NSG 123 MED-SURG EXAM 3: Hypertension, Heart Failure, PAD, Anemias,
Coagulopathies | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Medical-Surgical Nursing I – Hypertension (Stages, Primary vs Secondary, DASH Diet, HTN
Crisis: Urgency vs Emergency, Target Organ Damage); Antihypertensives (Thiazide Diuretics, ACE
Inhibitors, ARBs, Calcium Channel Blockers, Beta-Blockers); Heart Failure (Systolic vs Diastolic, Left vs
Right Sided, Congestion vs Perfusion, JVD, Acute Decompensated HF); Anemias (Iron Deficiency,
Pernicious Anemia/B12 Deficiency, Thalassemia, G-6-PD); Blood Transfusion Reactions (Hemolytic
Reaction, Fluid Overload); Thrombocytopenia, ITP, Hemophilia, Von Willebrand Disease; Peripheral
Artery Disease (PAD) Assessment & Management
Source: NSG 123 MED-SURG EXAM 3 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is hypertension?
Correct Answer: High blood pressure (silent killer).
1. Usually asymptomatic until target organ damage occurs.
2. Clinical manifestations when present: retinal changes (hemorrhages, exudates, cotton wool spots, papilledema), CAD with
angina/MI, LVH, cerebrovascular disease.
2. What are the stages of hypertension?
Correct Answer: Normal: <120/<80; Prehypertension: 120-129/<80; Stage 1: 130-139/80-89; Stage 2:
140-159/90-99; HTN CRISIS: ≥180 and ≥120.
1. ASCVD risk assessment guides treatment decisions.
2. Home BP monitoring and ambulatory BP monitoring detect masked and white coat hypertension.
3. What B/P measurements are used to accurately diagnose someone with HTN? And why?
Correct Answer: Home Blood Pressure Measurements (HBPM) and Ambulatory Blood Pressure
Measurements (ABPM) because of masked hypertension and white coat hypertension.
1. Patients with average BP readings ≥160/100 on one occasion are diagnosed immediately.
2. Normal BP: recheck in 1 year; Prehypertension: recheck in 3-6 months; Hypertension: recheck in 1 month.
4. What is primary hypertension?
Correct Answer: High blood pressure with unknown cause (essential hypertension).
1. Associated with lifestyle factors: obesity, sedentary lifestyle, high sodium intake, stress.
2. Treatment: lifestyle changes (weight loss, physical activity, moderation of alcohol, DASH diet).
5. What is secondary hypertension?
Correct Answer: High blood pressure caused by the effects of another disease.
1. Causes: renal artery stenosis, hyperaldosteronism, pheochromocytoma, sleep apnea, thyroid disease, coarctation of aorta.
2. Treatment focuses on underlying disorder.
, 6. Discuss what is Target Organ Damage (TOD) and how you assess a patient with suspected TOD.
Correct Answer: Target organ damage is the consequence of long-term hypertension exposure leading
to damage in different organs. Assess TOD by laboratory testing and physical assessment: urinalysis,
blood chemistry (sodium, potassium, creatinine, fasting glucose, cholesterol), 12-lead ECG. LVH
assessed by echocardiography; renal damage suggested by elevated BUN/creatinine,
microalbuminuria/macroalbuminuria.
1. Additional studies: creatinine clearance, renin level, urine tests, 24-hour urine protein.
2. Optional: uric acid, urine albumin to creatinine ratio.
7. What is the DASH diet?
Correct Answer: Dietary Approach to Stop Hypertension. Effective in lowering BP. If used with
weight loss, can lower SBP by 11-16 mm Hg. Low sodium (<2 g/day), high potassium (3500-5000
mg/day). Avoid high potassium in CKD.
1. High in fruits, vegetables, low-fat dairy products, whole grains.
2. Low in saturated fat, total fat, cholesterol, red meat, sweets, sugary beverages.
8. What is the difference between HTN Urgency and HTN Emergency?
Correct Answer: Hypertensive Urgency: severe BP elevation (SBP <180, DBP <120) WITHOUT
target organ damage. Cause: not taking antihypertensive meds causing rebound HTN. Hypertensive
Emergency: severe BP elevation WITH target organ damage. H.U patients may have headache,
dyspnea, nausea, vomiting, epistaxis, anxiety. H.E patients may have chest pain, SOB, back pain,
numbness/weakness, vision changes, difficulty speaking.
1. Organs affected in H.E: heart, kidney, eyes, brain.
2. Conditions associated: hypertensive encephalopathy, ischemic stroke, MI, heart failure with pulmonary edema, dissecting
aortic aneurysm, renal failure.
9. Nursing management of HTN Emergency vs HTN Urgency?
Correct Answer: HTN Emergency: Admit to ICU, parenteral antihypertensives. Reduce SBP by no
more than 25% within first hour, then to 160/100 within 2-6 hours, then normal BP within 24-48 hours.
For aortic dissection: SBP <120 within 1 hour. For preeclampsia/eclampsia: SBP <140 within first hour.
HTN Urgency: Address non-adherence (finances, anxiety, misunderstandings, drug side effects,
recreational drug use). Restart or increase antihypertensives.
1. Rapid BP reduction can cause cerebral ischemia.
2. Oral antihypertensives for urgency; IV for emergency.
10. What are Thiazide diuretics and their nursing considerations?
Correct Answer: chlorthalidone, hydrochlorothiazide, indapamide, metolazone. MOA: decrease blood
flow volume, renal blood flow, cardiac output; depletion of extracellular fluids, negative sodium
balance. Disadvantages: dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia,
GI disturbances, orthostatic hypotension. Cause loss of sodium, potassium, magnesium; increase uric
acid and calcium. Monitor electrolytes, encourage potassium-rich foods. Gerontologic: risk of
orthostatic hypotension.
1. First-line for most patients with hypertension.
2. Inexpensive, effective orally, effective long-term.
Coagulopathies | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: Medical-Surgical Nursing I – Hypertension (Stages, Primary vs Secondary, DASH Diet, HTN
Crisis: Urgency vs Emergency, Target Organ Damage); Antihypertensives (Thiazide Diuretics, ACE
Inhibitors, ARBs, Calcium Channel Blockers, Beta-Blockers); Heart Failure (Systolic vs Diastolic, Left vs
Right Sided, Congestion vs Perfusion, JVD, Acute Decompensated HF); Anemias (Iron Deficiency,
Pernicious Anemia/B12 Deficiency, Thalassemia, G-6-PD); Blood Transfusion Reactions (Hemolytic
Reaction, Fluid Overload); Thrombocytopenia, ITP, Hemophilia, Von Willebrand Disease; Peripheral
Artery Disease (PAD) Assessment & Management
Source: NSG 123 MED-SURG EXAM 3 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is hypertension?
Correct Answer: High blood pressure (silent killer).
1. Usually asymptomatic until target organ damage occurs.
2. Clinical manifestations when present: retinal changes (hemorrhages, exudates, cotton wool spots, papilledema), CAD with
angina/MI, LVH, cerebrovascular disease.
2. What are the stages of hypertension?
Correct Answer: Normal: <120/<80; Prehypertension: 120-129/<80; Stage 1: 130-139/80-89; Stage 2:
140-159/90-99; HTN CRISIS: ≥180 and ≥120.
1. ASCVD risk assessment guides treatment decisions.
2. Home BP monitoring and ambulatory BP monitoring detect masked and white coat hypertension.
3. What B/P measurements are used to accurately diagnose someone with HTN? And why?
Correct Answer: Home Blood Pressure Measurements (HBPM) and Ambulatory Blood Pressure
Measurements (ABPM) because of masked hypertension and white coat hypertension.
1. Patients with average BP readings ≥160/100 on one occasion are diagnosed immediately.
2. Normal BP: recheck in 1 year; Prehypertension: recheck in 3-6 months; Hypertension: recheck in 1 month.
4. What is primary hypertension?
Correct Answer: High blood pressure with unknown cause (essential hypertension).
1. Associated with lifestyle factors: obesity, sedentary lifestyle, high sodium intake, stress.
2. Treatment: lifestyle changes (weight loss, physical activity, moderation of alcohol, DASH diet).
5. What is secondary hypertension?
Correct Answer: High blood pressure caused by the effects of another disease.
1. Causes: renal artery stenosis, hyperaldosteronism, pheochromocytoma, sleep apnea, thyroid disease, coarctation of aorta.
2. Treatment focuses on underlying disorder.
, 6. Discuss what is Target Organ Damage (TOD) and how you assess a patient with suspected TOD.
Correct Answer: Target organ damage is the consequence of long-term hypertension exposure leading
to damage in different organs. Assess TOD by laboratory testing and physical assessment: urinalysis,
blood chemistry (sodium, potassium, creatinine, fasting glucose, cholesterol), 12-lead ECG. LVH
assessed by echocardiography; renal damage suggested by elevated BUN/creatinine,
microalbuminuria/macroalbuminuria.
1. Additional studies: creatinine clearance, renin level, urine tests, 24-hour urine protein.
2. Optional: uric acid, urine albumin to creatinine ratio.
7. What is the DASH diet?
Correct Answer: Dietary Approach to Stop Hypertension. Effective in lowering BP. If used with
weight loss, can lower SBP by 11-16 mm Hg. Low sodium (<2 g/day), high potassium (3500-5000
mg/day). Avoid high potassium in CKD.
1. High in fruits, vegetables, low-fat dairy products, whole grains.
2. Low in saturated fat, total fat, cholesterol, red meat, sweets, sugary beverages.
8. What is the difference between HTN Urgency and HTN Emergency?
Correct Answer: Hypertensive Urgency: severe BP elevation (SBP <180, DBP <120) WITHOUT
target organ damage. Cause: not taking antihypertensive meds causing rebound HTN. Hypertensive
Emergency: severe BP elevation WITH target organ damage. H.U patients may have headache,
dyspnea, nausea, vomiting, epistaxis, anxiety. H.E patients may have chest pain, SOB, back pain,
numbness/weakness, vision changes, difficulty speaking.
1. Organs affected in H.E: heart, kidney, eyes, brain.
2. Conditions associated: hypertensive encephalopathy, ischemic stroke, MI, heart failure with pulmonary edema, dissecting
aortic aneurysm, renal failure.
9. Nursing management of HTN Emergency vs HTN Urgency?
Correct Answer: HTN Emergency: Admit to ICU, parenteral antihypertensives. Reduce SBP by no
more than 25% within first hour, then to 160/100 within 2-6 hours, then normal BP within 24-48 hours.
For aortic dissection: SBP <120 within 1 hour. For preeclampsia/eclampsia: SBP <140 within first hour.
HTN Urgency: Address non-adherence (finances, anxiety, misunderstandings, drug side effects,
recreational drug use). Restart or increase antihypertensives.
1. Rapid BP reduction can cause cerebral ischemia.
2. Oral antihypertensives for urgency; IV for emergency.
10. What are Thiazide diuretics and their nursing considerations?
Correct Answer: chlorthalidone, hydrochlorothiazide, indapamide, metolazone. MOA: decrease blood
flow volume, renal blood flow, cardiac output; depletion of extracellular fluids, negative sodium
balance. Disadvantages: dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia,
GI disturbances, orthostatic hypotension. Cause loss of sodium, potassium, magnesium; increase uric
acid and calcium. Monitor electrolytes, encourage potassium-rich foods. Gerontologic: risk of
orthostatic hypotension.
1. First-line for most patients with hypertension.
2. Inexpensive, effective orally, effective long-term.
