HYPERTENSION PRACTICE QUESTIONS
(IPFC FINAL: HYPERTENSION
PRACTICE QUESTIONS) WITH
COMPLETE SOLUTIONS
RH is a 47-year-old white woman who has been seen by her family physician twice in
the past 2 weeks, and her BP (measured properly) was similar at both visits, averaging
138/88 mm Hg. RH has no significant medical history or risk factors for cardiovascular
disease; she is relatively active and likes to exercise. Which of the following would be
the most appropriate recommendation for RH?
A: She should be seen again by her physician within 3 months to see if she has
hypertension, but in the meantime work with recommended lifestyle modifications
(LSMs) listed within this chapter.
B: She should be counseled to undertake an intensive weight reduction program, with
follow-up in 2 years.
C: Initiate treatment with ramipril.
D: Initiate treatment with atenolol.
E: Initiate treatment with clonidine. - ANSWER-Answer a is correct. RH has
prehypertension and at this point guidelines do not recommend starting drug therapy;
however, it would be recommended to take preventative actions and provide education
as often as possible to delay the diagnosis of hypertension and other chronic disease
states.
ER is a 72-year-old man who presents to clinic. He is currently on lisinopril 40 mg daily,
HCTZ 25 mg daily, amlodipine 10 mg daily. His BP in clinic supports his elevated home
readings, providing an average BP of 162/89 mm Hg. He is open to adding therapy in
addition to altering his diet with reduced sodium intake (however, in discussion his diet
seemed appropriate). You have agreed to start spironolactone 25 mg daily. What side
effects do you educate the patient about?
A: Retrograde ejaculation
B: Rebound hypertension if immediate discontinuation occurs
C: Hypokalemia
D: Gynecomastia - ANSWER-Answer d is correct. Due to spironolactone's affinity
toward progesterone and androgen receptors, gynecomastia is a common side effect
and the patient should be informed of this.
Which of the following agents is likely to increase blood glucose? Select all that apply.
A: Chlorthalidone
, B: Furosemide
C: HCTZ
D: Lisinopril
E: Propranolol - ANSWER-Answers a, b, c, and e are correct. These are all associated
with blood glucose effects.
What diagnostic category is a BP of 158/104 mm Hg on June 1st and a BP of 150/110
mm Hg on June 4th (both of these BP measurements were taken on two separate clinic
dates as the patient refused to go to the emergency department)?
A: Normal
B: Prehypertension
C: Stage 1 hypertension
D: Stage 2 hypertension - ANSWER-Answer d is correct. Stage 2 is systolic blood
pressure (SBP) greater than or equal to 160 mm Hg and diastolic blood pressure (DBP)
is greater than or equal to 100 mm Hg. While the SBP appears to be stage 1, the DBP
is stage 2. Classification is driven by which one is the highest stage.
FS is a 50-year-old woman diagnosed with osteoporosis and hypertension. Which of the
following antihypertensives is likely to help the FS's osteoporosis in addition to lowering
her BP?
A: Torsemide
B: hydrochlorothiazide
C: captopril
D: metoprolol - ANSWER-Answer b is correct. HCTZ is a thiazide diuretic, the preferred
initial therapy for the treatment of hypertension. Unlike loop diuretics, thiazide diuretics
decrease the excretion of calcium, and added benefit in a patient with concomitant
osteoporosis.
Which of the following statements is true regarding lifestyle modifications (LSMs)?
Select all that apply.
A: LSM decreases the risk for cardiovascular disease.
B: LSM decreases the risk for renal disease.
C: LSM decreased morbidity.
D: LSM is critical for the prevention of hypertension but not the treatment. - ANSWER-
Answers a, b, and c are correct. All forms of cardiovascular disease, renal disease, and
stroke are decreased. Additionally, both morbidity and mortality are decreased through
LSMs.
Place the lifestyle modifications (LSMs) of weight reduction, moderation of alcohol
consumption, and physical activity in order of the decrease in expected/approximate
systolic blood pressure (SBP) reduction. Start with the lowest expected decrease in
SBP.
A: Moderation of alcohol consumption, physical activity, weight reduction.
(IPFC FINAL: HYPERTENSION
PRACTICE QUESTIONS) WITH
COMPLETE SOLUTIONS
RH is a 47-year-old white woman who has been seen by her family physician twice in
the past 2 weeks, and her BP (measured properly) was similar at both visits, averaging
138/88 mm Hg. RH has no significant medical history or risk factors for cardiovascular
disease; she is relatively active and likes to exercise. Which of the following would be
the most appropriate recommendation for RH?
A: She should be seen again by her physician within 3 months to see if she has
hypertension, but in the meantime work with recommended lifestyle modifications
(LSMs) listed within this chapter.
B: She should be counseled to undertake an intensive weight reduction program, with
follow-up in 2 years.
C: Initiate treatment with ramipril.
D: Initiate treatment with atenolol.
E: Initiate treatment with clonidine. - ANSWER-Answer a is correct. RH has
prehypertension and at this point guidelines do not recommend starting drug therapy;
however, it would be recommended to take preventative actions and provide education
as often as possible to delay the diagnosis of hypertension and other chronic disease
states.
ER is a 72-year-old man who presents to clinic. He is currently on lisinopril 40 mg daily,
HCTZ 25 mg daily, amlodipine 10 mg daily. His BP in clinic supports his elevated home
readings, providing an average BP of 162/89 mm Hg. He is open to adding therapy in
addition to altering his diet with reduced sodium intake (however, in discussion his diet
seemed appropriate). You have agreed to start spironolactone 25 mg daily. What side
effects do you educate the patient about?
A: Retrograde ejaculation
B: Rebound hypertension if immediate discontinuation occurs
C: Hypokalemia
D: Gynecomastia - ANSWER-Answer d is correct. Due to spironolactone's affinity
toward progesterone and androgen receptors, gynecomastia is a common side effect
and the patient should be informed of this.
Which of the following agents is likely to increase blood glucose? Select all that apply.
A: Chlorthalidone
, B: Furosemide
C: HCTZ
D: Lisinopril
E: Propranolol - ANSWER-Answers a, b, c, and e are correct. These are all associated
with blood glucose effects.
What diagnostic category is a BP of 158/104 mm Hg on June 1st and a BP of 150/110
mm Hg on June 4th (both of these BP measurements were taken on two separate clinic
dates as the patient refused to go to the emergency department)?
A: Normal
B: Prehypertension
C: Stage 1 hypertension
D: Stage 2 hypertension - ANSWER-Answer d is correct. Stage 2 is systolic blood
pressure (SBP) greater than or equal to 160 mm Hg and diastolic blood pressure (DBP)
is greater than or equal to 100 mm Hg. While the SBP appears to be stage 1, the DBP
is stage 2. Classification is driven by which one is the highest stage.
FS is a 50-year-old woman diagnosed with osteoporosis and hypertension. Which of the
following antihypertensives is likely to help the FS's osteoporosis in addition to lowering
her BP?
A: Torsemide
B: hydrochlorothiazide
C: captopril
D: metoprolol - ANSWER-Answer b is correct. HCTZ is a thiazide diuretic, the preferred
initial therapy for the treatment of hypertension. Unlike loop diuretics, thiazide diuretics
decrease the excretion of calcium, and added benefit in a patient with concomitant
osteoporosis.
Which of the following statements is true regarding lifestyle modifications (LSMs)?
Select all that apply.
A: LSM decreases the risk for cardiovascular disease.
B: LSM decreases the risk for renal disease.
C: LSM decreased morbidity.
D: LSM is critical for the prevention of hypertension but not the treatment. - ANSWER-
Answers a, b, and c are correct. All forms of cardiovascular disease, renal disease, and
stroke are decreased. Additionally, both morbidity and mortality are decreased through
LSMs.
Place the lifestyle modifications (LSMs) of weight reduction, moderation of alcohol
consumption, and physical activity in order of the decrease in expected/approximate
systolic blood pressure (SBP) reduction. Start with the lowest expected decrease in
SBP.
A: Moderation of alcohol consumption, physical activity, weight reduction.
