NURS 5434 HYPERTENSION (HTN) TEST EXAM 2026 |
ACCURATE REAL EXAM QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED VERSIONS |
EXPERT VERIFIED FOR GUARANTEED PASS |
HTN LATEST UPDATE
SECTION 1: PATHOPHYSIOLOGY AND ETIOLOGY OF HYPERTENSION (Questions 1-40)
Question 1
Blood pressure is determined by which two primary factors?
A. Stroke volume and heart rate
B. Cardiac output and total peripheral vascular resistance
C. Blood volume and vessel elasticity
D. Sympathetic and parasympathetic tone
Correct Answer: B
Rationale: Blood pressure equals cardiac output (CO) multiplied by total
peripheral vascular resistance (TPR). CO is determined by stroke volume and heart
rate, while TPR is determined by the diameter and elasticity of arterioles.
Pathogenic mechanisms in hypertension involve abnormalities in both CO and
TPR.
Question 2
Which of the following is the most common type of hypertension, accounting for
approximately 90-95% of cases?
A. Secondary hypertension
B. Malignant hypertension
C. Primary (essential) hypertension
D. White coat hypertension
Correct Answer: C
1
,Rationale: Primary (essential) hypertension has no identifiable cause and accounts
for 90-95% of all hypertension cases. It is a multifactorial condition involving
genetic, environmental, and lifestyle factors. Secondary hypertension (5-10%) is
caused by an underlying condition such as renal disease, endocrine disorders, or
medication use.
Question 3
The renin-angiotensin-aldosterone system (RAAS) contributes to hypertension
through which mechanism?
A. Vasodilation and decreased sodium reabsorption
B. Vasoconstriction and increased sodium and water retention
C. Decreased sympathetic nervous system activity
D. Increased production of atrial natriuretic peptide
Correct Answer: B
Rationale: The RAAS is activated by decreased renal perfusion, leading to the
release of renin. Renin converts angiotensinogen to angiotensin I, which is then
converted to angiotensin II by ACE. Angiotensin II causes potent vasoconstriction
and stimulates aldosterone release, leading to sodium and water retention. Both
mechanisms increase blood pressure.
Question 4
Which of the following is a modifiable risk factor for primary hypertension?
A. Family history of hypertension
B. African American race
C. High dietary sodium intake
D. Age > 65 years
Correct Answer: C
Rationale: High dietary sodium intake is a modifiable risk factor for hypertension.
Family history, race (African American), and age are non-modifiable risk factors.
Modifiable risk factors also include obesity, physical inactivity, excessive alcohol
consumption, and smoking.
2
,Question 5
The pathophysiology of hypertension in African American patients is often
characterized by:
A. Decreased sensitivity to dietary sodium
B. Increased renin-angiotensin system activity
C. Increased salt sensitivity and low renin levels
D. Increased beta-adrenergic receptor sensitivity
Correct Answer: C
Rationale: African American patients with hypertension often exhibit salt
sensitivity and low-renin hypertension. This is thought to be related to genetic
factors affecting renal sodium handling. This pathophysiological difference has
implications for pharmacotherapy, as these patients often respond well to
diuretics and calcium channel blockers.
Question 6
Which of the following best describes the role of the sympathetic nervous system
in hypertension?
A. It decreases heart rate and cardiac output
B. It causes vasodilation and decreases peripheral resistance
C. It increases heart rate, cardiac output, and peripheral vascular resistance
D. It has no significant role in primary hypertension
Correct Answer: C
Rationale: The sympathetic nervous system is overactive in many patients with
hypertension, leading to increased heart rate, increased cardiac output, and
increased peripheral vascular resistance. This is mediated by increased
catecholamine release (epinephrine, norepinephrine) and activation of alpha- and
beta-adrenergic receptors.
Question 7
Endothelial dysfunction in hypertension is characterized by:
3
, A. Increased production of nitric oxide (NO)
B. Decreased production of vasodilatory substances (NO, prostacyclin)
C. Increased production of vasodilatory substances
D. Increased expression of endothelial nitric oxide synthase (eNOS)
Correct Answer: B
Rationale: Endothelial dysfunction is a hallmark of hypertension. It is
characterized by decreased production of vasodilatory substances such as nitric
oxide (NO) and prostacyclin, and increased production of vasoconstrictive
substances such as endothelin-1. This imbalance contributes to increased vascular
tone and vascular remodeling.
Question 8
Which of the following is a characteristic finding in patients with isolated systolic
hypertension (ISH)?
A. Elevated diastolic blood pressure with normal systolic blood pressure
B. Elevated systolic blood pressure with normal or low diastolic blood pressure
C. Elevated pulse pressure with normal systolic and diastolic pressure
D. Normal blood pressure with elevated mean arterial pressure
Correct Answer: B
Rationale: Isolated systolic hypertension is defined as SBP ≥ 130 mm Hg with DBP
< 80 mm Hg. It is most common in older adults and is primarily due to reduced
vascular compliance (stiffening of the large arteries). ISH is a strong risk factor for
cardiovascular events.
Question 9
The "salt sensitivity" phenotype in hypertension is associated with:
A. Increased renin activity
B. Decreased sodium excretion in response to a sodium load
C. Decreased blood pressure response to sodium restriction
D. Increased aldosterone levels
4
ACCURATE REAL EXAM QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED VERSIONS |
EXPERT VERIFIED FOR GUARANTEED PASS |
HTN LATEST UPDATE
SECTION 1: PATHOPHYSIOLOGY AND ETIOLOGY OF HYPERTENSION (Questions 1-40)
Question 1
Blood pressure is determined by which two primary factors?
A. Stroke volume and heart rate
B. Cardiac output and total peripheral vascular resistance
C. Blood volume and vessel elasticity
D. Sympathetic and parasympathetic tone
Correct Answer: B
Rationale: Blood pressure equals cardiac output (CO) multiplied by total
peripheral vascular resistance (TPR). CO is determined by stroke volume and heart
rate, while TPR is determined by the diameter and elasticity of arterioles.
Pathogenic mechanisms in hypertension involve abnormalities in both CO and
TPR.
Question 2
Which of the following is the most common type of hypertension, accounting for
approximately 90-95% of cases?
A. Secondary hypertension
B. Malignant hypertension
C. Primary (essential) hypertension
D. White coat hypertension
Correct Answer: C
1
,Rationale: Primary (essential) hypertension has no identifiable cause and accounts
for 90-95% of all hypertension cases. It is a multifactorial condition involving
genetic, environmental, and lifestyle factors. Secondary hypertension (5-10%) is
caused by an underlying condition such as renal disease, endocrine disorders, or
medication use.
Question 3
The renin-angiotensin-aldosterone system (RAAS) contributes to hypertension
through which mechanism?
A. Vasodilation and decreased sodium reabsorption
B. Vasoconstriction and increased sodium and water retention
C. Decreased sympathetic nervous system activity
D. Increased production of atrial natriuretic peptide
Correct Answer: B
Rationale: The RAAS is activated by decreased renal perfusion, leading to the
release of renin. Renin converts angiotensinogen to angiotensin I, which is then
converted to angiotensin II by ACE. Angiotensin II causes potent vasoconstriction
and stimulates aldosterone release, leading to sodium and water retention. Both
mechanisms increase blood pressure.
Question 4
Which of the following is a modifiable risk factor for primary hypertension?
A. Family history of hypertension
B. African American race
C. High dietary sodium intake
D. Age > 65 years
Correct Answer: C
Rationale: High dietary sodium intake is a modifiable risk factor for hypertension.
Family history, race (African American), and age are non-modifiable risk factors.
Modifiable risk factors also include obesity, physical inactivity, excessive alcohol
consumption, and smoking.
2
,Question 5
The pathophysiology of hypertension in African American patients is often
characterized by:
A. Decreased sensitivity to dietary sodium
B. Increased renin-angiotensin system activity
C. Increased salt sensitivity and low renin levels
D. Increased beta-adrenergic receptor sensitivity
Correct Answer: C
Rationale: African American patients with hypertension often exhibit salt
sensitivity and low-renin hypertension. This is thought to be related to genetic
factors affecting renal sodium handling. This pathophysiological difference has
implications for pharmacotherapy, as these patients often respond well to
diuretics and calcium channel blockers.
Question 6
Which of the following best describes the role of the sympathetic nervous system
in hypertension?
A. It decreases heart rate and cardiac output
B. It causes vasodilation and decreases peripheral resistance
C. It increases heart rate, cardiac output, and peripheral vascular resistance
D. It has no significant role in primary hypertension
Correct Answer: C
Rationale: The sympathetic nervous system is overactive in many patients with
hypertension, leading to increased heart rate, increased cardiac output, and
increased peripheral vascular resistance. This is mediated by increased
catecholamine release (epinephrine, norepinephrine) and activation of alpha- and
beta-adrenergic receptors.
Question 7
Endothelial dysfunction in hypertension is characterized by:
3
, A. Increased production of nitric oxide (NO)
B. Decreased production of vasodilatory substances (NO, prostacyclin)
C. Increased production of vasodilatory substances
D. Increased expression of endothelial nitric oxide synthase (eNOS)
Correct Answer: B
Rationale: Endothelial dysfunction is a hallmark of hypertension. It is
characterized by decreased production of vasodilatory substances such as nitric
oxide (NO) and prostacyclin, and increased production of vasoconstrictive
substances such as endothelin-1. This imbalance contributes to increased vascular
tone and vascular remodeling.
Question 8
Which of the following is a characteristic finding in patients with isolated systolic
hypertension (ISH)?
A. Elevated diastolic blood pressure with normal systolic blood pressure
B. Elevated systolic blood pressure with normal or low diastolic blood pressure
C. Elevated pulse pressure with normal systolic and diastolic pressure
D. Normal blood pressure with elevated mean arterial pressure
Correct Answer: B
Rationale: Isolated systolic hypertension is defined as SBP ≥ 130 mm Hg with DBP
< 80 mm Hg. It is most common in older adults and is primarily due to reduced
vascular compliance (stiffening of the large arteries). ISH is a strong risk factor for
cardiovascular events.
Question 9
The "salt sensitivity" phenotype in hypertension is associated with:
A. Increased renin activity
B. Decreased sodium excretion in response to a sodium load
C. Decreased blood pressure response to sodium restriction
D. Increased aldosterone levels
4
