NURSING · PRACTICAL NURSE
PNH301 - TEST 2 | QUESTIONS AND
ANSWERS | 2026/2027 | WITH COMPLETE
SOLUTION!!
A+
Complete Domain Coverage · Application & Analysis Level
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Hypertension and Cardiovascular Risk Factor Management
Coronary Artery Disease and Chronic Stable Angina
Acute Coronary Syndromes and Myocardial Infarction
Heart Failure and Circulatory Shock
Peripheral Vascular Disorders and Related Nursing Care
STUVIAACTUALEXAM
, SECTION 1: Hypertension and Cardiovascular Risk Factor Management
Question 1
A 54-year-old client with newly diagnosed stage 2 hypertension has a blood pressure of 168/102 mm Hg on two separate clinic visits.
The client reports smoking one pack of cigarettes daily and consuming four alcoholic drinks most evenings. The nurse prioritizes which
teaching point as the most immediate modifiable lifestyle change that can produce a measurable blood-pressure reduction within
weeks?
A. Increase daily calcium intake to 1500 mg through dairy products
B. Eliminate alcohol intake or limit it to no more than two standard drinks per day for men
C. Begin a high-protein, low-carbohydrate diet to promote rapid weight loss
D. Schedule blood-pressure checks only once every six months once medication is started
Correct Answer: B
Rationale:
Excessive alcohol intake is a recognized modifiable risk factor that directly elevates blood pressure; reducing intake to recommended limits can
lower systolic pressure by several mm Hg within weeks. Calcium supplementation has limited evidence for hypertension control, rapid weight-loss
diets are not first-line, and infrequent monitoring is inappropriate for newly diagnosed stage 2 hypertension.
Question 2
A client with chronic hypertension is prescribed an ACE inhibitor. Two weeks after initiation the client returns with a persistent dry cough
that interferes with sleep. The nurse recognizes this adverse effect and anticipates which collaborative action?
A. Increase the ACE-inhibitor dose to overcome receptor tolerance
B. Discontinue the ACE inhibitor and switch to an angiotensin-receptor blocker
C. Add a codeine-based cough suppressant and continue the current dose
D. Switch the client to a non-dihydropyridine calcium-channel blocker immediately without provider input
Correct Answer: B
Rationale:
A dry, persistent cough is a classic adverse effect of ACE inhibitors caused by bradykinin accumulation. Switching to an ARB preserves the
renin-angiotensin blockade while avoiding the cough. Dose increases worsen the cough; cough suppressants mask the problem; nurses do not
independently change medication classes.
Question 3
While reviewing a client's medication list, the nurse notes concurrent use of an ACE inhibitor and a potassium-sparing diuretic. Which
laboratory value requires the most urgent attention and why?
A. Serum sodium of 138 mEq/L because hyponatremia is the primary risk
B. Serum potassium of 5.6 mEq/L because the combination increases hyperkalemia risk
C. Blood urea nitrogen of 18 mg/dL because renal failure is inevitable
D. Fasting glucose of 110 mg/dL because both drugs elevate blood sugar
Correct Answer: B
Rationale:
ACE inhibitors reduce aldosterone and potassium-sparing diuretics retain potassium; together they significantly elevate hyperkalemia risk. A
potassium of 5.6 mEq/L already indicates mild elevation requiring intervention. Sodium, BUN, and glucose values shown are within or near normal
and are not the primary interactive concern.
, Question 4
A 68-year-old client with long-standing hypertension reports dizziness upon standing. Sitting blood pressure is 142/88 mm Hg; standing
blood pressure after one minute is 118/70 mm Hg. The nurse interprets these findings and selects which priority nursing action?
A. Encourage the client to rise quickly to improve cerebral perfusion
B. Teach the client to change positions slowly and report ongoing symptoms
C. Immediately administer an additional dose of the prescribed antihypertensive
D. Document the readings as normal variation for older adults and take no action
Correct Answer: B
Rationale:
A drop of 20 mm Hg systolic or 10 mm Hg diastolic upon standing defines orthostatic hypotension, a common side effect of antihypertensives in
older adults. Slow position changes reduce fall risk. Rapid rising worsens symptoms; extra medication would further lower pressure; the change is
clinically significant and must be addressed.
Question 5
A client with hypertension is taught the DASH dietary pattern. During a follow-up visit the client states, 'I have been eating more fruits
and vegetables and switched to low-fat dairy, but I still salt my food heavily at the table.' Which response by the nurse best addresses
the remaining knowledge gap?
A. Salt intake is less important once fruits and vegetables are increased
B. Reducing sodium to less than 2300 mg per day, and ideally 1500 mg, is a core component of blood-pressure control
C. Table salt can be continued if the client also takes a daily diuretic
D. The DASH diet focuses only on increasing potassium and does not address sodium
Correct Answer: B
Rationale:
Sodium restriction is an essential element of the DASH approach and of hypertension management guidelines. Even with increased produce and
low-fat dairy, continued heavy salting undermines blood-pressure reduction. Diuretics do not license unrestricted sodium; DASH explicitly limits
sodium.
Question 6
A client receiving a beta-blocker for hypertension reports new onset of fatigue and a resting heart rate of 52 beats per minute. The
nurse's priority assessment before administering the next dose is to evaluate for which finding?
A. Elevated blood glucose indicating beta-blocker induced hyperglycemia
B. Signs of heart block or symptomatic bradycardia that may require dose adjustment
C. Increased respiratory rate suggesting beta-blocker induced bronchospasm only
D. Hypertensive urgency because the beta-blocker is no longer effective
Correct Answer: B
Rationale:
Beta-blockers slow heart rate and can cause symptomatic bradycardia or conduction delays. A rate of 52 bpm with fatigue warrants assessment for
heart block or need for dose reduction before giving another dose. Hyperglycemia is more associated with other agents; bronchospasm is relevant
mainly in reactive-airway disease; the drug is still acting.
PNH301 - TEST 2 | QUESTIONS AND
ANSWERS | 2026/2027 | WITH COMPLETE
SOLUTION!!
A+
Complete Domain Coverage · Application & Analysis Level
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Hypertension and Cardiovascular Risk Factor Management
Coronary Artery Disease and Chronic Stable Angina
Acute Coronary Syndromes and Myocardial Infarction
Heart Failure and Circulatory Shock
Peripheral Vascular Disorders and Related Nursing Care
STUVIAACTUALEXAM
, SECTION 1: Hypertension and Cardiovascular Risk Factor Management
Question 1
A 54-year-old client with newly diagnosed stage 2 hypertension has a blood pressure of 168/102 mm Hg on two separate clinic visits.
The client reports smoking one pack of cigarettes daily and consuming four alcoholic drinks most evenings. The nurse prioritizes which
teaching point as the most immediate modifiable lifestyle change that can produce a measurable blood-pressure reduction within
weeks?
A. Increase daily calcium intake to 1500 mg through dairy products
B. Eliminate alcohol intake or limit it to no more than two standard drinks per day for men
C. Begin a high-protein, low-carbohydrate diet to promote rapid weight loss
D. Schedule blood-pressure checks only once every six months once medication is started
Correct Answer: B
Rationale:
Excessive alcohol intake is a recognized modifiable risk factor that directly elevates blood pressure; reducing intake to recommended limits can
lower systolic pressure by several mm Hg within weeks. Calcium supplementation has limited evidence for hypertension control, rapid weight-loss
diets are not first-line, and infrequent monitoring is inappropriate for newly diagnosed stage 2 hypertension.
Question 2
A client with chronic hypertension is prescribed an ACE inhibitor. Two weeks after initiation the client returns with a persistent dry cough
that interferes with sleep. The nurse recognizes this adverse effect and anticipates which collaborative action?
A. Increase the ACE-inhibitor dose to overcome receptor tolerance
B. Discontinue the ACE inhibitor and switch to an angiotensin-receptor blocker
C. Add a codeine-based cough suppressant and continue the current dose
D. Switch the client to a non-dihydropyridine calcium-channel blocker immediately without provider input
Correct Answer: B
Rationale:
A dry, persistent cough is a classic adverse effect of ACE inhibitors caused by bradykinin accumulation. Switching to an ARB preserves the
renin-angiotensin blockade while avoiding the cough. Dose increases worsen the cough; cough suppressants mask the problem; nurses do not
independently change medication classes.
Question 3
While reviewing a client's medication list, the nurse notes concurrent use of an ACE inhibitor and a potassium-sparing diuretic. Which
laboratory value requires the most urgent attention and why?
A. Serum sodium of 138 mEq/L because hyponatremia is the primary risk
B. Serum potassium of 5.6 mEq/L because the combination increases hyperkalemia risk
C. Blood urea nitrogen of 18 mg/dL because renal failure is inevitable
D. Fasting glucose of 110 mg/dL because both drugs elevate blood sugar
Correct Answer: B
Rationale:
ACE inhibitors reduce aldosterone and potassium-sparing diuretics retain potassium; together they significantly elevate hyperkalemia risk. A
potassium of 5.6 mEq/L already indicates mild elevation requiring intervention. Sodium, BUN, and glucose values shown are within or near normal
and are not the primary interactive concern.
, Question 4
A 68-year-old client with long-standing hypertension reports dizziness upon standing. Sitting blood pressure is 142/88 mm Hg; standing
blood pressure after one minute is 118/70 mm Hg. The nurse interprets these findings and selects which priority nursing action?
A. Encourage the client to rise quickly to improve cerebral perfusion
B. Teach the client to change positions slowly and report ongoing symptoms
C. Immediately administer an additional dose of the prescribed antihypertensive
D. Document the readings as normal variation for older adults and take no action
Correct Answer: B
Rationale:
A drop of 20 mm Hg systolic or 10 mm Hg diastolic upon standing defines orthostatic hypotension, a common side effect of antihypertensives in
older adults. Slow position changes reduce fall risk. Rapid rising worsens symptoms; extra medication would further lower pressure; the change is
clinically significant and must be addressed.
Question 5
A client with hypertension is taught the DASH dietary pattern. During a follow-up visit the client states, 'I have been eating more fruits
and vegetables and switched to low-fat dairy, but I still salt my food heavily at the table.' Which response by the nurse best addresses
the remaining knowledge gap?
A. Salt intake is less important once fruits and vegetables are increased
B. Reducing sodium to less than 2300 mg per day, and ideally 1500 mg, is a core component of blood-pressure control
C. Table salt can be continued if the client also takes a daily diuretic
D. The DASH diet focuses only on increasing potassium and does not address sodium
Correct Answer: B
Rationale:
Sodium restriction is an essential element of the DASH approach and of hypertension management guidelines. Even with increased produce and
low-fat dairy, continued heavy salting undermines blood-pressure reduction. Diuretics do not license unrestricted sodium; DASH explicitly limits
sodium.
Question 6
A client receiving a beta-blocker for hypertension reports new onset of fatigue and a resting heart rate of 52 beats per minute. The
nurse's priority assessment before administering the next dose is to evaluate for which finding?
A. Elevated blood glucose indicating beta-blocker induced hyperglycemia
B. Signs of heart block or symptomatic bradycardia that may require dose adjustment
C. Increased respiratory rate suggesting beta-blocker induced bronchospasm only
D. Hypertensive urgency because the beta-blocker is no longer effective
Correct Answer: B
Rationale:
Beta-blockers slow heart rate and can cause symptomatic bradycardia or conduction delays. A rate of 52 bpm with fatigue warrants assessment for
heart block or need for dose reduction before giving another dose. Hyperglycemia is more associated with other agents; bronchospasm is relevant
mainly in reactive-airway disease; the drug is still acting.
