AGNP Exam 1 Solutions 100% Correct Latest Update 2025
mechanisms of BP control - Answers defects in excess NA, sympathetic hyperactivity, psychosocial
factors, RAAS, nitric oxide def., inc. insulin
Every increase of 20 systolic and 10 diastolic= - Answers doubled risk for CVD, starting at 115/75
HTN most prevalent in - Answers AA, women >50, men >45
RF for HTN - Answers age, arterial stiffness, dec baroreceptor sensitivity, inc sympathetic nervous system
sensitivity, endothelial dysfunction, decreased Na excretion, decreased plasma renin load, genetics
obesity BMI>30, metabolic syndrome, DM, high fat and K diets, sedentary, OSA, ETOH/tob
ETOH and HTN - Answers >2oz/d = linked to htn due to increased catecholamines
HTN is difficult to control if >4oz/d or binge drinking
smoking and HTN - Answers increases BP d/t increased plasma norepinephrine
Meds that increase BP - Answers NSAIDS (inc by 5)
estrogen-progesterone (causes mild sustained inc in bp in premenopausal women)
glucocorticoids (d/t Na retention)
Ephedrine products
History taking for HTN - Answers prior known Hx, Tx for htn, response to therapy
prior MI/CVA/PVD/CKD/DM
assess for ED/dyslipidemia/inflamm disease/chronic conditions
family Hx
Meds
physical activity level, diet, ETOH/tob., weight, drugs, psychosocial
PE for HTN - Answers Weight and BMI, BP
skin for hirsutism, cushing's findings, neurofibromatosis
Thyroid for nodules, goiter, bruit
Optic fundi for arterial narrowing, AV knicking, vasc. tortuosity
Carotids for bruits, diminuation of pulses
,Renal, Iliac, Femoral, Abd bruits
Abd aorta pulsation
PVD
PMI displaced laterally
Loud S1, rapid closure of aortic valve
S4, atrial contraction into poorly compliant LV
Mitral/Atrial regurgitation murmur common
pulmonary for crackles, signs of HF
Abd for enlarged kidneys, masses, distended bladder
Measuring BP - Answers sit quiet, feet on floor for 5 mins. arm supported at heart level, size of cuff 80%
of arm, 2-3 measurements 1 min apart
Non-Dip HTN - Answers ABPM detects a non-dip pattern, loss of nocturnal dip (at least 10% during
sleep)...is a predictor of CV risk, inc thrombotic stroke risk, accentuation of morning BP associated with
increased ICH (wake up stroke).
Labile HTN - Answers BP intermittently spikes above normal. Often progresses into sustained htn.
White coat HTN - Answers persistently high 140/90 at office only. Pt needs to monitor at home for 2
weeks and call with results
Masked HTN - Answers normal BP in office, HTN at home or when ambulating, occurs 15-20% without
diagnosis.
Isolated Diastolic HTN - Answers DBP >90, sys<140.
Common in elderly, obese, aortic stenosis, heavy etoh/tob
Isolated Systolic HTN - Answers SBP >140, common in elderly
Secondary HTN - Answers BP increase d/t definable etiology, often abrupt and severe. suspect if it
develops at early age or if those prev. controlled become refractory or if htn resistant to 3 medications.
May be d/t genetic syndromes, kidney disease, 70-80% blocked RAAS, primary hyperaldosteronism,
adrenal adenoma, cushings, pheochromocytoma, coarc of aorta
Malignant HTN - Answers rapid increase in DBP >130, manifested by increased ICP
s/s= restlessness, changed LOC, n/v, blurred vision, CN palsy, HF symptoms
, HTN urgency - Answers SBP >180, DBP >120
severe elevation with NO target organ damage
HTN emergency - Answers >180/>120 WITH new or worsening target organ damage
TOD examples - Answers ACS, flash pulmonary edema, ARF, aortic dissection, CVA, encephalopathy,
papilledema
JNC 8 - Answers normal: <120/<80
Prehtn: 120-139/80-89
stage 1: 140-159/90-99
stage 2: >160/>100
ACC/AHA - Answers normal: <120/<80
Elevated: 120-129/<80
Stage 1: 130-139/80-89
Stage 2: >140/>90
HTN diagnosis - Answers 3 separate readings, at least 1 week apart
3 goals for HTN Diagnostic Evaluation - Answers 1. Ascertain end organ damage
2. identify at risk patients for CV disease
2. screen for secondary causes
Diagnostic tests to run for HTN - Answers CMP, CBC, Thyroid, Lipid panel, UA
EKG, Echo
HTN management first line - Answers lifestyle modification
diet rich in K/mag/Ca, decrease Na
decrease weight, exercise, no ETOH/tob
Follow up in 1-2 weeks to reassess lifestyle mod.
Trial of lifestyle mod&nonpharm for up to 6mnths
Sodium daily for elderly, AA, DM, HTN pts - Answers sodium <2000mg/d
HTN target BP for JNC 8 - Answers >60 = <150/90
mechanisms of BP control - Answers defects in excess NA, sympathetic hyperactivity, psychosocial
factors, RAAS, nitric oxide def., inc. insulin
Every increase of 20 systolic and 10 diastolic= - Answers doubled risk for CVD, starting at 115/75
HTN most prevalent in - Answers AA, women >50, men >45
RF for HTN - Answers age, arterial stiffness, dec baroreceptor sensitivity, inc sympathetic nervous system
sensitivity, endothelial dysfunction, decreased Na excretion, decreased plasma renin load, genetics
obesity BMI>30, metabolic syndrome, DM, high fat and K diets, sedentary, OSA, ETOH/tob
ETOH and HTN - Answers >2oz/d = linked to htn due to increased catecholamines
HTN is difficult to control if >4oz/d or binge drinking
smoking and HTN - Answers increases BP d/t increased plasma norepinephrine
Meds that increase BP - Answers NSAIDS (inc by 5)
estrogen-progesterone (causes mild sustained inc in bp in premenopausal women)
glucocorticoids (d/t Na retention)
Ephedrine products
History taking for HTN - Answers prior known Hx, Tx for htn, response to therapy
prior MI/CVA/PVD/CKD/DM
assess for ED/dyslipidemia/inflamm disease/chronic conditions
family Hx
Meds
physical activity level, diet, ETOH/tob., weight, drugs, psychosocial
PE for HTN - Answers Weight and BMI, BP
skin for hirsutism, cushing's findings, neurofibromatosis
Thyroid for nodules, goiter, bruit
Optic fundi for arterial narrowing, AV knicking, vasc. tortuosity
Carotids for bruits, diminuation of pulses
,Renal, Iliac, Femoral, Abd bruits
Abd aorta pulsation
PVD
PMI displaced laterally
Loud S1, rapid closure of aortic valve
S4, atrial contraction into poorly compliant LV
Mitral/Atrial regurgitation murmur common
pulmonary for crackles, signs of HF
Abd for enlarged kidneys, masses, distended bladder
Measuring BP - Answers sit quiet, feet on floor for 5 mins. arm supported at heart level, size of cuff 80%
of arm, 2-3 measurements 1 min apart
Non-Dip HTN - Answers ABPM detects a non-dip pattern, loss of nocturnal dip (at least 10% during
sleep)...is a predictor of CV risk, inc thrombotic stroke risk, accentuation of morning BP associated with
increased ICH (wake up stroke).
Labile HTN - Answers BP intermittently spikes above normal. Often progresses into sustained htn.
White coat HTN - Answers persistently high 140/90 at office only. Pt needs to monitor at home for 2
weeks and call with results
Masked HTN - Answers normal BP in office, HTN at home or when ambulating, occurs 15-20% without
diagnosis.
Isolated Diastolic HTN - Answers DBP >90, sys<140.
Common in elderly, obese, aortic stenosis, heavy etoh/tob
Isolated Systolic HTN - Answers SBP >140, common in elderly
Secondary HTN - Answers BP increase d/t definable etiology, often abrupt and severe. suspect if it
develops at early age or if those prev. controlled become refractory or if htn resistant to 3 medications.
May be d/t genetic syndromes, kidney disease, 70-80% blocked RAAS, primary hyperaldosteronism,
adrenal adenoma, cushings, pheochromocytoma, coarc of aorta
Malignant HTN - Answers rapid increase in DBP >130, manifested by increased ICP
s/s= restlessness, changed LOC, n/v, blurred vision, CN palsy, HF symptoms
, HTN urgency - Answers SBP >180, DBP >120
severe elevation with NO target organ damage
HTN emergency - Answers >180/>120 WITH new or worsening target organ damage
TOD examples - Answers ACS, flash pulmonary edema, ARF, aortic dissection, CVA, encephalopathy,
papilledema
JNC 8 - Answers normal: <120/<80
Prehtn: 120-139/80-89
stage 1: 140-159/90-99
stage 2: >160/>100
ACC/AHA - Answers normal: <120/<80
Elevated: 120-129/<80
Stage 1: 130-139/80-89
Stage 2: >140/>90
HTN diagnosis - Answers 3 separate readings, at least 1 week apart
3 goals for HTN Diagnostic Evaluation - Answers 1. Ascertain end organ damage
2. identify at risk patients for CV disease
2. screen for secondary causes
Diagnostic tests to run for HTN - Answers CMP, CBC, Thyroid, Lipid panel, UA
EKG, Echo
HTN management first line - Answers lifestyle modification
diet rich in K/mag/Ca, decrease Na
decrease weight, exercise, no ETOH/tob
Follow up in 1-2 weeks to reassess lifestyle mod.
Trial of lifestyle mod&nonpharm for up to 6mnths
Sodium daily for elderly, AA, DM, HTN pts - Answers sodium <2000mg/d
HTN target BP for JNC 8 - Answers >60 = <150/90
