MEDSURG EXAM 1 QUESTIONS AND CORRECT ANSWERS
normal blood pressure CORRECT ANSWERS✓✓<120/<80 mmHg
elevated blood pressure CORRECT ANSWERS✓✓120-129/<80 mmHg
stage I HTN CORRECT ANSWERS✓✓130-139/80-89
stage II HTN CORRECT ANSWERS✓✓>=140/>=90 mmHg
modifiable risk factors CORRECT ANSWERS✓✓contributors of a noncommunicable disease that can be
altered by changing one's behavior or environment
modifiable risk factors for HTN CORRECT ANSWERS✓✓-high sodium diet
-obesity
-sedentary lifestyle
-DM
-smoking
nonmodifiable risk factors CORRECT ANSWERS✓✓nonchangeable or noncontrollable
nonmodifiable risk factors of HTN CORRECT ANSWERS✓✓-genetics
-family hx
-age
-race
secondary hypertension CORRECT ANSWERS✓✓results from another disease or is the side effect of
medications, ex:
-renal disease!!!!
,-obstructive sleep apnea!!!!
-endocrine disorders
-hormone therapy, steroids, !!!!immunosuppressants
consequences of uncontrolled HTN CORRECT ANSWERS✓✓end organ damage! want to prevent this
from occurring!!!!!!!
-kidneys: renal damage (failure, proteinuria)!
-vasculature: peripheral vascular disease
-eyes: retinopathy
-brain: hemorrhage, stroke
-heart: LVH, CHD, CHF
Million Hearts Campaign CORRECT ANSWERS✓✓Hypertension Control Change Package (HCCP)
-used to improve HTN control
-how? ABCs
million hearts campaign ABCs CORRECT ANSWERS✓✓-Aspirin for high risk patients
-Blood pressure control
-Cholesterol management
-Smoking cessation
Affordable Care Act and HTN CORRECT ANSWERS✓✓-annual wellness visits
-eRecords for improved monitoring
-no co-pay for preventative health services
treatment of HTN CORRECT ANSWERS✓✓-lifestyle changes: lose weight, eat fruits and veggies, reduce
salt intake (CDC and AHA recommends), become active, moderate alcohol intake
-pharmacotherapy
,reduced salt CORRECT ANSWERS✓✓CDC reccommends no more than 2300mg/day
AHA ideally less than 1500mg/day
DASH diet CORRECT ANSWERS✓✓Dietary Approaches to Stop Hypertension,
-high in grains, high in fruits, low in fats!!
increasing activity levels for HTN tx CORRECT ANSWERS✓✓150min/week!!!!!!!!!!!!!!
-exercising 10 MINUTES at a time 3 TIMES A DAY, 5 DAYS A WEEK can help lower BP
-or 30 minutes a day, 5 days a week
does lifestyle modification work? CORRECT ANSWERS✓✓yes!!!!! can make a significant difference in pt's
BP
goals for individuals w HTN (important) CORRECT ANSWERS✓✓<130/80!!!!!!!! (in the elevated BP range)
-may be able to complete w lifestyle modifications alone
-but may also need medications
first-line treatments for HTN CORRECT ANSWERS✓✓need to know
-thiazide-type diuretics
-calcium channel blockers
-angiotensin converting enzyme (ACE) inhibitors
-angiotensin receptor blockers (ARBs)
thiazide-type diuretics CORRECT ANSWERS✓✓decrease sodium reabsorption which increases fluid loss
in urine, which in turn decreases extracellular fluid and plasma volume, reducing cardiac output and
lowering BP
-also cause potassium loss while retaining calcium.
-initial therapy for african americans
, -not given if renal disease!!!!
calcium channel blockers CORRECT ANSWERS✓✓inhibit the entry of calcium ions into heart muscle cells,
causing a slowing of the heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing
of the smooth muscle cells of the blood vessels to cause dilation
-initial therapy for african americans, not recommended for reduced ejection fraction
ace inhibitors or ARBS CORRECT ANSWERS✓✓ACE inhibitors interfere w ACE and reduce activity of
angiotensin II; ARBs block action of angiotensin II
-better therapy choice for patients with HTN and CKD
-SHOULD NOT BE USED SIMULTANEOUSLY bc they have the same effect
common side effect with ACE? CORRECT ANSWERS✓✓COUGH!! CHRONIC COUGH!
beta blockers CORRECT ANSWERS✓✓decrease heart rate and dilate arteries by blocking beta receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
hypertension w stable ischemic heart disease CORRECT ANSWERS✓✓first line therapy:
-beta blockers
-ACE inhibitors or ARBs
HF w preserved ejection fraction CORRECT ANSWERS✓✓diuretics prescribed to control fluid overload
-after management of fluid overload, prescribed ACE inhibitors or ARBS and beta blockers to attain BP
goal
HF w reduced ejection fraction CORRECT ANSWERS✓✓calcium channel blockers NOT recommended!
stage I HTN initial therapy CORRECT ANSWERS✓✓monotherapy: single antihypertensive drug
-BP goal of <130/80
normal blood pressure CORRECT ANSWERS✓✓<120/<80 mmHg
elevated blood pressure CORRECT ANSWERS✓✓120-129/<80 mmHg
stage I HTN CORRECT ANSWERS✓✓130-139/80-89
stage II HTN CORRECT ANSWERS✓✓>=140/>=90 mmHg
modifiable risk factors CORRECT ANSWERS✓✓contributors of a noncommunicable disease that can be
altered by changing one's behavior or environment
modifiable risk factors for HTN CORRECT ANSWERS✓✓-high sodium diet
-obesity
-sedentary lifestyle
-DM
-smoking
nonmodifiable risk factors CORRECT ANSWERS✓✓nonchangeable or noncontrollable
nonmodifiable risk factors of HTN CORRECT ANSWERS✓✓-genetics
-family hx
-age
-race
secondary hypertension CORRECT ANSWERS✓✓results from another disease or is the side effect of
medications, ex:
-renal disease!!!!
,-obstructive sleep apnea!!!!
-endocrine disorders
-hormone therapy, steroids, !!!!immunosuppressants
consequences of uncontrolled HTN CORRECT ANSWERS✓✓end organ damage! want to prevent this
from occurring!!!!!!!
-kidneys: renal damage (failure, proteinuria)!
-vasculature: peripheral vascular disease
-eyes: retinopathy
-brain: hemorrhage, stroke
-heart: LVH, CHD, CHF
Million Hearts Campaign CORRECT ANSWERS✓✓Hypertension Control Change Package (HCCP)
-used to improve HTN control
-how? ABCs
million hearts campaign ABCs CORRECT ANSWERS✓✓-Aspirin for high risk patients
-Blood pressure control
-Cholesterol management
-Smoking cessation
Affordable Care Act and HTN CORRECT ANSWERS✓✓-annual wellness visits
-eRecords for improved monitoring
-no co-pay for preventative health services
treatment of HTN CORRECT ANSWERS✓✓-lifestyle changes: lose weight, eat fruits and veggies, reduce
salt intake (CDC and AHA recommends), become active, moderate alcohol intake
-pharmacotherapy
,reduced salt CORRECT ANSWERS✓✓CDC reccommends no more than 2300mg/day
AHA ideally less than 1500mg/day
DASH diet CORRECT ANSWERS✓✓Dietary Approaches to Stop Hypertension,
-high in grains, high in fruits, low in fats!!
increasing activity levels for HTN tx CORRECT ANSWERS✓✓150min/week!!!!!!!!!!!!!!
-exercising 10 MINUTES at a time 3 TIMES A DAY, 5 DAYS A WEEK can help lower BP
-or 30 minutes a day, 5 days a week
does lifestyle modification work? CORRECT ANSWERS✓✓yes!!!!! can make a significant difference in pt's
BP
goals for individuals w HTN (important) CORRECT ANSWERS✓✓<130/80!!!!!!!! (in the elevated BP range)
-may be able to complete w lifestyle modifications alone
-but may also need medications
first-line treatments for HTN CORRECT ANSWERS✓✓need to know
-thiazide-type diuretics
-calcium channel blockers
-angiotensin converting enzyme (ACE) inhibitors
-angiotensin receptor blockers (ARBs)
thiazide-type diuretics CORRECT ANSWERS✓✓decrease sodium reabsorption which increases fluid loss
in urine, which in turn decreases extracellular fluid and plasma volume, reducing cardiac output and
lowering BP
-also cause potassium loss while retaining calcium.
-initial therapy for african americans
, -not given if renal disease!!!!
calcium channel blockers CORRECT ANSWERS✓✓inhibit the entry of calcium ions into heart muscle cells,
causing a slowing of the heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing
of the smooth muscle cells of the blood vessels to cause dilation
-initial therapy for african americans, not recommended for reduced ejection fraction
ace inhibitors or ARBS CORRECT ANSWERS✓✓ACE inhibitors interfere w ACE and reduce activity of
angiotensin II; ARBs block action of angiotensin II
-better therapy choice for patients with HTN and CKD
-SHOULD NOT BE USED SIMULTANEOUSLY bc they have the same effect
common side effect with ACE? CORRECT ANSWERS✓✓COUGH!! CHRONIC COUGH!
beta blockers CORRECT ANSWERS✓✓decrease heart rate and dilate arteries by blocking beta receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
hypertension w stable ischemic heart disease CORRECT ANSWERS✓✓first line therapy:
-beta blockers
-ACE inhibitors or ARBs
HF w preserved ejection fraction CORRECT ANSWERS✓✓diuretics prescribed to control fluid overload
-after management of fluid overload, prescribed ACE inhibitors or ARBS and beta blockers to attain BP
goal
HF w reduced ejection fraction CORRECT ANSWERS✓✓calcium channel blockers NOT recommended!
stage I HTN initial therapy CORRECT ANSWERS✓✓monotherapy: single antihypertensive drug
-BP goal of <130/80
