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Section 1: Hypertension Pathophysiology & Classification (8
Questions)
Q1: According to the 2017 ACC/AHA guidelines, what is the systolic blood pressure
threshold for Stage 1 hypertension in adults?
A. ≥120 mmHg
B. ≥130 mmHg [CORRECT]
C. ≥140 mmHg
D. ≥150 mmHg
Correct Answer: B
Rationale: Correct because the 2017 ACC/AHA guidelines define Stage 1
hypertension as systolic BP 130–139 mmHg or diastolic BP 80–89 mmHg, lowering
the threshold from previous guidelines.
Q2: Which component of the renin-angiotensin-aldosterone system (RAAS) is
primarily responsible for vasoconstriction and increased blood pressure?
A. Renin
B. Angiotensin I
C. Angiotensin II [CORRECT]
D. Aldosterone
Correct Answer: C
Rationale: Correct because angiotensin II is a potent vasoconstrictor that directly
increases peripheral vascular resistance and stimulates aldosterone release.
Q3: In the pathophysiology of essential hypertension, increased sympathetic nervous
system activity primarily leads to which hemodynamic change?
A. Decreased cardiac output
B. Increased heart rate and peripheral vascular resistance [CORRECT]
C. Decreased stroke volume
D. Venodilation and reduced preload
, Correct Answer: B
Rationale: Correct because sympathetic activation increases heart rate, contractility,
and peripheral vascular resistance through alpha-1 and beta-1 adrenergic receptor
stimulation.
Q4: Endothelial dysfunction in hypertension is characterized by reduced production
of which vasodilator?
A. Angiotensin II
B. Endothelin-1
C. Nitric oxide [CORRECT]
D. Norepinephrine
Correct Answer: C
Rationale: Correct because impaired nitric oxide bioavailability reduces vasodilation,
promotes vascular smooth muscle proliferation, and contributes to sustained
elevation in blood pressure.
Q5: Vascular remodeling in chronic hypertension is best described as:
A. Decreased collagen deposition and arterial wall thinning
B. Increased lumen diameter and decreased wall thickness
C. Medial hypertrophy and increased wall-to-lumen ratio [CORRECT]
D. Endothelial hyperplasia with decreased peripheral resistance
Correct Answer: C
Rationale: Correct because chronic hypertension causes smooth muscle
hypertrophy, collagen deposition, and structural changes that increase arterial wall
thickness relative to lumen diameter.
Q6: A 55-year-old patient has a clinic blood pressure of 142/88 mmHg. According to
ACC/AHA guidelines, how should this be classified?
A. Normal
B. Elevated
C. Stage 1 hypertension [CORRECT]
D. Stage 2 hypertension
Correct Answer: C
Rationale: Correct because a systolic BP of 142 mmHg falls within the Stage 1
hypertension range (130–139 mmHg is Stage 1; however, 142/88 is actually Stage 2
- wait, let me correct. 142/88: systolic 142 is Stage 2 (≥140), diastolic 88 is Stage 1