HYPERTENSION, FNP 1 FINAL
QUESTIONS AND ANSWERS 100%
ACCURATE
What is the goal blood pressure for patients 60 years and older? - ANSWER-<150/90
(if pt has diabetes or CKD, consider starting tx at 140/90)
What are the parameters for a 'normal' blood pressure? - ANSWER-<120/80
What is the most common cause of secondary hypertension? - ANSWER-Renovascular
disease
What are the parameters for prehypertension?
What are the parameters for Stage 1 hypertension?
What are the parameters for Stage 2 hypertension? - ANSWER-SBP 120-139 or DBP
80-89 on 2 different occasions
SBP 140-159 or DBP 90-99 on 2 different occasions
SBP>160 or DBP > 100 on 2 different occasions
To confirm a new diagnosis of Stage 1 hypertension, how soon should you have the pt
return to recheck the reading?
To confirm a new diagnosis of Stage 2 hypertension, how soon should you have the pt
return to recheck the reading? - ANSWER-Within 2 months
Within 1 month
How should a pt be positioned in order to obtain an optimal blood pressure reading?
Are wrist monitors recommended for checking BP? - ANSWER-Seated comfortably for
at least 5 min, back supported, legs uncrossed, arm at level of the heart
No - use upper arm
How many blood pressure readings are needed in a week to allow for good clinical
decision making? - ANSWER-12 readings / week
, When should you consider initiating hypertension therapy with TWO drugs instead of
just one? - ANSWER-if SBP is 20 mmHg over goal or DBP is 10 mmHg over goal
(20/10) - one drug should be a diuretic
* it's nice to use multi-drug combinations (i.e. HCTZ + spironolactone)
What is the blood pressure goal for pts with diabetes or renal disease of ALL AGES? -
ANSWER-consider a goal of 140/90
What are two potential side effects that spironolactone can cause in men? - ANSWER-
gynecomastia and erectile dysfunction
Name some common potassium sparing diuretics? - ANSWER-spironolactone
(aldactone)
amiloride
What class (es) of antihypertensive medication increases the risk of hyperkalemia when
administered w/potassium sparing diuretics? - ANSWER-ACEI, ARB
What elements should be included in a focused exam of pt w/hypertension? -
ANSWER-- eyes (fundoscopic exam)
- head/neck (thyroid, carotid bruits, JVD)
- cardiac (murmurs, arrhythmias, friction rubs)
-abdomen (masses, bruits, hepatomegaly,violaceous striae)
- extremities (diminished peripheral pulses, edema)
- skin (hirsutism, acne, acanthosis nigricans)
Findings in the FUNDOSCOPIC EXAM of pt with HYPERTENSION? - ANSWER-1.
arteriolar narrowing
2. arteriolar/venous nicking
3. optic-disk swelling.
4. cotton wool spots (soft exudates)
cotton wool spot: caused by damage to retinal nerve fibers (d/t anything that occludes
retinal arteries)
How much can the DASH diet reduce SBP?
How much can weight loss reduce SBP?
What are other lifestyle modifications? - ANSWER-DASH lowers 8 - 14 mm Hg
Weight loss lowers 5 - 20 mm Hg per 10 kg
Reduce dietary sodium (lowers 2-8 mmHg)
Physical activity most days/week (lowers 4-9 mmHg)
QUESTIONS AND ANSWERS 100%
ACCURATE
What is the goal blood pressure for patients 60 years and older? - ANSWER-<150/90
(if pt has diabetes or CKD, consider starting tx at 140/90)
What are the parameters for a 'normal' blood pressure? - ANSWER-<120/80
What is the most common cause of secondary hypertension? - ANSWER-Renovascular
disease
What are the parameters for prehypertension?
What are the parameters for Stage 1 hypertension?
What are the parameters for Stage 2 hypertension? - ANSWER-SBP 120-139 or DBP
80-89 on 2 different occasions
SBP 140-159 or DBP 90-99 on 2 different occasions
SBP>160 or DBP > 100 on 2 different occasions
To confirm a new diagnosis of Stage 1 hypertension, how soon should you have the pt
return to recheck the reading?
To confirm a new diagnosis of Stage 2 hypertension, how soon should you have the pt
return to recheck the reading? - ANSWER-Within 2 months
Within 1 month
How should a pt be positioned in order to obtain an optimal blood pressure reading?
Are wrist monitors recommended for checking BP? - ANSWER-Seated comfortably for
at least 5 min, back supported, legs uncrossed, arm at level of the heart
No - use upper arm
How many blood pressure readings are needed in a week to allow for good clinical
decision making? - ANSWER-12 readings / week
, When should you consider initiating hypertension therapy with TWO drugs instead of
just one? - ANSWER-if SBP is 20 mmHg over goal or DBP is 10 mmHg over goal
(20/10) - one drug should be a diuretic
* it's nice to use multi-drug combinations (i.e. HCTZ + spironolactone)
What is the blood pressure goal for pts with diabetes or renal disease of ALL AGES? -
ANSWER-consider a goal of 140/90
What are two potential side effects that spironolactone can cause in men? - ANSWER-
gynecomastia and erectile dysfunction
Name some common potassium sparing diuretics? - ANSWER-spironolactone
(aldactone)
amiloride
What class (es) of antihypertensive medication increases the risk of hyperkalemia when
administered w/potassium sparing diuretics? - ANSWER-ACEI, ARB
What elements should be included in a focused exam of pt w/hypertension? -
ANSWER-- eyes (fundoscopic exam)
- head/neck (thyroid, carotid bruits, JVD)
- cardiac (murmurs, arrhythmias, friction rubs)
-abdomen (masses, bruits, hepatomegaly,violaceous striae)
- extremities (diminished peripheral pulses, edema)
- skin (hirsutism, acne, acanthosis nigricans)
Findings in the FUNDOSCOPIC EXAM of pt with HYPERTENSION? - ANSWER-1.
arteriolar narrowing
2. arteriolar/venous nicking
3. optic-disk swelling.
4. cotton wool spots (soft exudates)
cotton wool spot: caused by damage to retinal nerve fibers (d/t anything that occludes
retinal arteries)
How much can the DASH diet reduce SBP?
How much can weight loss reduce SBP?
What are other lifestyle modifications? - ANSWER-DASH lowers 8 - 14 mm Hg
Weight loss lowers 5 - 20 mm Hg per 10 kg
Reduce dietary sodium (lowers 2-8 mmHg)
Physical activity most days/week (lowers 4-9 mmHg)
