NURS 5434 FNP III Final Exam (PDF)
|(UPDATED 2026) Nursing Questions |
UTA Prep
BP screening in children
every year in children 3 and older
every visit in children 3 and older with risk factors (obesity, renal disease, diabetes, etc)
initial management of HTN in children
Elevated BP - lifestyle recommendations and then BP recheck in 6 months, then 6
months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods and recheck in 1-2 weeks, then 3
months later
Stage 2 HTN - check upper and lower extremity pressure and recheck in 1 week, refer
to specialist within 1 week
diagnosing pediatric HTN
auscultatory BP is over 95th percentile on 3 separate visits, to confirm - ambulatory BP
monitoring
HTN in age < 13 yo
elevated BP - >/= 90-95th percentile OR 120/80-95th percentile
Stage 1 - >/= 95th percentile to <90th + 12mmHg OR 130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/= 140/90
HTN in age >13 yo
,Elevated - 120/<80 to 129/<80
Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
determining cuff size in peds
cuff should be 40% of arm circumference and bladder 80-100% of arm circumference
approved meds for pediatric HTN
ACEIs
ARBs
CCBs
Thiazide diuretics
when is an echo needed in pediatric HTN?
symptomatic HTN
stage 2 HTN with modifiable risk factor (like obesity)
LVH
HTN with CKD or DM
persistent HTN despite lifestyle modifications
most common cause of HTN in adolescents and <13 yo
adolescents primary cause: obesity
younger primary cause: secondary causes, often renal disease
secondary causes of HTN in pediatrics
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
,obstructive sleep apnea
mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, caffeine, diet pills)
diagnostic tests for pediatric HTN pts
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal urinalysis or renal function
obese pts:
- HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
, Treatment of Pediatric HTN
1. lifestyle modifications - 30-60 min moderate to vigorous activity 3-5 days/week, DASH
diet, stress reduction, sleep intervention, family based intervention
2. pharmacologic - ACEI or ARB first may be best, CCBs or HCTZ for females at risk of
pregnancy, start low and titrate q2-4 weeks, may add a 2nd med if goal not achieved
@max dose of monotherapy
when to start meds in pediatric HTN
stage 2 HTN without known cause or when symptomatic
stage 1 HTN that persists after 6 months of lifestyle modifications
Any HTN with diabetes, CKD, or TOD (LVH on echo, retinal changes, microalbuminuria)
when to refer pediatric HTN to specialist
Stage 2 HTN at diagnosis
Evidence of target organ damage (LVH, retinopathy, proteinuria)
Age <6 years with HTN (high chance secondary)
No improvement on 2-3 meds
Suspected secondary cause
diagnostic criteria for anxiety
Excessive anxiety & worry about multiple events or activities for ≥6 months, difficult to
control
Associated with ≥3 (only 1 needed for kids):
Restlessness
Easily fatigued
|(UPDATED 2026) Nursing Questions |
UTA Prep
BP screening in children
every year in children 3 and older
every visit in children 3 and older with risk factors (obesity, renal disease, diabetes, etc)
initial management of HTN in children
Elevated BP - lifestyle recommendations and then BP recheck in 6 months, then 6
months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods and recheck in 1-2 weeks, then 3
months later
Stage 2 HTN - check upper and lower extremity pressure and recheck in 1 week, refer
to specialist within 1 week
diagnosing pediatric HTN
auscultatory BP is over 95th percentile on 3 separate visits, to confirm - ambulatory BP
monitoring
HTN in age < 13 yo
elevated BP - >/= 90-95th percentile OR 120/80-95th percentile
Stage 1 - >/= 95th percentile to <90th + 12mmHg OR 130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/= 140/90
HTN in age >13 yo
,Elevated - 120/<80 to 129/<80
Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
determining cuff size in peds
cuff should be 40% of arm circumference and bladder 80-100% of arm circumference
approved meds for pediatric HTN
ACEIs
ARBs
CCBs
Thiazide diuretics
when is an echo needed in pediatric HTN?
symptomatic HTN
stage 2 HTN with modifiable risk factor (like obesity)
LVH
HTN with CKD or DM
persistent HTN despite lifestyle modifications
most common cause of HTN in adolescents and <13 yo
adolescents primary cause: obesity
younger primary cause: secondary causes, often renal disease
secondary causes of HTN in pediatrics
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
,obstructive sleep apnea
mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, caffeine, diet pills)
diagnostic tests for pediatric HTN pts
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal urinalysis or renal function
obese pts:
- HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
, Treatment of Pediatric HTN
1. lifestyle modifications - 30-60 min moderate to vigorous activity 3-5 days/week, DASH
diet, stress reduction, sleep intervention, family based intervention
2. pharmacologic - ACEI or ARB first may be best, CCBs or HCTZ for females at risk of
pregnancy, start low and titrate q2-4 weeks, may add a 2nd med if goal not achieved
@max dose of monotherapy
when to start meds in pediatric HTN
stage 2 HTN without known cause or when symptomatic
stage 1 HTN that persists after 6 months of lifestyle modifications
Any HTN with diabetes, CKD, or TOD (LVH on echo, retinal changes, microalbuminuria)
when to refer pediatric HTN to specialist
Stage 2 HTN at diagnosis
Evidence of target organ damage (LVH, retinopathy, proteinuria)
Age <6 years with HTN (high chance secondary)
No improvement on 2-3 meds
Suspected secondary cause
diagnostic criteria for anxiety
Excessive anxiety & worry about multiple events or activities for ≥6 months, difficult to
control
Associated with ≥3 (only 1 needed for kids):
Restlessness
Easily fatigued
