UTA FAMILY 3 FINAL EXAM EVALUATION QUESTIONS
WITH ANSWERS 2025/2026 GRADED A+
When starting patient on new bp therapy always have them return in _____months until
goal is met - 1 month
What hypertensive medications should not be prescribed simultaneously? - - ACE
- ARB
- Renin Inhibitor
2017 ACC/AHA guidelines: initiation of drug therapy in stage 2 HTN - initiate drug
therapy with 2 first line medications of different classes as separate agents or combo
drug
2017 ACC/AHA guidelines: initiation of drug therapy in stage 1 HTN - initiate therapy
with a single drug
2017 ACC/AHA guidelines: HTN reassessment for new or adjusted drug regimen -
follow up at monthly intervals until control is sustained
2017 ACC/AHA guidelines: black adults with HTN, no HF or CKD - initiate therapy with
thiazide diuretic or CCB
2017 ACC/AHA guidelines: pregnant or planning pregnancy safe drug choice - -
methyldopa
- nifedipine
- labetalol
2017 ACC/AHA guidelines: drugs contraindicated in pregnant women - - ACE
- ARBs
- direct renin inhibitors
2017 ACC/AHA vs JNC 8 older community dwelling adults ≥ 65 yo - - JNC 8 treat BP if
> 150/90
- 2017 treat if SBP ≥ 130
2017 ACC/AHA guidelines: hypertensive crisis - > 180/120
admit to ICU if target organ damage
2017 ACC/AHA guidelines: secondary stroke prevention BP threshold - ≥ 140/90
2017 ACC/AHA guidelines: no CVD and ASCVD risk < 10% BP threshold - ≥ 140/90
ISH 2020: BP's for diagnosis - 140/90 for office diagnosis
135/85 for home
130/80 for ABPM
,TOD brain - - CVA
- encephalopathy
- dementia
- multi infarct
- early cognitive decline
TOD eyes - - flame hemorrhage
- papilloedema
- hard exudates
- cotton wool spots
TOD heart - - LVH
- CAD
- MI
- rhythm disorders
- aortic and PAD
- AAA
TOD kidneys - - CKD
- GFR < 60
TOD erectile dysfunction - - CVD risk factor
- early diagnostic indicator
- need full sexual history
Diagnosis of HTN is made on the - 3rd elevated BP
Resistant HTN def - When a patient takes 3 medications with complementary
mechanisms of action (a diuretic should be 1 component) but does not achieve control
or when BP control is achieved but requires ≥4 medications
What to do if pt has resistant HTN - Consider pseudoHTN, BP technique, white coat
HTN, med compliance, and secondary HTN
identify and reverse lifestyle factors (obesity, exercise, alcohol, diet)
stop interfering meds (NSAIDs, sympathomimetic decongestants, stimulants, OC's,
licorice, ephedra)
screen for secondary HTN
Maximize diuretic therapy, add a mineralocorticoid receptor antagonist, add another
agent of different MOA, use loop diuretics it pt's w/ CKD
refer
, How to exclude pseudoresistance - ensure accurate off bp measurements
assess for nonadherence
obtain home, work, or ambulatory BP reading to exclude white coat effect
2017 ACC/AHA guidelines: hypertensive URGENCY - - elevated BP (180/120)
WITHOUT current organ damage
- happens when patients stop taking their meds
- doesn't require a rapid decrease
- check proteinuria and BMP
- one week follow up
-give ER precautions
-avoid clonidine (causes rebound HTN)
Hypertensive emergency def - 180/120 + TOD damage
What to do if HTN emergency - admit to ICU
Consider: aortic dissection, severe pre-e, pheochromocytoma
Role of ambulatory BP monitoring - can provide:
-estimates of mean BP over the entire monitoring period and separately during
nighttime and daytime
-determine the daytime-to-nighttime BP ratio to identify the extent of nocturnal "dipping,"
-identify the early-morning BP surge pattern
estimate BP variability
-allow for recognition of symptomatic hypotension.
-suspected white coat/masked HTN
-more info on resistant HTN
Clinical evidence for Accelerated HTN - - severe arteriosclerosis
- grade 3 or 4 hypertensive retinopathy
- renal insufficiency for which there is no apparent cause
- prognosis if untreated poor
List meds that can elevate BP - - oral contraceptives
- cyclosporine
- TCAs
- sympathomimetic decongestants
- appetite suppressants
- corticosteroids
- NSAIDs
-erythropoietin
- anabolic steroids
- MAOI
- Norepinephrine reuptake inhibitors
WITH ANSWERS 2025/2026 GRADED A+
When starting patient on new bp therapy always have them return in _____months until
goal is met - 1 month
What hypertensive medications should not be prescribed simultaneously? - - ACE
- ARB
- Renin Inhibitor
2017 ACC/AHA guidelines: initiation of drug therapy in stage 2 HTN - initiate drug
therapy with 2 first line medications of different classes as separate agents or combo
drug
2017 ACC/AHA guidelines: initiation of drug therapy in stage 1 HTN - initiate therapy
with a single drug
2017 ACC/AHA guidelines: HTN reassessment for new or adjusted drug regimen -
follow up at monthly intervals until control is sustained
2017 ACC/AHA guidelines: black adults with HTN, no HF or CKD - initiate therapy with
thiazide diuretic or CCB
2017 ACC/AHA guidelines: pregnant or planning pregnancy safe drug choice - -
methyldopa
- nifedipine
- labetalol
2017 ACC/AHA guidelines: drugs contraindicated in pregnant women - - ACE
- ARBs
- direct renin inhibitors
2017 ACC/AHA vs JNC 8 older community dwelling adults ≥ 65 yo - - JNC 8 treat BP if
> 150/90
- 2017 treat if SBP ≥ 130
2017 ACC/AHA guidelines: hypertensive crisis - > 180/120
admit to ICU if target organ damage
2017 ACC/AHA guidelines: secondary stroke prevention BP threshold - ≥ 140/90
2017 ACC/AHA guidelines: no CVD and ASCVD risk < 10% BP threshold - ≥ 140/90
ISH 2020: BP's for diagnosis - 140/90 for office diagnosis
135/85 for home
130/80 for ABPM
,TOD brain - - CVA
- encephalopathy
- dementia
- multi infarct
- early cognitive decline
TOD eyes - - flame hemorrhage
- papilloedema
- hard exudates
- cotton wool spots
TOD heart - - LVH
- CAD
- MI
- rhythm disorders
- aortic and PAD
- AAA
TOD kidneys - - CKD
- GFR < 60
TOD erectile dysfunction - - CVD risk factor
- early diagnostic indicator
- need full sexual history
Diagnosis of HTN is made on the - 3rd elevated BP
Resistant HTN def - When a patient takes 3 medications with complementary
mechanisms of action (a diuretic should be 1 component) but does not achieve control
or when BP control is achieved but requires ≥4 medications
What to do if pt has resistant HTN - Consider pseudoHTN, BP technique, white coat
HTN, med compliance, and secondary HTN
identify and reverse lifestyle factors (obesity, exercise, alcohol, diet)
stop interfering meds (NSAIDs, sympathomimetic decongestants, stimulants, OC's,
licorice, ephedra)
screen for secondary HTN
Maximize diuretic therapy, add a mineralocorticoid receptor antagonist, add another
agent of different MOA, use loop diuretics it pt's w/ CKD
refer
, How to exclude pseudoresistance - ensure accurate off bp measurements
assess for nonadherence
obtain home, work, or ambulatory BP reading to exclude white coat effect
2017 ACC/AHA guidelines: hypertensive URGENCY - - elevated BP (180/120)
WITHOUT current organ damage
- happens when patients stop taking their meds
- doesn't require a rapid decrease
- check proteinuria and BMP
- one week follow up
-give ER precautions
-avoid clonidine (causes rebound HTN)
Hypertensive emergency def - 180/120 + TOD damage
What to do if HTN emergency - admit to ICU
Consider: aortic dissection, severe pre-e, pheochromocytoma
Role of ambulatory BP monitoring - can provide:
-estimates of mean BP over the entire monitoring period and separately during
nighttime and daytime
-determine the daytime-to-nighttime BP ratio to identify the extent of nocturnal "dipping,"
-identify the early-morning BP surge pattern
estimate BP variability
-allow for recognition of symptomatic hypotension.
-suspected white coat/masked HTN
-more info on resistant HTN
Clinical evidence for Accelerated HTN - - severe arteriosclerosis
- grade 3 or 4 hypertensive retinopathy
- renal insufficiency for which there is no apparent cause
- prognosis if untreated poor
List meds that can elevate BP - - oral contraceptives
- cyclosporine
- TCAs
- sympathomimetic decongestants
- appetite suppressants
- corticosteroids
- NSAIDs
-erythropoietin
- anabolic steroids
- MAOI
- Norepinephrine reuptake inhibitors
