682 Final
Study online at https://quizlet.com/_97rs5y
1. In obtaining an office BP measurement, which of the The patient should sit in a
following is most reflective of the best practice? chair with feet flat on the
floor for at least 5 min-
utes before obtaining the
reading
2. What is the correct drug class of diltiazem? nondihydropyridine calci-
um channel blocker
3. A risk factor for acquired aortic stenosis is: prior rheumatic fever.
4. From the 2017 update to the 2013 heart failure Amlodipine 5 mg qd
ACC/AHA guidelines, which of the following would
NOT be a first line treatment for HFrEF?
5. You examine a 24-year-old woman with mitral valve pectus excavatum.
prolapse (MVP). Her physical examination findings
may also include:
6. The S4 heart sound has which of the following charac- It is noted in the pres-
teristics? ence of poorly controlled
hypertension.
7. You see a 59-year-old man with poorly controlled hy- patient report of acute vi-
pertension. On physical examination, you note grade sual change.
1 hypertensive retinopathy. You anticipate all of the
following will be present except:
8. You see a 38-year-old African American male with hy- calcium channel blocker
pertension who is currently being treated with thi-
azide-type diuretic. His current blood pressure read-
ing is 156/94 mm Hg and he has no history of diabetes
mellitus or chronic kidney disease. Following current
, 682 Final
Study online at https://quizlet.com/_97rs5y
best evidence, you consider adding which of the fol-
lowing medications?
9. Mr. G is a 63 year old patient with a long history of Primary Aldosteronism
hypertension, previously controlled on Lisinopril and
HCTZ. His BP has been rising, to 170/104 at the last
visit. He insisted he is adherent with his medications.
The clinician added amlodipine, which dropped the BP
to 160/96, but it is 180/110 today. He is asymptomatic
with an essentially negative ROS. The patient has
sleep apnea, which is effectively treated with CPAP. His
GFR was 64 last month. According to figure 10 (page
e193) in the 2017 ACC/AHA hypertension treatment
guidelines, what other causes of secondary hyperten-
sion would be most likely to be causing Mr. G's new
onset resistant hypertension?
10. A 68-year-old woman presents with hypertension and Initiate therapy with hy-
BP of 152-158/92-96 mm Hg documented over 2 drochlorothiazide.
months on three different occasions. Electrocardio-
gram (ECG) and creatinine are normal, and she has
no proteinuria. Clinical findings include the following:
BMI 26.4 kg/m2; no S3, S4, or murmur; and point of
maximal impulse at fifth intercostal space, mid-clavic-
ular line. Which of the following represents the best
intervention?
11. When a heart valve fails to close properly, it is said to incompetent.
be:
12. The S3 heart sound has all of the following character- a presystolic sound
istics except:
, 682 Final
Study online at https://quizlet.com/_97rs5y
13. You are treating a healthy a 52 year old African Ameri- avoid disease-related tar-
can well woman never-smoker whose BP has been av- get organ damage.
eraging 135 systolic and 84 diastolic for several years.
She is on no regular medications. What additional in-
formation do you need in order to determine whether
she should be treated with medication, in addition
to lifestyle changes, according to the 2018 ACC/AHA
hypertension guidelines?
14. What is the correct drug class of telmisartan? angiotensin receptor an-
tagonist
15. You examine a 78-year-old woman with long-stand- left ventricular hypertro-
ing, poorly controlled hypertension. When evaluating phy.
her for hypertensive target organ damage, you look
for evidence of:
16. In the person with hypertension, the nurse practition- consuming at least 1-2
er (NP) recommends all of the following to potentially servings of alcohol.
reduce BP in a patient with a BMI of 30 kg/m2 except:
17. The most important long-term goal of treating hyper- avoid disease-related tar-
tension is to: get organ damage.
18. From the 2017 update to the 2013 heart failure Any or all of the above
ACC/AHA guidelines, which of the following would could be first line treat-
NOT be a first line treatment for HFpEF? ments for HFrEF as need-
ed to reduce systolic BP to
below 130
19. You are evaluating a patient who has rheumatic heart localized diastolic with lit-
disease. When assessing her for mitral stenosis, you tle radiation.
, 682 Final
Study online at https://quizlet.com/_97rs5y
auscultate the heart, anticipating finding the follow-
ing murmur:
20. Additional findings in MVP include: a mid-systolic click.
21. Of the following patients, who is in greatest need of a 54-year-old woman with
endocarditis prophylaxis when planning dental work? a prosthetic aortic valve
22. When compared with Caucasians, African Americans CCB
tend to have a reduced effect with monotherapy with
all of the following blood pressure medications ex-
cept:
23. You see a 68-year-old woman as a patient who is trans- prescribe an an-
ferring care into your practice. She has a 10-year his- giotensin-converting en-
tory of hypertension, diabetes mellitus, and hyperlipi- zyme inhibitor (ACEI).
demia. Current medications include hydrochloroth-
iazide (HCTZ), glipizide, metformin, simvastatin, and
daily low-dose aspirin. Today's BP reading is 158/92
mm Hg, and the rest of her history and examination
are unremarkable. Documentation from her former
healthcare provider indicates that her BP has been
in the range for the past 12 months. Your next best
action is to:
24. Mary is a 68 year old white female. She is a nev- None of the above; she
er smoker, not a diabetic, does not have kidney dis- should be treated with
ease, and her only medications are two ES Tylenol medication based on BP
prn (takes 2-3 times per week), Prilosec 20 mg prn alone
(takes daily), and Claritin 10 mg per day. Her blood
pressure has been an average of 152/92 for several
months now, which has not changed with efforts to
decrease her BP through non-pharmacologic means.
Study online at https://quizlet.com/_97rs5y
1. In obtaining an office BP measurement, which of the The patient should sit in a
following is most reflective of the best practice? chair with feet flat on the
floor for at least 5 min-
utes before obtaining the
reading
2. What is the correct drug class of diltiazem? nondihydropyridine calci-
um channel blocker
3. A risk factor for acquired aortic stenosis is: prior rheumatic fever.
4. From the 2017 update to the 2013 heart failure Amlodipine 5 mg qd
ACC/AHA guidelines, which of the following would
NOT be a first line treatment for HFrEF?
5. You examine a 24-year-old woman with mitral valve pectus excavatum.
prolapse (MVP). Her physical examination findings
may also include:
6. The S4 heart sound has which of the following charac- It is noted in the pres-
teristics? ence of poorly controlled
hypertension.
7. You see a 59-year-old man with poorly controlled hy- patient report of acute vi-
pertension. On physical examination, you note grade sual change.
1 hypertensive retinopathy. You anticipate all of the
following will be present except:
8. You see a 38-year-old African American male with hy- calcium channel blocker
pertension who is currently being treated with thi-
azide-type diuretic. His current blood pressure read-
ing is 156/94 mm Hg and he has no history of diabetes
mellitus or chronic kidney disease. Following current
, 682 Final
Study online at https://quizlet.com/_97rs5y
best evidence, you consider adding which of the fol-
lowing medications?
9. Mr. G is a 63 year old patient with a long history of Primary Aldosteronism
hypertension, previously controlled on Lisinopril and
HCTZ. His BP has been rising, to 170/104 at the last
visit. He insisted he is adherent with his medications.
The clinician added amlodipine, which dropped the BP
to 160/96, but it is 180/110 today. He is asymptomatic
with an essentially negative ROS. The patient has
sleep apnea, which is effectively treated with CPAP. His
GFR was 64 last month. According to figure 10 (page
e193) in the 2017 ACC/AHA hypertension treatment
guidelines, what other causes of secondary hyperten-
sion would be most likely to be causing Mr. G's new
onset resistant hypertension?
10. A 68-year-old woman presents with hypertension and Initiate therapy with hy-
BP of 152-158/92-96 mm Hg documented over 2 drochlorothiazide.
months on three different occasions. Electrocardio-
gram (ECG) and creatinine are normal, and she has
no proteinuria. Clinical findings include the following:
BMI 26.4 kg/m2; no S3, S4, or murmur; and point of
maximal impulse at fifth intercostal space, mid-clavic-
ular line. Which of the following represents the best
intervention?
11. When a heart valve fails to close properly, it is said to incompetent.
be:
12. The S3 heart sound has all of the following character- a presystolic sound
istics except:
, 682 Final
Study online at https://quizlet.com/_97rs5y
13. You are treating a healthy a 52 year old African Ameri- avoid disease-related tar-
can well woman never-smoker whose BP has been av- get organ damage.
eraging 135 systolic and 84 diastolic for several years.
She is on no regular medications. What additional in-
formation do you need in order to determine whether
she should be treated with medication, in addition
to lifestyle changes, according to the 2018 ACC/AHA
hypertension guidelines?
14. What is the correct drug class of telmisartan? angiotensin receptor an-
tagonist
15. You examine a 78-year-old woman with long-stand- left ventricular hypertro-
ing, poorly controlled hypertension. When evaluating phy.
her for hypertensive target organ damage, you look
for evidence of:
16. In the person with hypertension, the nurse practition- consuming at least 1-2
er (NP) recommends all of the following to potentially servings of alcohol.
reduce BP in a patient with a BMI of 30 kg/m2 except:
17. The most important long-term goal of treating hyper- avoid disease-related tar-
tension is to: get organ damage.
18. From the 2017 update to the 2013 heart failure Any or all of the above
ACC/AHA guidelines, which of the following would could be first line treat-
NOT be a first line treatment for HFpEF? ments for HFrEF as need-
ed to reduce systolic BP to
below 130
19. You are evaluating a patient who has rheumatic heart localized diastolic with lit-
disease. When assessing her for mitral stenosis, you tle radiation.
, 682 Final
Study online at https://quizlet.com/_97rs5y
auscultate the heart, anticipating finding the follow-
ing murmur:
20. Additional findings in MVP include: a mid-systolic click.
21. Of the following patients, who is in greatest need of a 54-year-old woman with
endocarditis prophylaxis when planning dental work? a prosthetic aortic valve
22. When compared with Caucasians, African Americans CCB
tend to have a reduced effect with monotherapy with
all of the following blood pressure medications ex-
cept:
23. You see a 68-year-old woman as a patient who is trans- prescribe an an-
ferring care into your practice. She has a 10-year his- giotensin-converting en-
tory of hypertension, diabetes mellitus, and hyperlipi- zyme inhibitor (ACEI).
demia. Current medications include hydrochloroth-
iazide (HCTZ), glipizide, metformin, simvastatin, and
daily low-dose aspirin. Today's BP reading is 158/92
mm Hg, and the rest of her history and examination
are unremarkable. Documentation from her former
healthcare provider indicates that her BP has been
in the range for the past 12 months. Your next best
action is to:
24. Mary is a 68 year old white female. She is a nev- None of the above; she
er smoker, not a diabetic, does not have kidney dis- should be treated with
ease, and her only medications are two ES Tylenol medication based on BP
prn (takes 2-3 times per week), Prilosec 20 mg prn alone
(takes daily), and Claritin 10 mg per day. Her blood
pressure has been an average of 152/92 for several
months now, which has not changed with efforts to
decrease her BP through non-pharmacologic means.
