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PATHOPHYSI_NSG_530 EXAM STUDY QUESTIONS AND ANSWERS VERIFIED 100 % CORRECTLY

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PATHOPHYSI_NSG_530 EXAM STUDY QUESTIONS AND ANSWERS VERIFIED 100 % CORRECTLY CHAPTER 5 ASSESSMENT QUESTIONS Student Questions (10 questions) 1. A 65-year-old black male presents to the clinic today with average BP of 148/88 mm Hg and heart rate of 70 beats/min. He has past medical histo...

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  • September 16, 2024
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PATHOPHYSI_NSG_530 EXAM STUDY QUESTIONS AND
ANSWERS VERIFIED 100 % CORRECTLY
CHAPTER 5 ASSESSMENT QUESTIONS
Student Questions (10 questions)
1. A 65-year-old black male presents to the clinic today with average BP of 148/88 mm Hg and heart rate of 70
beats/min. He has past medical history of type 2 diabetes and chronic obstructive pulmonary disease (group B).
His most recent serum potassium is 3.6 mEq/L (mmol/L), serum creatinine is 0.9 mg/dL (80 µmol/L),
calculated creatinine clearance is 92 mL/min (1.54 mL/s) and urine albumin is within normal limits. His current
medication list includes atorvastatin, metformin, and inhaled tiotropium. Which of the following
antihypertensives would be the most appropriate initial therapy?

A. Amlodipine
B. Chlorthalidone
C. Atenolol
D. Lisinopril


2. A 67-year-old Asian man with a recent non-ST segment elevation myocardial infarction (MI) (2 weeks ago)
has an average BP of 138/86 mm Hg and a heart rate of 76 beats/min. Which of the following antihypertensive
agents is preferred in this setting?

A. Metoprolol tartrate
B. Acebutolol
C. Hydrochlorothiazide
D. Spironolactone


3. A 58-year old Indian American male presents to urgent care with chief complaints of severe headache,
confusion, and blurred vision. Upon examination, his vital signs and relevant lab values include: BP 218/124
mm Hg; HR 92 beats/min; RR 18 breaths/min; serum potassium 4.8 mEq/L (mmol/L); serum creatinine 2.4
mg/dL (212 µmol/L); blood urea nitrogen 45 mg/dL (16.1 mmol/L); serum glucose 145 mg/dL (8.0 mmol/L);
hemoglobin A1C 6.4% (0.064; 46 mmol/mol Hb); AST 28 U/L (0.47 µkat/L); ALT 20 U/L (0.33 µkat/L);
urinalysis shows positive of proteins and negative of ketones. He has medical history of hypertension but no
history of renal or hepatic impairment. According to the pharmacists, his antihypertensive medications are
overdue for a refill by 2 months. Which of the following statements is most accurate?

A. He is experiencing hypertensive urgency
B. Goal is to reduce systolic blood pressure by up to 25% within an hour
C. Goal is to reduce systolic blood pressure by 25% to 50% within an hour
D. Administration of short-acting oral antihypertensive such as labetalol or clonidine is appropriate

,4. A 72-year-old black man with history of hypertension, prior MI, and benign prostatic hypertrophy, is
currently receiving amlodipine 5 mg QAM and carvedilol 12.5 mg twice daily. He has an average 24-hour
Ambulatory Blood Pressure of 156/92 mm Hg and HR of 60 beats/min with notable nocturnal hypertension. He

,complains of nocturia but states that the swelling in his feet improved when his amlodipine dose was reduced.
Which of the following presents the most clinically appropriate course of action?

A. Increase amlodipine to 10 mg daily and change to bedtime
B. Increase carvedilol to 25 mg twice daily
C. Initiate chlorthalidone 50 mg daily in AM
D. Initiate lisinopril 5 mg once daily at bedtime

5. A 55-year-old white man with seated office blood pressure (BP) readings of 138/89 mm Hg and 136/84 mm
Hg is asked to return in 2 weeks for repeat measurements, which are 138/88 mm Hg and 134/82 mm Hg. Which
of the following classifies his BP per the 2017 ACC/AHA guidelines?

A. Stage 2 hypertension
B. Stage 1 hypertension
C. Elevated BP
D. Optimal BP


6. A 34-year-old black man presents to your clinic with a BP of 160/94 mm Hg. Repeat readings over the past 2
weeks average 156/92 mm Hg. The patient has no past medical history with the exception of Crohn disease,
which is currently treated with chronic steroid therapy. He is also taking an over-the-counter NSAID for
ongoing back pain. Physical examination and laboratory tests are unremarkable. Appropriate interventions at
this time include:

A. No intervention because patient most likely has drug-induced hypertension
B. NSAID is appropriate as long as he follows the instructions on the package insert
C. Reassessment of the dose and need for long-term oral steroids D. Initiation of antihypertensive therapy


7. A 45-year-old African-American woman who has resistant hypertension, heart failure with reduced ejection
fraction, type 2 diabetes, and dyslipidemia comes to the clinic for a medication management visit. Her current
medications include enalapril/hydrochlorothiazide (Vaseretic), metoprolol succinate, hydralazine, isosorbide
dinitrate, metformin, and atorvastatin. She has been adherent to all her medications. She complains of recently
developed fatigue, arthralgia, and mild peripheral edema, and a butterfly rash across her nose and upper cheeks.
Which of the following statements is correct?

A. The most likely medication causing this adverse reaction is the angiotensin-converting enzyme inhibitor,
enalapril
B. This is likely to be a dose-independent adverse drug reaction
C. Testing for N-acetyltransferase-1 (NAT-1) and NAT-2 genes may help to prevent this adverse effect D.
Discontinue all medications due to unknown etiology of this reaction

, 8. A 52-year-old Asian male is newly diagnosed with stage 1 hypertension. Significant lab values are potassium
level of 4.5 mEq/L (mmol/L) and an estimated GFR of 25 mL/min/1.73 m2. His past medical history includes
type 2 diabetes, chronic kidney disease (stage G4, A1), hyperlipidemia, and gout. His 10-year ASCVD risk is
estimated at 10.8%. Which of the following medications would be preferred for this patient?

A. Chlorthalidone
B. Amlodipine
C. Losartan
D. Metoprolol tartrate


9. A 57-year-old white woman has type 2 diabetes, morbid obesity, and hypertension. She is currently taking
only lisinopril 20 mg daily and her office blood pressures are consistently at goal less than 130/80 mm Hg, but
her home readings are significantly higher. Which of the following is a possible explanation for her elevated
home readings?

A. Her home BP cuff is too small
B. She has white coat hypertension
C. Her home BP cuff is too large
D. She checks her blood pressure immediately after exercise
10. A 55-year-old black woman has a history of left ventricular hypertrophy with a left ventricular ejection
fraction of 55% (0.55). She has had hypertension for 10 years and is currently taking chlorthalidone 25 mg

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