NSG 555 Exam 1 V3 Questions and Answers
2026 – Nurse Practitioners in Primary Care
Questions & Study Guide | Complete Exam-
Style Questions with Correct Detailed Answers
& Rationales (Reliable Answers)
Question 1
A 56-year-old patient presents for a routine primary-care visit.
Blood pressure measurements obtained on two separate
occasions are 146/92 mmHg and 144/90 mmHg. The patient
has no symptoms of acute end-organ injury. How should the
blood pressure be classified according to the ACC/AHA
classification system?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Rationale: The ACC/AHA classification defines stage 2
hypertension as a systolic blood pressure of at least 140 mmHg
,or a diastolic blood pressure of at least 90 mmHg. This patient's
repeated readings meet both systolic and diastolic thresholds. A
single elevated office reading should not automatically establish
a diagnosis, but repeated measurements at this level strongly
support hypertension when properly obtained and confirmed.
Hypertensive urgency is not an appropriate classification
because the patient has no evidence of acute target-organ
injury.
Question 2
A 48-year-old patient reports a blood pressure reading of
178/108 mmHg obtained at home. At the office, the repeat
measurement is 176/106 mmHg. The patient denies chest pain,
dyspnea, neurologic symptoms, visual changes, and severe
headache. What is the most appropriate immediate approach?
A. Diagnose hypertensive emergency and send the patient
directly for intravenous medication
B. Reassure the patient that no follow-up is necessary
C. Promptly evaluate for symptoms or evidence of target-
organ injury and arrange appropriate outpatient management
if none is present
D. Tell the patient to exercise vigorously to lower the blood
pressure
,Answer: C. Promptly evaluate for symptoms or evidence of
target-organ injury and arrange appropriate outpatient
management if none is present
Rationale: Severe blood pressure elevation requires assessment
for acute target-organ injury, including neurologic deficits,
acute coronary syndrome, pulmonary edema, aortic
catastrophe, or acute kidney injury. Hypertensive emergency is
defined by severe blood pressure elevation accompanied by
acute target-organ injury, not by the numerical blood pressure
alone. If the patient remains asymptomatic and no acute organ
injury is identified, management is generally directed toward
timely medication initiation or adjustment and close follow-up
rather than emergency intravenous treatment. Rapid,
uncontrolled reduction in an otherwise stable patient can also
cause harm.
Question 3
A 52-year-old patient has newly diagnosed uncomplicated
hypertension. Which medication class is considered an
appropriate first-line option?
A. Clonidine
B. Thiazide-type diuretic
, C. Hydralazine
D. Minoxidil
Answer: B. Thiazide-type diuretic
Rationale: Thiazide-type diuretics are among the established
first-line medication classes for uncomplicated hypertension.
Other commonly accepted first-line options include ACE
inhibitors, angiotensin receptor blockers, and calcium-channel
blockers. Clonidine, hydralazine, and minoxidil are generally not
preferred initial therapies for uncomplicated hypertension
because of their adverse-effect profiles, dosing considerations,
or limited role in routine first-line management.
Question 4
A patient taking lisinopril develops swelling of the lips and
tongue approximately 2 hours after taking the medication.
Which complication is most concerning?
A. Hypokalemia
B. Acute gout
C. Angioedema
D. Orthostatic hypotension
Answer: C. Angioedema
2026 – Nurse Practitioners in Primary Care
Questions & Study Guide | Complete Exam-
Style Questions with Correct Detailed Answers
& Rationales (Reliable Answers)
Question 1
A 56-year-old patient presents for a routine primary-care visit.
Blood pressure measurements obtained on two separate
occasions are 146/92 mmHg and 144/90 mmHg. The patient
has no symptoms of acute end-organ injury. How should the
blood pressure be classified according to the ACC/AHA
classification system?
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Answer: D. Stage 2 hypertension
Rationale: The ACC/AHA classification defines stage 2
hypertension as a systolic blood pressure of at least 140 mmHg
,or a diastolic blood pressure of at least 90 mmHg. This patient's
repeated readings meet both systolic and diastolic thresholds. A
single elevated office reading should not automatically establish
a diagnosis, but repeated measurements at this level strongly
support hypertension when properly obtained and confirmed.
Hypertensive urgency is not an appropriate classification
because the patient has no evidence of acute target-organ
injury.
Question 2
A 48-year-old patient reports a blood pressure reading of
178/108 mmHg obtained at home. At the office, the repeat
measurement is 176/106 mmHg. The patient denies chest pain,
dyspnea, neurologic symptoms, visual changes, and severe
headache. What is the most appropriate immediate approach?
A. Diagnose hypertensive emergency and send the patient
directly for intravenous medication
B. Reassure the patient that no follow-up is necessary
C. Promptly evaluate for symptoms or evidence of target-
organ injury and arrange appropriate outpatient management
if none is present
D. Tell the patient to exercise vigorously to lower the blood
pressure
,Answer: C. Promptly evaluate for symptoms or evidence of
target-organ injury and arrange appropriate outpatient
management if none is present
Rationale: Severe blood pressure elevation requires assessment
for acute target-organ injury, including neurologic deficits,
acute coronary syndrome, pulmonary edema, aortic
catastrophe, or acute kidney injury. Hypertensive emergency is
defined by severe blood pressure elevation accompanied by
acute target-organ injury, not by the numerical blood pressure
alone. If the patient remains asymptomatic and no acute organ
injury is identified, management is generally directed toward
timely medication initiation or adjustment and close follow-up
rather than emergency intravenous treatment. Rapid,
uncontrolled reduction in an otherwise stable patient can also
cause harm.
Question 3
A 52-year-old patient has newly diagnosed uncomplicated
hypertension. Which medication class is considered an
appropriate first-line option?
A. Clonidine
B. Thiazide-type diuretic
, C. Hydralazine
D. Minoxidil
Answer: B. Thiazide-type diuretic
Rationale: Thiazide-type diuretics are among the established
first-line medication classes for uncomplicated hypertension.
Other commonly accepted first-line options include ACE
inhibitors, angiotensin receptor blockers, and calcium-channel
blockers. Clonidine, hydralazine, and minoxidil are generally not
preferred initial therapies for uncomplicated hypertension
because of their adverse-effect profiles, dosing considerations,
or limited role in routine first-line management.
Question 4
A patient taking lisinopril develops swelling of the lips and
tongue approximately 2 hours after taking the medication.
Which complication is most concerning?
A. Hypokalemia
B. Acute gout
C. Angioedema
D. Orthostatic hypotension
Answer: C. Angioedema
