Study with our free AANP Practice Questions, Qbank Test 4. The questions include answers and detailed rationales. Nursing topics focus on diagnosis, diagnostic tests, critical thinking, priorities of care, safe and effective care, treatments, and AANP clinical management. Achieve your highest score on the AANP Exam! Review cardiac valvular disease, treatment of common cardiovascular disorders, diagnostic testing, and clinical management of critical illness and cardiovascular disease.
A 30-year-old pregnant patient at 36 weeks’ gestation presents with hypertension (blood pressure of 160/100 mm Hg) and lower abdominal pain. She reports decreased fetal movements. On examination, you note edema and uterine tenderness. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) Superimposed preeclampsia on chronic hypertension
Rationale: This patient’s presentation with new-onset hypertension, severe headache, visual disturbances, edema, and hyperreflexia at 32 weeks’ gestation is concerning for superimposed preeclampsia on chronic hypertension. Superimposed preeclampsia can lead to serious complications, including eclampsia, and requires prompt management.
A 25-year-old pregnant patient at 38 weeks’ gestation presents with hypertension (blood pressure of 160/100 mm Hg), headache, epigastric pain, and nausea. On examination, you note edema and right upper quadrant tenderness. Laboratory tests reveal elevated liver enzymes and thrombocytopenia. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) HELLP syndrome
Rationale: This patient’s presentation with hypertension, headache, epigastric pain, nausea, edema, right upper quadrant tenderness, elevated liver enzymes, and thrombocytopenia at 38 weeks’ gestation is highly suggestive of HELLP syndrome, a severe complication of preeclampsia.
A 30-year-old pregnant patient at 28 weeks’ gestation presents with hypertension (blood pressure of 145/95 mm Hg), proteinuria, and facial swelling. On examination, you note mild edema and no other concerning findings. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) Superimposed preeclampsia on chronic hypertension
Rationale: This patient’s presentation with hypertension, proteinuria, facial swelling, and mild edema at 28 weeks’ gestation is consistent with preeclampsia, a common complication of hypertension during pregnancy.
A 32-year-old pregnant patient at 36 weeks’ gestation presents with hypertension (blood pressure of 160/100 mm Hg), headache, and visual disturbances. She reports severe right upper quadrant pain. On examination, you note significant edema and epigastric tenderness. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) HELLP syndrome
Rationale: This patient’s presentation with hypertension, headache, visual disturbances, severe right upper quadrant pain, significant edema, and epigastric tenderness at 36 weeks’ gestation is indicative of impending eclampsia, which is a life-threatening complication of preeclampsia.
A 26-year-old pregnant patient at 30 weeks’ gestation presents with hypertension (blood pressure of 150/95 mm Hg) and proteinuria. She reports no other symptoms. On examination, you note mild edema and no other concerning findings. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) Superimposed preeclampsia on chronic hypertension
Rationale: This patient’s presentation with hypertension, proteinuria, mild edema, and no other symptoms at 30 weeks’ gestation is consistent with preeclampsia, a common complication of hypertension during pregnancy.
A 34-year-old pregnant patient at 24 weeks’ gestation presents with hypertension (blood pressure of 140/90 mm Hg) and significant proteinuria. She also reports headache, right upper quadrant pain, and visual disturbances. On examination, you note marked edema and epigastric tenderness. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) HELLP syndrome
Rationale: This patient’s presentation with hypertension, significant proteinuria, headache, right upper quadrant pain, visual disturbances, marked edema, and epigastric tenderness at 24 weeks’ gestation is indicative of preeclampsia, a serious complication of pregnancy.
A 28-year-old pregnant patient at 32 weeks’ gestation presents with new-onset hypertension (blood pressure of 150/95 mm Hg) and significant proteinuria. She has a history of chronic hypertension but has never experienced these symptoms before. On examination, you note no other concerning findings. Which of the following complications of hypertension during pregnancy is most likely occurring in this patient?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Eclampsia
E) Superimposed preeclampsia on chronic hypertension
Rationale: This patient’s presentation with new-onset hypertension, significant proteinuria, and a history of chronic hypertension at 32 weeks’ gestation suggests superimposed preeclampsia on chronic hypertension, a serious complication requiring careful management.
A 50-year-old adult patient with a history of hypertension presents for a follow-up visit. Despite lifestyle modifications, their blood pressure remains elevated. You decide to initiate antihypertensive medication. Which of the following medications is considered a first-line treatment for hypertension in adults?
A) Lisinopril
B) Hydrochlorothiazide
C) Amlodipine
D) Clonidine
E) Metoprolol
Rationale: Hydrochlorothiazide is considered a first-line treatment for hypertension in adults. It is a thiazide diuretic that helps reduce blood pressure by promoting the excretion of sodium and water from the body.
A 15-year-old adolescent patient with newly diagnosed hypertension presents for management. You decide to initiate antihypertensive medication. Which of the following medications is considered a first-line treatment for hypertension in children and adolescents?
A) Lisinopril
B) Hydrochlorothiazide
C) Amlodipine
D) Clonidine
E) Metoprolol
Rationale: Lisinopril is considered a first-line treatment for hypertension in children and adolescents. It is an ACE inhibitor that helps lower blood pressure by relaxing blood vessels.
A 60-year-old adult patient with hypertension is already taking hydrochlorothiazide but has persistently elevated blood pressure. You decide to add another antihypertensive medication to achieve better control. Which of the following classes of antihypertensive medications is commonly used as an add-on therapy for adults with hypertension?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Beta-blockers
Rationale: Calcium channel blockers are commonly used as add-on therapy for adults with hypertension. They work by relaxing blood vessels, reducing the workload of the heart, and lowering blood pressure.
A 22-year-old female with newly diagnosed hypertension is started on antihypertensive medication. The parents are concerned about potential side effects and ask you about the medication’s mechanism of action. Which of the following classes of antihypertensive medications primarily acts by reducing the heart rate and cardiac output?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Beta-blockers
Rationale: Beta-blockers primarily reduce the heart rate and cardiac output by blocking the effects of adrenaline. This results in lower blood pressure.
A 55-year-old adult patient with hypertension and a history of heart failure is currently taking lisinopril. You decide to add another antihypertensive medication to their regimen. Which of the following classes of antihypertensive medications is commonly used in patients with heart failure and hypertension due to its cardio-protective effects?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Angiotensin receptor blockers (ARBs)
Rationale: Angiotensin receptor blockers (ARBs) are commonly used in patients with heart failure and hypertension due to their cardio-protective effects. They block the effects of angiotensin II and help relax blood vessels.
A 45-year-old adult patient with hypertension is started on a new antihypertensive medication. Within a week, they develop a dry cough that is bothersome. You suspect the cough is related to the medication. Which class of antihypertensive medications is known to commonly cause a dry cough as a side effect?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Beta-blockers
Rationale: ACE inhibitors are known to commonly cause a dry cough as a side effect. This can be bothersome to some patients, and an alternative medication may be considered.
A 60-year-old adult patient with hypertension and a history of gout is currently taking allopurinol to manage their gout symptoms. When selecting an antihypertensive medication for this patient, which class should you avoid to minimize the risk of exacerbating their gout?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Loop diuretics
Rationale: Thiazide diuretics can increase uric acid levels and may exacerbate gout symptoms. Therefore, they should be avoided in patients with a history of gout.
A 35-year-old adult patient with hypertension and diabetes is currently taking metformin to manage their diabetes. When selecting an antihypertensive medication for this patient, which class is commonly chosen due to its potential benefits for both hypertension and diabetes management?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Angiotensin receptor blockers (ARBs)
Rationale: Angiotensin receptor blockers (ARBs) are commonly chosen in patients with both hypertension and diabetes due to their potential benefits for blood pressure control and kidney protection.
A 65-year-old adult patient with hypertension and benign prostatic hyperplasia (BPH) is currently taking tamsulosin for their BPH symptoms. Which class of antihypertensive medications should be avoided in this patient due to the potential risk of worsening BPH symptoms?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Beta-blockers
Rationale: Alpha-blockers like tamsulosin are commonly used to manage BPH symptoms. Adding another alpha-blocker as an antihypertensive medication can increase the risk of side effects and worsening BPH symptoms.
A 40-year-old adult patient with hypertension is currently taking warfarin for anticoagulation. When selecting an antihypertensive medication for this patient, which class should be chosen to minimize the potential for drug interactions with warfarin?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Alpha-blockers
E) Beta-blockers
Rationale: Calcium channel blockers are less likely to interact with warfarin compared to some other classes of antihypertensive medications, making them a suitable choice in patients requiring anticoagulation.
A 65-year-old patient with a history of hypertension and coronary artery disease presents with dyspnea, fatigue, and swelling in the lower extremities. On examination, you note jugular venous distention, bilateral rales on lung auscultation, and pitting edema in the ankles. Which of the following is the most likely complication of congestive heart failure (CHF) in this patient?
A) Pulmonary embolism
B) Aortic dissection
C) Ventricular fibrillation
D) Pleural effusion
E) Hepatic cirrhosis
Rationale: The presentation with jugular venous distention, bilateral rales, and pitting edema is indicative of congestive heart failure with associated pleural effusion as a complication. Pleural effusion can occur due to elevated left ventricular filling pressures.
A 50-year-old patient with a history of CHF presents with worsening dyspnea and productive cough with pink, frothy sputum. On examination, you note crackles in both lung bases and elevated jugular venous pressure. Which of the following complications of CHF is most likely occurring in this patient?
A) Pulmonary embolism
B) Aortic dissection
C) Ventricular fibrillation
D) Pulmonary edema
E) Hepatic cirrhosis
Rationale: This patient’s presentation with pink, frothy sputum, crackles in both lung bases, and elevated jugular venous pressure is indicative of pulmonary edema, a severe complication of CHF.
A 60-year-old patient with a history of CHF presents with sudden-onset chest pain and shortness of breath. On examination, you note a difference in blood pressure between the arms and absent pulses in the lower extremities. Which of the following complications of CHF is most likely occurring in this patient?
A) Pulmonary embolism
B) Aortic dissection
C) Ventricular fibrillation
D) Pulmonary edema
E) Peripheral arterial embolism
Rationale: This patient’s presentation with chest pain, shortness of breath, a difference in blood pressure between the arms, and absent pulses in the lower extremities is concerning for aortic dissection, which can occur as a complication of CHF.
A 70-year-old patient with a history of congestive heart failure (CHF) presents with worsening dyspnea, orthopnea, and peripheral edema. On examination, you note elevated jugular venous pressure, crackles in the lung bases, and lower extremity edema. An echocardiogram shows reduced ejection fraction. Which of the following medications is considered a cornerstone of treatment for CHF with reduced ejection fraction?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Spironolactone
E) Isosorbide dinitrate/hydralazine
Rationale: Lisinopril, an ACE inhibitor, is considered a cornerstone of treatment for CHF with reduced ejection fraction. It helps improve symptoms, reduce hospitalizations, and improve survival in these patients.
A 65-year-old patient with CHF and a history of diabetes presents with worsening shortness of breath and fluid retention. On examination, you note increased jugular venous pressure, crackles in the lung bases, and bilateral ankle edema. Which of the following medications should be initiated in this patient to improve glycemic control and reduce CHF symptoms?
A) Furosemide
B) Metoprolol
C) Lisinopril
D) Spironolactone
E) Empagliflozin
Rationale: Empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, not only improves glycemic control but also has shown benefits in reducing CHF hospitalizations and cardiovascular events in patients with diabetes and CHF.
A 60-year-old patient with CHF presents with recurrent hospitalizations for exacerbations of heart failure. Despite being on optimal medical therapy, the patient remains symptomatic. Which of the following medications should be considered as an adjunct therapy to reduce hospitalizations and improve outcomes in this patient?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Metoprolol succinate
Rationale: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is indicated as an adjunct therapy in patients with CHF to reduce hospitalizations and improve symptoms and survival.
A 75-year-old patient with CHF presents with recurrent exacerbations and a history of reduced ejection fraction. Despite being on optimal medical therapy, the patient remains symptomatic. Which of the following medications should be added to the treatment regimen to further reduce the risk of hospitalization and improve survival?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Amiodarone
Rationale: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is indicated in patients with CHF with reduced ejection fraction to reduce hospitalizations and improve survival.
A 58-year-old patient with CHF presents with worsening dyspnea on exertion and a history of atrial fibrillation (AF). On examination, you note irregularly irregular heartbeats, elevated jugular venous pressure, and crackles in the lung bases. Which of the following medications should be initiated in this patient to control heart rate and reduce CHF symptoms?
A) Furosemide
B) Digoxin
C) Lisinopril
D) Sacubitril/valsartan
E) Metoprolol succinate
Rationale: Metoprolol succinate, a beta-blocker, is indicated in patients with CHF and AF to control heart rate and reduce symptoms.
