NRNP 6531 Latest Update 2025-2026
Questions and Correct Answers With
Rationales | Rated A+
1. Which are causes of secondary hypertension?
a. Increased salt intake
b. Isometric exercises
c. Nonsteroidal anti-inflammatory drugs
d. Oral contraceptives
e. Sleep apnea - ANSWERS-ANS: C, D, E
Rationale: NSAIDs and OCPs can both increase the risk of hypertension.
Sleep apnea causes secondary hypertension. Increased salt intake does
not cause HTN, but those with HTN are more sensitive to sale. Regular
isometric exercise can decrease blood pressure.
2. A 55-year-old patient has a blood pressure of 138/85 on three
occasions. The patient denies headaches, palpitations, snoring, muscle
weakness, and nocturia and does not take any medications. What will
the provider do next to evaluate this patient?
a. Assess serum cortisol levels
b. Continue to monitor blood pressure at each health maintenance
visit
,c. Order urinalysis, CBC, BUN, and creatinine
d. Refer to a specialist for a sleep study - ANSWERS-ANS: C
Rationale: This patient has pre-hypertension levels and should be
evaluated. UA, CBC, BUN, and creatinine help to evaluate renal function
and are in the initial workup. Serum cortisol levels are performed if
pheochromocytoma is suspected, which would cause headache. The
patient does not have snoring, so a sleep study is not indicated at this
time. It is not correct to continue to monitor without assessing possible
causes of early hypertension.
3. An African-American patient who is being treated with a thiazide
diuretic for chronic hypertension reports blurred vision and shortness of
breath. The provider notes a blood pressure of 185/115. What is the
recommended action for this patient?
a. Add a beta blocker to the patient's regimen
b. Admit to the hospital for evaluation and treatment
c. Increase the dose of the thiazide medication
d. Prescribe a calcium channel blocker - ANSWERS-ANS: B
Rationale: Patients with a blood pressure >180/120 or those with signs
of target organ symptoms should be admitted to inpatient treatment
with specialist consultation. Changing the medications may be done with
consultation, but a hospitalization and stabilization must be done
initially.
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm.
The patient has
poorly- controlled hypertension, and decompensated heart failure. What
is the
recommendation for treatment for this patient?
,a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the aneurysm - ANSWERS-
ANS: D
Rationale: This patient's aneurysm is less than 5.5 cm and repair is not
necessary at this time. Serial US surveillance is necessary to continue to
evaluate size. Repair is risky in patients with hypertension and heart
failure, so avoiding procedures if possible is recommended.
A patient reports sustained, irregular heart palpitations. What is the
most likely cause of
these
symptoms?
a. Anemia
b. Atrial fibrillation
c. Extrasystole
d. Paroxysmal attacks - ANSWERS-ANS: B
Rationale: Atrial fibrillation causes palpitations that are irregular and
tend to be sustained. Anemia will cause rapid palpitations that are
regular. Extrasystole causes palpitations or an awareness of isolated
extra beats with a pause. Paroxysmal attacks start and terminate
abruptly and are usually rapid and regular.
3. A child with a history of asthma is brought to the clinic with a rapid
heart rate. A cardiac monitor shows a heart rate of 225 beats per
minute. The provider notifies transport to take the child to the
emergency department. What initial intervention may be attempted in
the clinic?
, a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage - ANSWERS-ANS: D
Rationale: This child has paroxysmal supraventricular tachycardi
a. Vagal maneuvers or carotid massage may be attempted to slow the
ventricular rate.
Adenosine is contraindicated in patients with asthm
a. Medications such as beta blockers and digoxin are not used in
emergency treatment
of PSVT.
1. According to current research, which are associated with a decreased
incidence of
stroke?
a. 7 servings of fruits and vegetables per day
b. B-complex vitamin supplements
c. Intensive insulin therapy in type 1 diabetes
d. Low-sugar soda
e. Mediterranean diet - ANSWERS-ANS: A, C, E
Rationale: Individuals without hypertension in Sweden who consumed 7
servings of fruits and vegetables per day had a 19% lower risk of stroke
than those consuming only one serving per day. Intensive insulin therapy
in patients with type 1 diabetes was shown to lower the risk of stroke.
Consuming a Mediterranean diet is associated with a reduced stroke
risk. B-complex vitamins and low-sugar soda have not shown a
decreased risk.
2. During a routine health maintenance examination, the provider
auscultates a cervical
Questions and Correct Answers With
Rationales | Rated A+
1. Which are causes of secondary hypertension?
a. Increased salt intake
b. Isometric exercises
c. Nonsteroidal anti-inflammatory drugs
d. Oral contraceptives
e. Sleep apnea - ANSWERS-ANS: C, D, E
Rationale: NSAIDs and OCPs can both increase the risk of hypertension.
Sleep apnea causes secondary hypertension. Increased salt intake does
not cause HTN, but those with HTN are more sensitive to sale. Regular
isometric exercise can decrease blood pressure.
2. A 55-year-old patient has a blood pressure of 138/85 on three
occasions. The patient denies headaches, palpitations, snoring, muscle
weakness, and nocturia and does not take any medications. What will
the provider do next to evaluate this patient?
a. Assess serum cortisol levels
b. Continue to monitor blood pressure at each health maintenance
visit
,c. Order urinalysis, CBC, BUN, and creatinine
d. Refer to a specialist for a sleep study - ANSWERS-ANS: C
Rationale: This patient has pre-hypertension levels and should be
evaluated. UA, CBC, BUN, and creatinine help to evaluate renal function
and are in the initial workup. Serum cortisol levels are performed if
pheochromocytoma is suspected, which would cause headache. The
patient does not have snoring, so a sleep study is not indicated at this
time. It is not correct to continue to monitor without assessing possible
causes of early hypertension.
3. An African-American patient who is being treated with a thiazide
diuretic for chronic hypertension reports blurred vision and shortness of
breath. The provider notes a blood pressure of 185/115. What is the
recommended action for this patient?
a. Add a beta blocker to the patient's regimen
b. Admit to the hospital for evaluation and treatment
c. Increase the dose of the thiazide medication
d. Prescribe a calcium channel blocker - ANSWERS-ANS: B
Rationale: Patients with a blood pressure >180/120 or those with signs
of target organ symptoms should be admitted to inpatient treatment
with specialist consultation. Changing the medications may be done with
consultation, but a hospitalization and stabilization must be done
initially.
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm.
The patient has
poorly- controlled hypertension, and decompensated heart failure. What
is the
recommendation for treatment for this patient?
,a. Endovascular stent grafting of the aneurysm
b. Immediate open surgical repair of the aneurysm
c. No intervention is necessary for this patient
d. Serial ultrasonographic surveillance of the aneurysm - ANSWERS-
ANS: D
Rationale: This patient's aneurysm is less than 5.5 cm and repair is not
necessary at this time. Serial US surveillance is necessary to continue to
evaluate size. Repair is risky in patients with hypertension and heart
failure, so avoiding procedures if possible is recommended.
A patient reports sustained, irregular heart palpitations. What is the
most likely cause of
these
symptoms?
a. Anemia
b. Atrial fibrillation
c. Extrasystole
d. Paroxysmal attacks - ANSWERS-ANS: B
Rationale: Atrial fibrillation causes palpitations that are irregular and
tend to be sustained. Anemia will cause rapid palpitations that are
regular. Extrasystole causes palpitations or an awareness of isolated
extra beats with a pause. Paroxysmal attacks start and terminate
abruptly and are usually rapid and regular.
3. A child with a history of asthma is brought to the clinic with a rapid
heart rate. A cardiac monitor shows a heart rate of 225 beats per
minute. The provider notifies transport to take the child to the
emergency department. What initial intervention may be attempted in
the clinic?
, a. Administration of intravenous adenosine
b. Giving a beta blocker
c. Providing a loading dose of digoxin
d. Using a vagal maneuver or carotid massage - ANSWERS-ANS: D
Rationale: This child has paroxysmal supraventricular tachycardi
a. Vagal maneuvers or carotid massage may be attempted to slow the
ventricular rate.
Adenosine is contraindicated in patients with asthm
a. Medications such as beta blockers and digoxin are not used in
emergency treatment
of PSVT.
1. According to current research, which are associated with a decreased
incidence of
stroke?
a. 7 servings of fruits and vegetables per day
b. B-complex vitamin supplements
c. Intensive insulin therapy in type 1 diabetes
d. Low-sugar soda
e. Mediterranean diet - ANSWERS-ANS: A, C, E
Rationale: Individuals without hypertension in Sweden who consumed 7
servings of fruits and vegetables per day had a 19% lower risk of stroke
than those consuming only one serving per day. Intensive insulin therapy
in patients with type 1 diabetes was shown to lower the risk of stroke.
Consuming a Mediterranean diet is associated with a reduced stroke
risk. B-complex vitamins and low-sugar soda have not shown a
decreased risk.
2. During a routine health maintenance examination, the provider
auscultates a cervical
