ANCC FNP REVIEW QUESTIONS WITH
CORRECT ANSWERS GRADED A+ 2026-2027
1
,special considerations for Thiazides ANSWER > Chlorthalidone is preferred on the
basis of prolonged half-life and proven trial reduction of CVD.
Monitor for hyponatremia and hypokalemia, monitor uric acid and calcium levels.
Use with caution in patients with history of acute gout unless patient is on uric acid-
lowering therapy.
special considerations for ACE inhibitors ANSWER > Do not use in combination with
ARBs or direct renin inhibitor.
There is an increased risk of hyperkalemia, especially in patients with CKD or in those
on K+ supplements or K+-sparing drugs.
There is a risk of acute renal failure in patients with severe bilateral renal artery
stenosis.
Do not use if patient has history of angioedema with ACE inhibitors.
2
,ACE inhibitor cough is common, in 5 to 20 percent of patients, due to bradykinin
production.
Avoid in pregnant females or females of reproductive age without adequate
contraception
special considerations for Angiotensin receptor blockers ANSWER > Do not use in
combination with ACE inhibitors or direct renin inhibitor.
There is an increased risk of hyperkalemia in CKD or in those on K+ supplements or
K+-sparing drugs.
There is a risk of acute renal failure in patients with severe bilateral renal artery
stenosis.
Do not use if patient has history of angioedema with ARBs. Patients with a history of
angioedema with an ACE inhibitor can receive an ARB beginning 6 weeks after ACE
inhibitor is discontinued.
Avoid in pregnant females or females of reproductive age without adequate
contraception.
3
, Lower risk of cough than ACE-Is.
special considerations for Calcium channel blockers ANSWER > Associated with dose-
related pedal edema, which is more common in females than men.
When should you Refer to a Nephrologist or Cardiologist in a hypertensive patient?
ANSWER > -signs of end-organ damage
-evidence of a secondary cause of hypertension
-only on one to two medications
Generally, failure to achieve blood pressure goal in patients who are adhering to full
doses of an appropriate three to four drug regimen that includes a diuretic may warrant
referral to a nephrologist or cardiologist
Before referring, clinicians should first review other causes of inadequate hypertension
control such as:
-Improper blood pressure measurement
-White coat hypertension
-Excess sodium intake
4
CORRECT ANSWERS GRADED A+ 2026-2027
1
,special considerations for Thiazides ANSWER > Chlorthalidone is preferred on the
basis of prolonged half-life and proven trial reduction of CVD.
Monitor for hyponatremia and hypokalemia, monitor uric acid and calcium levels.
Use with caution in patients with history of acute gout unless patient is on uric acid-
lowering therapy.
special considerations for ACE inhibitors ANSWER > Do not use in combination with
ARBs or direct renin inhibitor.
There is an increased risk of hyperkalemia, especially in patients with CKD or in those
on K+ supplements or K+-sparing drugs.
There is a risk of acute renal failure in patients with severe bilateral renal artery
stenosis.
Do not use if patient has history of angioedema with ACE inhibitors.
2
,ACE inhibitor cough is common, in 5 to 20 percent of patients, due to bradykinin
production.
Avoid in pregnant females or females of reproductive age without adequate
contraception
special considerations for Angiotensin receptor blockers ANSWER > Do not use in
combination with ACE inhibitors or direct renin inhibitor.
There is an increased risk of hyperkalemia in CKD or in those on K+ supplements or
K+-sparing drugs.
There is a risk of acute renal failure in patients with severe bilateral renal artery
stenosis.
Do not use if patient has history of angioedema with ARBs. Patients with a history of
angioedema with an ACE inhibitor can receive an ARB beginning 6 weeks after ACE
inhibitor is discontinued.
Avoid in pregnant females or females of reproductive age without adequate
contraception.
3
, Lower risk of cough than ACE-Is.
special considerations for Calcium channel blockers ANSWER > Associated with dose-
related pedal edema, which is more common in females than men.
When should you Refer to a Nephrologist or Cardiologist in a hypertensive patient?
ANSWER > -signs of end-organ damage
-evidence of a secondary cause of hypertension
-only on one to two medications
Generally, failure to achieve blood pressure goal in patients who are adhering to full
doses of an appropriate three to four drug regimen that includes a diuretic may warrant
referral to a nephrologist or cardiologist
Before referring, clinicians should first review other causes of inadequate hypertension
control such as:
-Improper blood pressure measurement
-White coat hypertension
-Excess sodium intake
4
