HYPERTENSION CASE STUDY WITH ANSWERS
Page 1
, HYPERTENSION CASE STUDY WITH ANSWERS
HYPERTENSION
CASE STUDY
WITH DETAILED ANSWERS
Clinical Scenarios for Nursing Students & Educators
This case study presents a realistic clinical scenario involving a patient with hypertension, followed by comprehensive
questions that test assessment skills, clinical reasoning, pharmacology knowledge, patient education, and critical thinking.
Each question includes a detailed rationale to enhance learning.
Page 2
, HYPERTENSION CASE STUDY WITH ANSWERS
CASE STUDY: MR. JAMES HARRISON
Patient Profile
Name: James Harrison
Age: 58 years old
Gender: Male
Race: African American
Marital Status: Married, lives with wife
Occupation: Truck driver (long-haul, sedentary job)
Insurance: Commercial insurance with prescription coverage
CHIEF COMPLAINT:
"I have been feeling more tired than usual, and my wife says I have been snoring really loud. I came in because my home
blood pressure readings have been high."
HISTORY OF PRESENT ILLNESS:
Mr. Harrison was diagnosed with hypertension 5 years ago but admits to being inconsistent with his medications. He
reports taking his prescribed lisinopril 10 mg "when I remember, maybe 3-4 times a week." He stopped taking
hydrochlorothiazide 6 months ago because it "made me pee too much during my driving routes." He has not seen his
primary care provider in 18 months.
Over the past 3 months, he has noticed:
- Increasing fatigue and shortness of breath when climbing stairs
- Occasional morning headaches
- Blurred vision that comes and goes
- Increased nocturia (3-4 times per night)
- Loud snoring with episodes of gasping (per wife)
- Mild bilateral ankle swelling by end of day
He denies chest pain, palpitations, dizziness, or syncope. He reports no recent illness or stress.
Past Medical History
* Hypertension - diagnosed 5 years ago, poorly controlled
* Type 2 Diabetes Mellitus - diagnosed 3 years ago, taking metformin 1000 mg BID, last
HbA1c 8.2% (6 months ago)* Dyslipidemia - on atorvastatin 40 mg daily
* Obstructive Sleep Apnea - suspected, never formally diagnosed
* Chronic low back pain - takes ibuprofen 600 mg 2-3 times daily
Family History
* Father: Died of myocardial infarction at age 62
* Mother: Hypertension, chronic kidney disease, alive at age 81
* Brother: Type 2 diabetes, hypertension, age 55
* Sister: Obesity, no known chronic conditions
Social History
* Tobacco: 1 pack per day for 35 years (35 pack-years)
* Alcohol: 2-3 beers on weekends
* Caffeine: 4-5 cups of coffee daily
* Diet: Fast food 4-5 times per week, high sodium intake, few fruits/vegetables
Page 3
Page 1
, HYPERTENSION CASE STUDY WITH ANSWERS
HYPERTENSION
CASE STUDY
WITH DETAILED ANSWERS
Clinical Scenarios for Nursing Students & Educators
This case study presents a realistic clinical scenario involving a patient with hypertension, followed by comprehensive
questions that test assessment skills, clinical reasoning, pharmacology knowledge, patient education, and critical thinking.
Each question includes a detailed rationale to enhance learning.
Page 2
, HYPERTENSION CASE STUDY WITH ANSWERS
CASE STUDY: MR. JAMES HARRISON
Patient Profile
Name: James Harrison
Age: 58 years old
Gender: Male
Race: African American
Marital Status: Married, lives with wife
Occupation: Truck driver (long-haul, sedentary job)
Insurance: Commercial insurance with prescription coverage
CHIEF COMPLAINT:
"I have been feeling more tired than usual, and my wife says I have been snoring really loud. I came in because my home
blood pressure readings have been high."
HISTORY OF PRESENT ILLNESS:
Mr. Harrison was diagnosed with hypertension 5 years ago but admits to being inconsistent with his medications. He
reports taking his prescribed lisinopril 10 mg "when I remember, maybe 3-4 times a week." He stopped taking
hydrochlorothiazide 6 months ago because it "made me pee too much during my driving routes." He has not seen his
primary care provider in 18 months.
Over the past 3 months, he has noticed:
- Increasing fatigue and shortness of breath when climbing stairs
- Occasional morning headaches
- Blurred vision that comes and goes
- Increased nocturia (3-4 times per night)
- Loud snoring with episodes of gasping (per wife)
- Mild bilateral ankle swelling by end of day
He denies chest pain, palpitations, dizziness, or syncope. He reports no recent illness or stress.
Past Medical History
* Hypertension - diagnosed 5 years ago, poorly controlled
* Type 2 Diabetes Mellitus - diagnosed 3 years ago, taking metformin 1000 mg BID, last
HbA1c 8.2% (6 months ago)* Dyslipidemia - on atorvastatin 40 mg daily
* Obstructive Sleep Apnea - suspected, never formally diagnosed
* Chronic low back pain - takes ibuprofen 600 mg 2-3 times daily
Family History
* Father: Died of myocardial infarction at age 62
* Mother: Hypertension, chronic kidney disease, alive at age 81
* Brother: Type 2 diabetes, hypertension, age 55
* Sister: Obesity, no known chronic conditions
Social History
* Tobacco: 1 pack per day for 35 years (35 pack-years)
* Alcohol: 2-3 beers on weekends
* Caffeine: 4-5 cups of coffee daily
* Diet: Fast food 4-5 times per week, high sodium intake, few fruits/vegetables
Page 3
