NURS 5434 HYPERTENSION EXAM 200 ACTUAL QUESTIONS
AND CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+ ASSURED PASS
The NURS 5434 Hypertension exam is a graduate-level nursing assessment
designed to evaluate advanced practice knowledge of the pathophysiology,
pharmacology, and comprehensive management of hypertension. The exam
covers the ACC/AHA hypertension guidelines, including blood pressure
classification, lifestyle modifications, and pharmacologic treatment across
diverse patient populations. Key content areas include antihypertensive drug
classes such as ACE inhibitors, ARBs, calcium channel blockers, beta-
blockers, diuretics, and direct vasodilators, along with their mechanisms,
adverse effects, and contraindications. The exam also addresses hypertensive
emergencies, secondary hypertension, and the management of comorbid
conditions such as diabetes, chronic kidney disease, and heart failure.
Successful completion demonstrates clinical competency in evidence-based
hypertension management.
1. A nurse is assessing a client who has newly diagnosed hypertension. Which of
the following blood pressure readings is consistent with a diagnosis of stage 1
hypertension according to the ACC/AHA guidelines?
A) 118/76 mm Hg
B) 128/82 mm Hg
C) 138/88 mm Hg
D) 158/98 mm Hg
Answer: C
Rationale: According to the ACC/AHA guidelines, stage 1 hypertension is defined
as a systolic blood pressure of 130 to 139 mm Hg or a diastolic blood pressure of
80 to 89 mm Hg. A reading of 138/88 mm Hg falls within this range. A reading of
118/76 is normal, 128/82 is elevated, and 158/98 is stage 2 hypertension.
2. A nurse is providing teaching to a client who has hypertension and a new
prescription for hydrochlorothiazide. Which of the following instructions should
the nurse include?
A) Take the medication at bedtime
B) Increase intake of potassium-rich foods
,C) Restrict fluid intake to 1 liter per day
D) Take the medication with a high-fat meal
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia,
so the client should increase intake of potassium-rich foods such as bananas and
oranges. The medication should be taken in the morning to avoid nocturia, fluid
restriction is not typically required, and it can be taken without regard to meals.
3. A nurse is assessing a client who has hypertension and is taking lisinopril.
Which of the following findings indicates an adverse effect of this medication?
A) Dry cough
B) Hypokalemia
C) Tachycardia
D) Weight gain
Answer: A
Rationale: Lisinopril is an ACE inhibitor, and a persistent dry cough is a common
adverse effect due to the accumulation of bradykinin. Hypokalemia is more
common with diuretics, tachycardia is not a typical adverse effect, and weight gain
is not associated with ACE inhibitors.
4. A nurse is evaluating the effectiveness of lifestyle modifications for a client with
hypertension. Which of the following dietary approaches is most effective for
lowering blood pressure?
A) Low-carbohydrate diet
B) DASH diet
C) High-protein diet
D) Low-fat diet
Answer: B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet, which
emphasizes fruits, vegetables, whole grains, and low-fat dairy while limiting
sodium and saturated fat, is the most effective dietary approach for lowering blood
pressure. The other diets are not specifically proven for hypertension management.
5. A nurse is caring for a client who has a hypertensive crisis. Which of the
following is the priority nursing intervention?
A) Administer oral antihypertensive medication
B) Place the client in a supine position
C) Administer intravenous antihypertensive agents as prescribed
D) Encourage the client to ambulate
Answer: C
,Rationale: In a hypertensive crisis, rapid reduction of blood pressure is needed, and
intravenous antihypertensive agents are the priority to prevent target organ
damage. Oral medications act too slowly, supine positioning does not lower blood
pressure, and ambulation is not appropriate.
6. A nurse is assessing a client who has hypertension and reports a headache and
blurred vision. Which of the following complications should the nurse suspect?
A) Hypertensive encephalopathy
B) Myocardial infarction
C) Stroke
D) Renal failure
Answer: A
Rationale: Hypertensive encephalopathy is a severe complication of hypertension
characterized by headache, blurred vision, confusion, and seizures due to cerebral
edema. Myocardial infarction presents with chest pain, stroke with neurologic
deficits, and renal failure with changes in urine output.
7. A nurse is providing teaching to a client who has hypertension and a new
prescription for amlodipine. Which of the following adverse effects should the
nurse instruct the client to report?
A) Edema of the ankles
B) Dry cough
C) Bradycardia
D) Hyperkalemia
Answer: A
Rationale: Amlodipine is a calcium channel blocker that commonly causes
peripheral edema due to vasodilation. Dry cough is associated with ACE inhibitors,
bradycardia is more common with beta-blockers or nondihydropyridine calcium
channel blockers, and hyperkalemia is associated with ACE inhibitors and ARBs.
8. A nurse is reviewing the laboratory results of a client who has hypertension and
is taking spironolactone. Which of the following findings should the nurse report to
the provider?
A) Serum potassium of 5.2 mEq/L
B) Serum sodium of 140 mEq/L
C) Serum creatinine of 1.0 mg/dL
D) Serum calcium of 9.5 mg/dL
Answer: A
, Rationale: Spironolactone is a potassium-sparing diuretic, and a serum potassium
of 5.2 mEq/L is above the normal range, indicating hyperkalemia, which should be
reported. The other values are within normal limits.
9. A nurse is assessing a client who has stage 2 hypertension. Which of the
following blood pressure readings is consistent with this diagnosis?
A) 132/86 mm Hg
B) 142/92 mm Hg
C) 152/96 mm Hg
D) 162/102 mm Hg
Answer: D
Rationale: Stage 2 hypertension is defined as a systolic blood pressure of 160 mm
Hg or higher or a diastolic blood pressure of 100 mm Hg or higher. A reading of
162/102 mm Hg meets this criterion. The other readings are stage 1 or elevated.
10. A nurse is providing teaching to a client who has hypertension about the
importance of medication adherence. Which of the following statements by the
client indicates understanding?
A) I can stop my medication when my blood pressure is normal
B) I will take my medication at the same time every day
C) I can skip a dose if I feel dizzy
D) I will double my dose if I miss a day
Answer: B
Rationale: Taking medication at the same time every day promotes adherence and
maintains consistent blood levels. Stopping medication when blood pressure is
normal can cause rebound hypertension, skipping doses is not recommended, and
doubling doses can cause toxicity.
11. A nurse is assessing a client who has hypertension and is taking metoprolol.
Which of the following findings indicates that the medication is effective?
A) Heart rate of 56 beats per minute
B) Blood pressure of 148/94 mm Hg
C) Respiratory rate of 22 breaths per minute
D) Blood glucose of 110 mg/dL
Answer: A
Rationale: Metoprolol is a beta-blocker that lowers blood pressure and heart rate. A
heart rate of 56 beats per minute may be a therapeutic effect, but blood pressure of
148/94 is elevated and indicates the medication is not fully effective. The
respiratory rate and blood glucose are not direct indicators of metoprolol
effectiveness.
AND CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+ ASSURED PASS
The NURS 5434 Hypertension exam is a graduate-level nursing assessment
designed to evaluate advanced practice knowledge of the pathophysiology,
pharmacology, and comprehensive management of hypertension. The exam
covers the ACC/AHA hypertension guidelines, including blood pressure
classification, lifestyle modifications, and pharmacologic treatment across
diverse patient populations. Key content areas include antihypertensive drug
classes such as ACE inhibitors, ARBs, calcium channel blockers, beta-
blockers, diuretics, and direct vasodilators, along with their mechanisms,
adverse effects, and contraindications. The exam also addresses hypertensive
emergencies, secondary hypertension, and the management of comorbid
conditions such as diabetes, chronic kidney disease, and heart failure.
Successful completion demonstrates clinical competency in evidence-based
hypertension management.
1. A nurse is assessing a client who has newly diagnosed hypertension. Which of
the following blood pressure readings is consistent with a diagnosis of stage 1
hypertension according to the ACC/AHA guidelines?
A) 118/76 mm Hg
B) 128/82 mm Hg
C) 138/88 mm Hg
D) 158/98 mm Hg
Answer: C
Rationale: According to the ACC/AHA guidelines, stage 1 hypertension is defined
as a systolic blood pressure of 130 to 139 mm Hg or a diastolic blood pressure of
80 to 89 mm Hg. A reading of 138/88 mm Hg falls within this range. A reading of
118/76 is normal, 128/82 is elevated, and 158/98 is stage 2 hypertension.
2. A nurse is providing teaching to a client who has hypertension and a new
prescription for hydrochlorothiazide. Which of the following instructions should
the nurse include?
A) Take the medication at bedtime
B) Increase intake of potassium-rich foods
,C) Restrict fluid intake to 1 liter per day
D) Take the medication with a high-fat meal
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia,
so the client should increase intake of potassium-rich foods such as bananas and
oranges. The medication should be taken in the morning to avoid nocturia, fluid
restriction is not typically required, and it can be taken without regard to meals.
3. A nurse is assessing a client who has hypertension and is taking lisinopril.
Which of the following findings indicates an adverse effect of this medication?
A) Dry cough
B) Hypokalemia
C) Tachycardia
D) Weight gain
Answer: A
Rationale: Lisinopril is an ACE inhibitor, and a persistent dry cough is a common
adverse effect due to the accumulation of bradykinin. Hypokalemia is more
common with diuretics, tachycardia is not a typical adverse effect, and weight gain
is not associated with ACE inhibitors.
4. A nurse is evaluating the effectiveness of lifestyle modifications for a client with
hypertension. Which of the following dietary approaches is most effective for
lowering blood pressure?
A) Low-carbohydrate diet
B) DASH diet
C) High-protein diet
D) Low-fat diet
Answer: B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet, which
emphasizes fruits, vegetables, whole grains, and low-fat dairy while limiting
sodium and saturated fat, is the most effective dietary approach for lowering blood
pressure. The other diets are not specifically proven for hypertension management.
5. A nurse is caring for a client who has a hypertensive crisis. Which of the
following is the priority nursing intervention?
A) Administer oral antihypertensive medication
B) Place the client in a supine position
C) Administer intravenous antihypertensive agents as prescribed
D) Encourage the client to ambulate
Answer: C
,Rationale: In a hypertensive crisis, rapid reduction of blood pressure is needed, and
intravenous antihypertensive agents are the priority to prevent target organ
damage. Oral medications act too slowly, supine positioning does not lower blood
pressure, and ambulation is not appropriate.
6. A nurse is assessing a client who has hypertension and reports a headache and
blurred vision. Which of the following complications should the nurse suspect?
A) Hypertensive encephalopathy
B) Myocardial infarction
C) Stroke
D) Renal failure
Answer: A
Rationale: Hypertensive encephalopathy is a severe complication of hypertension
characterized by headache, blurred vision, confusion, and seizures due to cerebral
edema. Myocardial infarction presents with chest pain, stroke with neurologic
deficits, and renal failure with changes in urine output.
7. A nurse is providing teaching to a client who has hypertension and a new
prescription for amlodipine. Which of the following adverse effects should the
nurse instruct the client to report?
A) Edema of the ankles
B) Dry cough
C) Bradycardia
D) Hyperkalemia
Answer: A
Rationale: Amlodipine is a calcium channel blocker that commonly causes
peripheral edema due to vasodilation. Dry cough is associated with ACE inhibitors,
bradycardia is more common with beta-blockers or nondihydropyridine calcium
channel blockers, and hyperkalemia is associated with ACE inhibitors and ARBs.
8. A nurse is reviewing the laboratory results of a client who has hypertension and
is taking spironolactone. Which of the following findings should the nurse report to
the provider?
A) Serum potassium of 5.2 mEq/L
B) Serum sodium of 140 mEq/L
C) Serum creatinine of 1.0 mg/dL
D) Serum calcium of 9.5 mg/dL
Answer: A
, Rationale: Spironolactone is a potassium-sparing diuretic, and a serum potassium
of 5.2 mEq/L is above the normal range, indicating hyperkalemia, which should be
reported. The other values are within normal limits.
9. A nurse is assessing a client who has stage 2 hypertension. Which of the
following blood pressure readings is consistent with this diagnosis?
A) 132/86 mm Hg
B) 142/92 mm Hg
C) 152/96 mm Hg
D) 162/102 mm Hg
Answer: D
Rationale: Stage 2 hypertension is defined as a systolic blood pressure of 160 mm
Hg or higher or a diastolic blood pressure of 100 mm Hg or higher. A reading of
162/102 mm Hg meets this criterion. The other readings are stage 1 or elevated.
10. A nurse is providing teaching to a client who has hypertension about the
importance of medication adherence. Which of the following statements by the
client indicates understanding?
A) I can stop my medication when my blood pressure is normal
B) I will take my medication at the same time every day
C) I can skip a dose if I feel dizzy
D) I will double my dose if I miss a day
Answer: B
Rationale: Taking medication at the same time every day promotes adherence and
maintains consistent blood levels. Stopping medication when blood pressure is
normal can cause rebound hypertension, skipping doses is not recommended, and
doubling doses can cause toxicity.
11. A nurse is assessing a client who has hypertension and is taking metoprolol.
Which of the following findings indicates that the medication is effective?
A) Heart rate of 56 beats per minute
B) Blood pressure of 148/94 mm Hg
C) Respiratory rate of 22 breaths per minute
D) Blood glucose of 110 mg/dL
Answer: A
Rationale: Metoprolol is a beta-blocker that lowers blood pressure and heart rate. A
heart rate of 56 beats per minute may be a therapeutic effect, but blood pressure of
148/94 is elevated and indicates the medication is not fully effective. The
respiratory rate and blood glucose are not direct indicators of metoprolol
effectiveness.
