NURS 5338 CP2 EXAM / ACTUAL NURS 5338 CP2 FINAL EXAM
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM APPROVED QUESTIONS WITH WELL ELABORATED
ANSWERS AND DETAILED RATIONALES
1. A 58-year-old patient has repeated office blood pressures of 146/92 mmHg
and reports no symptoms. The patient has no diabetes, chronic kidney
disease, or cardiovascular disease. Which initial management approach is
most appropriate after confirming persistent hypertension with appropriate
measurements?
A. Begin lifestyle modification and an appropriate first-line antihypertensive
strategy based on the degree of elevation
B. Reassure the patient because hypertension is asymptomatic and requires
treatment only when symptoms develop
C. Immediately prescribe an intravenous antihypertensive medication in the
outpatient setting
D. Delay all treatment for one year regardless of subsequent blood-pressure
measurements
Answer: A
2. A 67-year-old patient with hypertension and chronic kidney disease is being
evaluated before starting an ACE inhibitor. Which laboratory parameter is
particularly important to obtain and monitor after therapy is initiated?
A. Serum amylase
B. Serum potassium and creatinine
C. Hemoglobin A1c only
D. Serum bilirubin
Answer: B
3. A patient taking lisinopril develops a persistent dry cough several weeks
after therapy begins, with no evidence of infection or heart failure. Which
medication class would generally be considered as an alternative when an
ACE-inhibitor-associated cough is suspected?
A. Nitrate
pg. 1
, B. Thiazide diuretic
C. Angiotensin II receptor blocker
D. Loop diuretic
Answer: C
4. A 72-year-old patient with hypertension also has symptomatic benign
prostatic hyperplasia. The clinician is considering an antihypertensive that
can also improve urinary symptoms. Which medication class may provide
both effects but requires attention to orthostatic hypotension?
A. ACE inhibitor
B. Calcium-channel blocker
C. Thiazide diuretic
D. Alpha-1 adrenergic blocker
Answer: D
5. A patient with hypertension is prescribed hydrochlorothiazide and returns
several weeks later with weakness and muscle cramps. Laboratory testing
reveals a reduced serum potassium concentration. Which mechanism best
explains this adverse effect?
A. Increased distal sodium delivery promotes potassium secretion
B. Direct inhibition of aldosterone receptors
C. Reduced renal filtration of potassium
D. Increased gastrointestinal potassium absorption
Answer: A
6. A patient with hypertension and chronic stable angina is being considered
for pharmacologic therapy. Which class is particularly useful for reducing
myocardial oxygen demand and preventing angina symptoms?
A. Alpha-glucosidase inhibitor
B. Beta-adrenergic blocker
C. Proton-pump inhibitor
D. Bile-acid sequestrant
Answer: B
pg. 2
, 7. A patient taking a beta blocker for hypertension reports fatigue and a
resting pulse of 48 beats/minute. Which assessment finding would most
strongly support excessive beta-adrenergic blockade?
A. Increased appetite
B. Hyperactive bowel sounds
C. Symptomatic bradycardia
D. Increased urinary frequency
Answer: C
8. A patient with hypertension is prescribed amlodipine and develops bilateral
ankle edema without dyspnea or evidence of systemic fluid overload.
Which mechanism most directly contributes to this adverse effect?
A. Increased aldosterone synthesis
B. Reduced cardiac contractility causing pulmonary edema
C. Increased renal sodium retention from aldosterone excess
D. Arteriolar dilation increasing capillary hydrostatic pressure
Answer: D
9. A patient presents with a blood pressure of 214/124 mmHg and new-onset
confusion and visual changes. Which clinical interpretation is most
appropriate?
A. Hypertensive emergency requiring immediate evaluation for acute
target-organ injury
B. Uncomplicated hypertension suitable for routine follow-up next month
C. White-coat hypertension requiring no evaluation
D. Isolated diastolic hypertension without acute significance
Answer: A
10. A patient with hypertension asks why lifestyle interventions remain
important even after an antihypertensive medication is prescribed. Which
explanation is most accurate?
A. Lifestyle interventions eliminate the need for monitoring
B. Dietary sodium reduction, physical activity, weight management, and
other measures can improve blood-pressure control and cardiovascular risk
pg. 3
, C. Lifestyle interventions are useful only when antihypertensive medication
is contraindicated
D. Lifestyle changes increase the required medication dose
Answer: B
11. A 64-year-old patient with a history of myocardial infarction has an LDL
cholesterol level that remains elevated despite dietary changes. Which
pharmacologic approach is generally central to secondary cardiovascular
prevention?
A. Short-term antibiotic therapy
B. High-intensity statin therapy when tolerated and appropriate
C. Daily corticosteroid therapy
D. Chronic proton-pump inhibitor therapy
Answer: B
12. A patient taking atorvastatin reports new severe generalized muscle pain
and weakness. Which laboratory test is most appropriate when significant
statin-associated muscle injury is suspected?
A. Creatine kinase
B. Serum lipase
C. Thyroid-stimulating hormone only
D. Serum sodium
Answer: A
13. A patient taking a statin asks why liver testing may be considered during
treatment. Which response best explains the concern?
A. Statins routinely cause acute liver failure in most patients
B. Statins directly destroy red blood cells
C. Hepatic enzyme abnormalities can occur and should be evaluated when
clinically indicated
D. Statins prevent all hepatic metabolism of other medications
Answer: C
14. A patient with hyperlipidemia cannot tolerate several statins because of
recurrent muscle symptoms despite appropriate evaluation and
pg. 4
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM APPROVED QUESTIONS WITH WELL ELABORATED
ANSWERS AND DETAILED RATIONALES
1. A 58-year-old patient has repeated office blood pressures of 146/92 mmHg
and reports no symptoms. The patient has no diabetes, chronic kidney
disease, or cardiovascular disease. Which initial management approach is
most appropriate after confirming persistent hypertension with appropriate
measurements?
A. Begin lifestyle modification and an appropriate first-line antihypertensive
strategy based on the degree of elevation
B. Reassure the patient because hypertension is asymptomatic and requires
treatment only when symptoms develop
C. Immediately prescribe an intravenous antihypertensive medication in the
outpatient setting
D. Delay all treatment for one year regardless of subsequent blood-pressure
measurements
Answer: A
2. A 67-year-old patient with hypertension and chronic kidney disease is being
evaluated before starting an ACE inhibitor. Which laboratory parameter is
particularly important to obtain and monitor after therapy is initiated?
A. Serum amylase
B. Serum potassium and creatinine
C. Hemoglobin A1c only
D. Serum bilirubin
Answer: B
3. A patient taking lisinopril develops a persistent dry cough several weeks
after therapy begins, with no evidence of infection or heart failure. Which
medication class would generally be considered as an alternative when an
ACE-inhibitor-associated cough is suspected?
A. Nitrate
pg. 1
, B. Thiazide diuretic
C. Angiotensin II receptor blocker
D. Loop diuretic
Answer: C
4. A 72-year-old patient with hypertension also has symptomatic benign
prostatic hyperplasia. The clinician is considering an antihypertensive that
can also improve urinary symptoms. Which medication class may provide
both effects but requires attention to orthostatic hypotension?
A. ACE inhibitor
B. Calcium-channel blocker
C. Thiazide diuretic
D. Alpha-1 adrenergic blocker
Answer: D
5. A patient with hypertension is prescribed hydrochlorothiazide and returns
several weeks later with weakness and muscle cramps. Laboratory testing
reveals a reduced serum potassium concentration. Which mechanism best
explains this adverse effect?
A. Increased distal sodium delivery promotes potassium secretion
B. Direct inhibition of aldosterone receptors
C. Reduced renal filtration of potassium
D. Increased gastrointestinal potassium absorption
Answer: A
6. A patient with hypertension and chronic stable angina is being considered
for pharmacologic therapy. Which class is particularly useful for reducing
myocardial oxygen demand and preventing angina symptoms?
A. Alpha-glucosidase inhibitor
B. Beta-adrenergic blocker
C. Proton-pump inhibitor
D. Bile-acid sequestrant
Answer: B
pg. 2
, 7. A patient taking a beta blocker for hypertension reports fatigue and a
resting pulse of 48 beats/minute. Which assessment finding would most
strongly support excessive beta-adrenergic blockade?
A. Increased appetite
B. Hyperactive bowel sounds
C. Symptomatic bradycardia
D. Increased urinary frequency
Answer: C
8. A patient with hypertension is prescribed amlodipine and develops bilateral
ankle edema without dyspnea or evidence of systemic fluid overload.
Which mechanism most directly contributes to this adverse effect?
A. Increased aldosterone synthesis
B. Reduced cardiac contractility causing pulmonary edema
C. Increased renal sodium retention from aldosterone excess
D. Arteriolar dilation increasing capillary hydrostatic pressure
Answer: D
9. A patient presents with a blood pressure of 214/124 mmHg and new-onset
confusion and visual changes. Which clinical interpretation is most
appropriate?
A. Hypertensive emergency requiring immediate evaluation for acute
target-organ injury
B. Uncomplicated hypertension suitable for routine follow-up next month
C. White-coat hypertension requiring no evaluation
D. Isolated diastolic hypertension without acute significance
Answer: A
10. A patient with hypertension asks why lifestyle interventions remain
important even after an antihypertensive medication is prescribed. Which
explanation is most accurate?
A. Lifestyle interventions eliminate the need for monitoring
B. Dietary sodium reduction, physical activity, weight management, and
other measures can improve blood-pressure control and cardiovascular risk
pg. 3
, C. Lifestyle interventions are useful only when antihypertensive medication
is contraindicated
D. Lifestyle changes increase the required medication dose
Answer: B
11. A 64-year-old patient with a history of myocardial infarction has an LDL
cholesterol level that remains elevated despite dietary changes. Which
pharmacologic approach is generally central to secondary cardiovascular
prevention?
A. Short-term antibiotic therapy
B. High-intensity statin therapy when tolerated and appropriate
C. Daily corticosteroid therapy
D. Chronic proton-pump inhibitor therapy
Answer: B
12. A patient taking atorvastatin reports new severe generalized muscle pain
and weakness. Which laboratory test is most appropriate when significant
statin-associated muscle injury is suspected?
A. Creatine kinase
B. Serum lipase
C. Thyroid-stimulating hormone only
D. Serum sodium
Answer: A
13. A patient taking a statin asks why liver testing may be considered during
treatment. Which response best explains the concern?
A. Statins routinely cause acute liver failure in most patients
B. Statins directly destroy red blood cells
C. Hepatic enzyme abnormalities can occur and should be evaluated when
clinically indicated
D. Statins prevent all hepatic metabolism of other medications
Answer: C
14. A patient with hyperlipidemia cannot tolerate several statins because of
recurrent muscle symptoms despite appropriate evaluation and
pg. 4
