as:
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
🟢 C. Stage 1 Hypertension
🔴 RATIONALE: The 2017 ACC/AHA guidelines define Stage 1 hypertension as a systolic
BP of 130-139 mmHg OR a diastolic BP of 80-89 mmHg. The patient's BP of 138/86 falls
