ATI MEDICAL SURGICAL EXAM
CARDIOVASCULAR ENDOCRINE
GASTROINTESTINAL FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
◉ common side effect with ACE?.
Answer: COUGH!! CHRONIC COUGH!
◉ beta blockers.
Answer: decrease heart rate and dilate arteries by blocking beta
receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
◉ hypertension w stable ischemic heart disease.
Answer: first line therapy:
-beta blockers
-ACE inhibitors or ARBs
◉ HF w preserved ejection fraction.
Answer: diuretics prescribed to control fluid overload
,-after management of fluid overload, prescribed ACE inhibitors or
ARBS and beta blockers to attain BP goal
◉ HF w reduced ejection fraction.
Answer: calcium channel blockers NOT recommended!
◉ stage I HTN initial therapy.
Answer: monotherapy: single antihypertensive drug
-BP goal of <130/80
◉ stage II HTN initial therapy.
Answer: combination drug therapy: 2 first-line antihypertensive
drugs with an average BP more than 20/10 above the BP target
◉ HTN management in older patients.
Answer: ideally dont want to bottom out their BP w drugs
(remember, decr kidney and liver function so drugs have incr
effects)... so tx is different... less
◉ other factors to consider w HTN pharmacotherapy.
Answer: each medication is about equal in effect, but:
-wide variability in response
,-some drugs work well w certain pts and some drugs dont... not sure
why
-also need to consider cost, concurrent diagnoses, and drug
interactions
◉ why might there be poor treatment adherence for pts w HTN?.
Answer: we must educate pts on:
-MED SIDE EFFECTS!!!!!!
—ex: sleepy, fatigued, ACE cough, beta blocker erectile dysfunction,
urinary frequency
-HTN may not have symptoms, but end stage organ failure!!! HTN is
#1 cause of kidney failure
-cost of medications
◉ malignant HTN.
Answer: >=180/>=120; also termed hypertensive crisis
◉ etiology of malignant HTN.
Answer: -unknown
-pt abruptly discontinues meds
-preeclampsia of pregnancy
◉ symptoms of malignant HTN.
, Answer: no symptoms OR:
-blurred vision
-HA
-confusion
◉ complications of malignant HTN.
Answer: -cerebral edema
-retinal hemorrhage
-acute renal damage
◉ tx for malignant HTN.
Answer: requires immediate but SLOW treatment; target BP
<160/<100
-MAP should not be lowered more than 10-20% first hour, then
approx 25% during next 23 hours!
-medications: nitrates, clonidine, captopril, furosemide (fluid
overloaded pts)
-bedrest, quiet environment
-monitor BP q 5-30 minutes!
◉ why BP lowered slowly for malignant HTN?.
Answer: prevent cerebral ischemia
CARDIOVASCULAR ENDOCRINE
GASTROINTESTINAL FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
◉ common side effect with ACE?.
Answer: COUGH!! CHRONIC COUGH!
◉ beta blockers.
Answer: decrease heart rate and dilate arteries by blocking beta
receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
◉ hypertension w stable ischemic heart disease.
Answer: first line therapy:
-beta blockers
-ACE inhibitors or ARBs
◉ HF w preserved ejection fraction.
Answer: diuretics prescribed to control fluid overload
,-after management of fluid overload, prescribed ACE inhibitors or
ARBS and beta blockers to attain BP goal
◉ HF w reduced ejection fraction.
Answer: calcium channel blockers NOT recommended!
◉ stage I HTN initial therapy.
Answer: monotherapy: single antihypertensive drug
-BP goal of <130/80
◉ stage II HTN initial therapy.
Answer: combination drug therapy: 2 first-line antihypertensive
drugs with an average BP more than 20/10 above the BP target
◉ HTN management in older patients.
Answer: ideally dont want to bottom out their BP w drugs
(remember, decr kidney and liver function so drugs have incr
effects)... so tx is different... less
◉ other factors to consider w HTN pharmacotherapy.
Answer: each medication is about equal in effect, but:
-wide variability in response
,-some drugs work well w certain pts and some drugs dont... not sure
why
-also need to consider cost, concurrent diagnoses, and drug
interactions
◉ why might there be poor treatment adherence for pts w HTN?.
Answer: we must educate pts on:
-MED SIDE EFFECTS!!!!!!
—ex: sleepy, fatigued, ACE cough, beta blocker erectile dysfunction,
urinary frequency
-HTN may not have symptoms, but end stage organ failure!!! HTN is
#1 cause of kidney failure
-cost of medications
◉ malignant HTN.
Answer: >=180/>=120; also termed hypertensive crisis
◉ etiology of malignant HTN.
Answer: -unknown
-pt abruptly discontinues meds
-preeclampsia of pregnancy
◉ symptoms of malignant HTN.
, Answer: no symptoms OR:
-blurred vision
-HA
-confusion
◉ complications of malignant HTN.
Answer: -cerebral edema
-retinal hemorrhage
-acute renal damage
◉ tx for malignant HTN.
Answer: requires immediate but SLOW treatment; target BP
<160/<100
-MAP should not be lowered more than 10-20% first hour, then
approx 25% during next 23 hours!
-medications: nitrates, clonidine, captopril, furosemide (fluid
overloaded pts)
-bedrest, quiet environment
-monitor BP q 5-30 minutes!
◉ why BP lowered slowly for malignant HTN?.
Answer: prevent cerebral ischemia
