In obtaining an office BP measurement, which of the following is most
reflective of the best practice?
The patient should sit in a chair with feet flat on the floor for at least 5
minutes before obtaining the reading
What is the correct drug class of diltiazem?
nondihydropyridine calcium channel blocker
A risk factor for acquired aortic stenosis is:
prior rheumatic fever.
From the 2017 update to the 2013 heart failure ACC/AHA guidelines, which of
the following would NOT be a first line treatment for HFrEF?
Amlodipine 5 mg qd
You examine a 24-year-old woman with mitral valve prolapse (MVP). Her
physical examination findings may also include:
pectus excavatum.
The S4 heart sound has which of the following characteristics?
It is noted in the presence of poorly controlled hypertension.
,You see a 59-year-old man with poorly controlled hypertension. On physical
examination, you note grade 1 hypertensive retinopathy. You anticipate all of
the following will be present except:
patient report of acute visual change.
You see a 38-year-old African American male with hypertension who is
currently being treated with thiazide-type diuretic. His current blood pressure
reading is 156/94 mm Hg and he has no history of diabetes mellitus or
chronic kidney disease. Following current best evidence, you consider adding
which of the following medications?
calcium channel blocker
We have an expert-written solution to this problem!
Mr. G is a 63 year old patient with a long history of hypertension, previously
controlled on Lisinopril and HCTZ. His BP has been rising, to 170/104 at the
last visit. He insisted he is adherent with his medications. The clinician added
amlodipine, which dropped the BP to 160/96, but it is 180/110 today. He is
asymptomatic with an essentially negative ROS. The patient has sleep
apnea, which is effectively treated with CPAP. His GFR was 64 last month.
According to figure 10 (page e193) in the 2017 ACC/AHA hypertension
treatment guidelines, what other causes of secondary hypertension would be
most likely to be causing Mr. G's new onset resistant hypertension?
Primary Aldosteronism
A 68-year-old woman presents with hypertension and BP of 152-158/92-96
mm Hg documented over 2 months on three different occasions.
Electrocardiogram (ECG) and creatinine are normal, and she has no
proteinuria. Clinical findings include the following: BMI 26.4 kg/m2; no S3, S4,
,or murmur; and point of maximal impulse at fifth intercostal space, mid-
clavicular line. Which of the following represents the best intervention?
Initiate therapy with hydrochlorothiazide.
When a heart valve fails to close properly, it is said to be:
incompetent.
The S3 heart sound has all of the following characteristics except:
a presystolic sound
You are treating a healthy a 52 year old African American well woman never-
smoker whose BP has been averaging 135 systolic and 84 diastolic for
several years. She is on no regular medications. What additional information
do you need in order to determine whether she should be treated with
medication, in addition to lifestyle changes, according to the 2018 ACC/AHA
hypertension guidelines?
avoid disease-related target organ damage.
What is the correct drug class of telmisartan?
angiotensin receptor antagonist
, You examine a 78-year-old woman with long-standing, poorly controlled
hypertension. When evaluating her for hypertensive target organ damage,
you look for evidence of:
left ventricular hypertrophy.
In the person with hypertension, the nurse practitioner (NP) recommends all
of the following to potentially reduce BP in a patient with a BMI of 30 kg/m2
except:
consuming at least 1-2 servings of alcohol.
The most important long-term goal of treating hypertension is to:
avoid disease-related target organ damage.
From the 2017 update to the 2013 heart failure ACC/AHA guidelines, which of
the following would NOT be a first line treatment for HFpEF?
Any or all of the above could be first line treatments for HFrEF as needed to
reduce systolic BP to below 130
You are evaluating a patient who has rheumatic heart disease. When
assessing her for mitral stenosis, you auscultate the heart, anticipating
finding the following murmur:
localized diastolic with little radiation.
We have an expert-written solution to this problem!
reflective of the best practice?
The patient should sit in a chair with feet flat on the floor for at least 5
minutes before obtaining the reading
What is the correct drug class of diltiazem?
nondihydropyridine calcium channel blocker
A risk factor for acquired aortic stenosis is:
prior rheumatic fever.
From the 2017 update to the 2013 heart failure ACC/AHA guidelines, which of
the following would NOT be a first line treatment for HFrEF?
Amlodipine 5 mg qd
You examine a 24-year-old woman with mitral valve prolapse (MVP). Her
physical examination findings may also include:
pectus excavatum.
The S4 heart sound has which of the following characteristics?
It is noted in the presence of poorly controlled hypertension.
,You see a 59-year-old man with poorly controlled hypertension. On physical
examination, you note grade 1 hypertensive retinopathy. You anticipate all of
the following will be present except:
patient report of acute visual change.
You see a 38-year-old African American male with hypertension who is
currently being treated with thiazide-type diuretic. His current blood pressure
reading is 156/94 mm Hg and he has no history of diabetes mellitus or
chronic kidney disease. Following current best evidence, you consider adding
which of the following medications?
calcium channel blocker
We have an expert-written solution to this problem!
Mr. G is a 63 year old patient with a long history of hypertension, previously
controlled on Lisinopril and HCTZ. His BP has been rising, to 170/104 at the
last visit. He insisted he is adherent with his medications. The clinician added
amlodipine, which dropped the BP to 160/96, but it is 180/110 today. He is
asymptomatic with an essentially negative ROS. The patient has sleep
apnea, which is effectively treated with CPAP. His GFR was 64 last month.
According to figure 10 (page e193) in the 2017 ACC/AHA hypertension
treatment guidelines, what other causes of secondary hypertension would be
most likely to be causing Mr. G's new onset resistant hypertension?
Primary Aldosteronism
A 68-year-old woman presents with hypertension and BP of 152-158/92-96
mm Hg documented over 2 months on three different occasions.
Electrocardiogram (ECG) and creatinine are normal, and she has no
proteinuria. Clinical findings include the following: BMI 26.4 kg/m2; no S3, S4,
,or murmur; and point of maximal impulse at fifth intercostal space, mid-
clavicular line. Which of the following represents the best intervention?
Initiate therapy with hydrochlorothiazide.
When a heart valve fails to close properly, it is said to be:
incompetent.
The S3 heart sound has all of the following characteristics except:
a presystolic sound
You are treating a healthy a 52 year old African American well woman never-
smoker whose BP has been averaging 135 systolic and 84 diastolic for
several years. She is on no regular medications. What additional information
do you need in order to determine whether she should be treated with
medication, in addition to lifestyle changes, according to the 2018 ACC/AHA
hypertension guidelines?
avoid disease-related target organ damage.
What is the correct drug class of telmisartan?
angiotensin receptor antagonist
, You examine a 78-year-old woman with long-standing, poorly controlled
hypertension. When evaluating her for hypertensive target organ damage,
you look for evidence of:
left ventricular hypertrophy.
In the person with hypertension, the nurse practitioner (NP) recommends all
of the following to potentially reduce BP in a patient with a BMI of 30 kg/m2
except:
consuming at least 1-2 servings of alcohol.
The most important long-term goal of treating hypertension is to:
avoid disease-related target organ damage.
From the 2017 update to the 2013 heart failure ACC/AHA guidelines, which of
the following would NOT be a first line treatment for HFpEF?
Any or all of the above could be first line treatments for HFrEF as needed to
reduce systolic BP to below 130
You are evaluating a patient who has rheumatic heart disease. When
assessing her for mitral stenosis, you auscultate the heart, anticipating
finding the following murmur:
localized diastolic with little radiation.
We have an expert-written solution to this problem!
