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Quizzes > Health & Medicine > Diseases & Conditions

Hypertension NCLEX Questions Quiz

Master hypertension nursing assessment - start the blood pressure quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art stethoscope and blood pressure cuff with heart icon and quiz text on teal background

Calling all nursing students! Ready to tackle hypertension NCLEX questions with confidence? This free assessment quiz on blood pressure management guides you through hypertension nursing assessment, critical thinking, and pharmacology scenarios to sharpen your skills. Whether you're brushing up on nclex questions about hypertension or deepening your understanding of drug therapy, you'll get instant feedback and practical tips to boost your score. It's perfect for busy students balancing clinical rotations, pinpointing weaknesses before exam day. Plus, explore our nclex questions for hypertension set and take the antihypertensive drugs quiz . Jump in now and ace your NCLEX prep!

According to the 2017 ACC/AHA guidelines, which systolic blood pressure reading defines stage 1 hypertension?
140-159 mm Hg
?160 mm Hg
130-139 mm Hg
120-129 mm Hg
Stage 1 hypertension is defined by the ACC/AHA as a systolic pressure between 130-139 mm Hg or diastolic between 80-89 mm Hg. Early identification allows prompt lifestyle and pharmacologic interventions. Accurate classification helps reduce cardiovascular risk. American Heart Association
What is considered a normal blood pressure reading in adults?
<140/90 mm Hg
<120/80 mm Hg
?110/70 mm Hg
<130/85 mm Hg
Normal adult blood pressure is defined as less than 120/80 mm Hg. Readings above this threshold are classified as elevated or hypertensive. Maintaining normal levels reduces cardiovascular risk. CDC Blood Pressure Facts
Which statement best describes primary (essential) hypertension?
It is always salt-responsive
It results from a known endocrine disorder
It is caused by renal artery stenosis
It has no identifiable secondary cause
Primary or essential hypertension has no specific secondary cause and accounts for most cases of high blood pressure. It is multifactorial involving genetics, environment, and lifestyle. Identifying it guides general management strategies. NCBI Hypertension Overview
Which of the following is a major modifiable risk factor for hypertension?
Race
Obesity
Age
Gender
Obesity is a key modifiable risk factor for hypertension; weight reduction significantly lowers blood pressure. Other factors like age and race are nonmodifiable. Addressing obesity through diet and exercise improves outcomes. WHO Obesity Factsheet
Which lifestyle modification yields the greatest reduction in blood pressure?
Sodium restriction
Regular exercise
Weight loss
Alcohol moderation
Weight loss in overweight individuals has the largest effect on reducing blood pressure, with a decrease of about 5-20 mm Hg per 10 kg lost. While other modifications also help, weight reduction is most impactful. NIH Nutrition Reviews
The DASH diet emphasizes which of the following?
High intake of fruits, vegetables, and low-fat dairy
Only liquid meal replacements
Elimination of dietary fats
High-protein, low-carbohydrate foods
The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits, vegetables, whole grains, and low-fat dairy, reducing sodium and saturated fat intake. Clinical trials show it lowers blood pressure effectively. NHLBI DASH Plan
Which component of the blood pressure reading corresponds to ventricular contraction?
Pulse pressure
Diastolic pressure
Systolic pressure
Mean arterial pressure
Systolic pressure measures the force in the arteries during ventricular contraction. Diastolic pressure reflects relaxation. Understanding these phases is essential for accurate assessment. Hypertension Journal
For accurate blood pressure measurement, the cuff bladder width should cover approximately what percentage of the upper arm circumference?
20%
80%
60%
40%
Guidelines recommend a cuff bladder width of 40% of arm circumference to ensure accurate readings. Incorrect sizing can lead to false high or low pressures. Proper technique reduces measurement error. J Watch Accuracy Primer
Orthostatic hypotension is diagnosed when there is a drop in systolic blood pressure of at least how many mm Hg upon standing?
20 mm Hg
40 mm Hg
10 mm Hg
30 mm Hg
Orthostatic hypotension is defined by a ?20 mm Hg drop in systolic or ?10 mm Hg drop in diastolic pressure within three minutes of standing. It indicates autonomic dysfunction or volume depletion. NCBI Orthostatic Hypotension
Which term describes elevated blood pressure readings in a clinical setting but normal readings at home?
Secondary hypertension
Resistant hypertension
White coat hypertension
Masked hypertension
White coat hypertension refers to elevated office readings with normal out-of-office measurements, often due to anxiety. Ambulatory monitoring helps confirm the diagnosis. ESC White Coat HTN
Which of the following defines isolated systolic hypertension?
Normal systolic and diastolic
Elevated diastolic with normal systolic
Both systolic and diastolic elevated
Elevated systolic with normal diastolic
Isolated systolic hypertension is when systolic pressure is ?130 mm Hg and diastolic is <80 mm Hg. It is common in older adults due to arterial stiffness. Treatment strategies may differ from combined hypertension. AHA Isolated Systolic HTN
Which retinal finding is an early sign of hypertensive retinopathy?
Cotton wool spots
Hard exudates
Arteriolar narrowing
Flame hemorrhages
Generalized arteriolar narrowing is the earliest ophthalmoscopic sign of hypertensive retinopathy, reflecting vascular constriction. Advanced changes include hemorrhages and exudates. NCBI Retinopathy Review
Which dietary change is recommended for primary prevention of hypertension?
Increase saturated fat intake
Adopt the DASH diet
Avoid all dairy products
Eliminate all carbohydrates
The DASH diet reduces blood pressure by emphasizing fruits, vegetables, whole grains, and low-fat dairy. It is widely recommended for primary prevention of hypertension. NHLBI DASH Plan
Regular aerobic exercise typically lowers systolic blood pressure by how much?
15-20 mm Hg
No change
1-2 mm Hg
5-10 mm Hg
Regular aerobic activity can lower systolic blood pressure by about 5-10 mm Hg. Consistency and moderate intensity are key for sustained benefits. PMC Exercise and BP
What is the recommended maximum daily alcohol intake for men to help manage blood pressure?
4 standard drinks
2 standard drinks
3 standard drinks
1 standard drink
Current guidelines recommend no more than two standard drinks per day for men and one for women to prevent blood pressure elevation. Excessive alcohol can increase hypertension risk. AHA Alcohol Guidelines
Nicotine's acute effect on blood vessels is to:
No effect on vessel tone
Cause vasoconstriction
Act as a diuretic
Promote vasodilation
Nicotine stimulates sympathetic activity leading to vasoconstriction and increased blood pressure. Chronic smoking also damages endothelium. PMC Nicotine Effects
What triggers renin release from juxtaglomerular cells?
Low renal perfusion pressure
Increased glomerular filtration rate
High arterial blood pressure
High sodium delivery to distal tubule
Renin release is stimulated by decreased renal perfusion pressure, sympathetic activation, and low sodium chloride at the macula densa. It initiates the RAAS cascade. NKF Renin Function
Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure primarily by:
Antagonizing angiotensin II receptors
Blocking aldosterone receptors
Preventing conversion of angiotensin I to II
Inhibiting renin secretion
ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone-mediated sodium retention. This lowers blood pressure effectively. NCBI ACE Inhibitors
A common adverse effect of captopril is:
Hypoglycemia
Tinnitus
Photosensitivity
Dry cough
ACE inhibitors like captopril increase bradykinin levels, leading to a persistent dry cough in some patients. It often resolves after drug discontinuation. NCBI Drug Adverse Effects
Beta-blockers can be problematic in diabetic patients because they may:
Increase peripheral glucose uptake
Induce insulin release
Mask hypoglycemia symptoms
Cause hyperglycemia via gluconeogenesis
Nonselective beta-blockers can mask the adrenergic symptoms of hypoglycemia (tremor, tachycardia), delaying recognition by diabetic patients. Careful monitoring is essential. JBC Diabetes & Beta-Blockers
Which side effect is most commonly associated with dihydropyridine calcium channel blockers?
Hypokalemia
Peripheral edema
Bradycardia
Cough
Dihydropyridine CCBs like amlodipine cause arteriolar dilation leading to peripheral edema. This is dose-related and often the limiting adverse effect. PMC CCB Side Effects
Hydrochlorothiazide is classified as which type of diuretic?
Potassium-sparing diuretic
Loop diuretic
Osmotic diuretic
Thiazide diuretic
Hydrochlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal tubule, promoting natriuresis and lowering blood pressure. NKF Thiazide Diuretics
Thiazide diuretics typically cause which electrolyte imbalance?
Hyperkalemia
Hypernatremia
Hypercalciuria
Hypokalemia
Thiazide diuretics increase potassium excretion, often causing hypokalemia. They also reduce urinary calcium excretion. Monitoring electrolytes is important. NCBI Diuretic Effects
In patients with a GFR below 30 mL/min, which diuretic class remains effective?
Carbonic anhydrase inhibitors
Thiazide diuretics
Loop diuretics
Potassium-sparing diuretics
Loop diuretics remain effective at low GFR by acting on the thick ascending limb, making them preferred in renal impairment. Thiazides lose efficacy when GFR is low. NKF Loop Diuretics
Hydralazine lowers blood pressure primarily by:
Venous dilation
Arterial vasodilation
Inhibiting aldosterone synthesis
Decreasing heart rate
Hydralazine selectively dilates arterioles, reducing afterload and lowering systemic vascular resistance. Reflex tachycardia may occur. NCBI Hydralazine
Sodium nitroprusside is administered in hypertensive emergencies via:
Intravenous infusion
Subcutaneous infusion
Intramuscular injection
Oral tablet
Sodium nitroprusside is given as a continuous IV infusion for rapid BP control in hypertensive emergencies. It requires close monitoring due to cyanide toxicity risk. Hypertension Emergencies
What differentiates a hypertensive emergency from urgency?
Emergency has lower blood pressure
Emergency has end-organ damage
Urgency requires IV therapy
Urgency has end-organ damage
A hypertensive emergency involves severely elevated BP with acute end-organ damage, requiring immediate IV treatment. Hypertensive urgency lacks organ injury and is managed more gradually. NCBI HTN Emergency vs Urgency
What is the recommended blood pressure target for patients with diabetes mellitus?
<140/90 mm Hg
<130/80 mm Hg
<150/90 mm Hg
<120/70 mm Hg
Guidelines recommend a BP goal of <130/80 mm Hg in most patients with diabetes to reduce cardiovascular and renal complications. Individualization is important. ADA Diabetes HTN Guidelines
Which blood urea nitrogen (BUN) level is within normal range?
7-20 mg/dL
20-40 mg/dL
30-50 mg/dL
1-5 mg/dL
Normal BUN ranges from 7-20 mg/dL; elevations can indicate renal impairment or volume depletion. It's used alongside creatinine to assess kidney function. LabTestsOnline BUN
An ECG finding suggestive of left ventricular hypertrophy is:
Flattened T waves in V1-V3
Deep S wave in V1 and tall R wave in V5
Q waves in inferior leads
ST-segment elevation in leads II, III, aVF
The Sokolow-Lyon criteria for LVH include a deep S wave in V1 plus a tall R wave in V5 or V6 exceeding 35 mm. It reflects increased myocardial mass. PMC ECG LVH Criteria
On echocardiography, left ventricular hypertrophy appears as:
Hyperdynamic ejection fraction
Dilated left ventricle with thin walls
Mitral regurgitation jets
Thickened ventricular walls
Echocardiography shows increased left ventricular wall thickness in LVH. It may also show diastolic dysfunction. AHA Echo Guidelines
Which chest X-ray finding is common in chronic hypertension leading to heart failure?
Pleural effusions
Cardiomegaly
Mediastinal shift
Pulmonary nodules
Chronic hypertension may lead to left ventricular hypertrophy and eventual heart failure, manifesting as cardiomegaly on chest X-ray. Other signs include interstitial edema. Radiopaedia Cardiomegaly
Which of the following defines resistant hypertension?
BP uncontrolled on three medications including a diuretic
BP uncontrolled on four antihypertensives
BP uncontrolled on two medications
BP uncontrolled only on monotherapy
Resistant hypertension is blood pressure that remains above goal despite use of three antihypertensive agents of different classes, one of which is a diuretic. Evaluation for secondary causes is warranted. AHA Resistant HTN
According to JNC7, first-line therapy for stage 1 hypertension is:
Calcium channel blocker
ACE inhibitor
Beta-blocker
Hydrochlorothiazide
JNC7 recommends a thiazide diuretic such as hydrochlorothiazide as initial therapy for most patients with stage 1 hypertension unless contraindicated. NCBI JNC7 Guidelines
A bruit heard over the flank region suggests which secondary cause of hypertension?
Cushing syndrome
Pheochromocytoma
Renal artery stenosis
Hyperthyroidism
A renal artery bruit suggests turbulent blood flow from renal artery stenosis, a common cause of secondary hypertension. Doppler ultrasound or angiography confirms the diagnosis. PMC Renal Artery Stenosis
Which physical finding is characteristic of Cushing syndrome - related hypertension?
Hyperpigmented skin
Truncal obesity and purple striae
Exophthalmos
Bradycardia
Cushing syndrome often presents with truncal obesity, purple striae, moon facies, and hypertension due to cortisol excess. Early recognition is key. Endocrine Society
The classic triad of pheochromocytoma includes episodic:
Bradycardia, diaphoresis, nausea
Chest pain, palpitations, syncope
Weight gain, cold intolerance, hoarseness
Headache, sweating, tachycardia
Pheochromocytoma releases catecholamines causing episodic headaches, diaphoresis, and tachycardia (the classic triad). Measurement of metanephrines confirms the diagnosis. NCBI Pheochromocytoma
Obstructive sleep apnea contributes to hypertension primarily through:
RAAS suppression
Direct renal injury
Sympathetic activation from repetitive hypoxia
Increased vagal tone during sleep
Repetitive hypoxia in sleep apnea triggers sympathetic surges, raising blood pressure. Treating sleep apnea often helps control resistant hypertension. AHA Sleep Apnea HTN
Primary hyperaldosteronism (Conn's syndrome) typically presents with:
Hypernatremia with normal potassium
Hyperkalemia and metabolic acidosis
Hypokalemia and metabolic alkalosis
Hypokalemia and metabolic acidosis
Excess aldosterone causes sodium retention, potassium excretion, hypokalemia, and metabolic alkalosis. The aldosterone-to-renin ratio aids in diagnosis. NCBI Conn's Syndrome
In hemodialysis patients, "dry weight" refers to:
Weight before dialysis session
Weight without excess fluid
Weight after overhydration
Weight with prescribed fluid allowance
Dry weight is the post-dialysis weight at which the patient is normotensive and euvolemic. Achieving dry weight prevents hypertension and volume overload. NKF Dry Weight
When teaching home blood pressure monitoring, the nurse should instruct the patient to:
Use the smallest cuff for better accuracy
Take two readings morning and evening
Measure only when feeling unwell
Take one reading daily at random times
Home monitoring should involve two readings in the morning and evening, one minute apart, over several days to obtain reliable averages. Proper technique improves diagnostic accuracy. AHA Home Monitoring
Abrupt discontinuation of clonidine often leads to:
Hypotension and bradycardia
Persistent cough
Rebound hypertension and tachycardia
Orthostatic hypotension
Clonidine withdrawal causes rebound sympathetic activity with rapid BP elevation and tachycardia. Tapering is essential. NCBI Clonidine Withdrawal
In severe preeclampsia, which antihypertensive is often first-line?
Hydrochlorothiazide
Labetalol
ACE inhibitor
Verapamil
Labetalol is considered first-line for acute blood pressure control in severe preeclampsia due to its safety profile in pregnancy. Hydralazine is an alternative. ACOG Preeclampsia
Which consideration is most important when treating hypertension in the elderly?
Avoid doses below standard adult levels
Prefer beta-blockers over all other classes
Monitor for orthostatic hypotension
Aggressively lower BP to normal immediately
Elderly patients are prone to orthostatic hypotension due to impaired baroreceptor response, so gradual dose titration and monitoring for postural changes are essential. PMC Geriatric HTN
A sudden tear in the aortic intima presents with:
Dull, constant chest ache
Sharp, localized abdominal pain
Epigastric burning sensation
Tearing chest pain radiating to the back
Aortic dissection classically causes sudden, severe tearing pain that radiates to the back. It is a life-threatening hypertensive emergency. NCBI Aortic Dissection
Which neurological sign suggests hypertensive encephalopathy?
Bilateral lower extremity weakness
Visual hallucinations only
Flaccid paralysis
Headache, confusion, and seizures
Hypertensive encephalopathy presents with headache, altered mental status, and seizures due to cerebral edema from severely elevated blood pressure. Prompt BP reduction is critical. NCBI Hypertensive Encephalopathy
Which antihypertensive is considered safe for chronic use during pregnancy?
Enalapril
ACE inhibitors
Methyldopa
Spironolactone
Methyldopa is a centrally acting alpha-2 agonist considered safe for long-term use in pregnancy. ACE inhibitors are contraindicated. ACOG Pregnancy HTN
In a patient with asthma, which antihypertensive should be used with caution?
ACE inhibitors
Nonselective beta-blockers
Thiazide diuretics
Calcium channel blockers
Nonselective beta-blockers block ?2 receptors in the lungs, potentially precipitating bronchospasm in asthmatics. Cardioselective agents or other classes are preferred. NCBI Asthma & Beta-Blockers
An aldosterone-to-renin ratio above which threshold suggests primary hyperaldosteronism?
50
20
5
10
An aldosterone-to-renin ratio >20 is a key screening test for primary hyperaldosteronism (Conn's syndrome). Confirmatory testing follows if elevated. NCBI Primary Hyperaldosteronism
Liddle syndrome, a monogenic form of hypertension, is characterized by:
High renin and low aldosterone
Low renin and low aldosterone
Low renin and high aldosterone
High renin and high aldosterone
Liddle syndrome features a gain-of-function mutation in ENaC channels leading to sodium retention, hypertension, hypokalemia, and suppressed renin and aldosterone. NCBI Liddle Syndrome
Which combination constitutes optimal triple therapy for resistant hypertension?
Thiazide, ARB, potassium-sparing diuretic
ACE inhibitor, beta-blocker, loop diuretic
Thiazide, ACE inhibitor, calcium channel blocker
Beta-blocker, CCB, aldosterone antagonist
Resistant hypertension often responds to a thiazide diuretic, ACE inhibitor (or ARB), and calcium channel blocker. This combination targets different mechanisms. AHA Resistant HTN
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Study Outcomes

  1. Understand Blood Pressure Classifications -

    After completing this quiz, you will be able to explain hypertension stages based on systolic and diastolic readings and recognize normal versus elevated values.

  2. Apply Pharmacologic Management -

    You will be able to select appropriate antihypertensive medications and dosing strategies in simulated NCLEX questions for hypertension.

  3. Analyze Nursing Assessment Data -

    You will learn to interpret vital signs and clinical findings to identify key indicators of hypertension in patient assessments.

  4. Differentiate Hypertensive Emergencies and Urgencies -

    You will distinguish between emergency and urgency presentations and prioritize interventions accordingly.

  5. Evaluate Patient Education Strategies -

    You will assess and recommend effective teaching points on lifestyle modifications and blood pressure management for patient care.

Cheat Sheet

  1. Classification and Staging -

    Review the American College of Cardiology/A.S.H. guidelines categorizing blood pressure: Normal (<120/80 mmHg), Elevated (120 - 129/<80 mmHg), Stage 1 (130 - 139/80 - 89 mmHg), and Stage 2 (≥140/≥90 mmHg). This framework is frequently tested in hypertension NCLEX questions so you can accurately stage a client's blood pressure. Remember the "NE 1 2" mnemonic - Normal, Elevated, Stage 1, Stage 2 - to lock in these cutoffs.

  2. Mean Arterial Pressure (MAP) Calculation -

    Master the formula MAP = (2×DBP + SBP)/3, an essential metric for perfusion assessment in NCLEX questions for hypertension. For example, with a BP of 120/80, MAP = (2×80 + 120)/3 = 93 mmHg, ensuring vital organs are adequately perfused. Practicing these calculations boosts your confidence both in the quiz on blood pressure and clinical decision-making.

  3. Renin-Angiotensin-Aldosterone System (RAAS) -

    Understand how decreased renal perfusion triggers renin release, converting angiotensinogen to angiotensin I, then to angiotensin II via ACE - this potent vasoconstrictor raises BP and stimulates aldosterone secretion. Recognizing RAAS in pathophysiology questions about hypertension helps you explain why ACE inhibitors or ARBs are first-line treatments. A quick mnemonic: "RAAS up = BP up" will help you recall this cascade under pressure.

  4. Hypertension Nursing Assessment -

    Conduct thorough evaluations, including orthostatic BP measurements, auscultation for bruits, and inspection for target organ damage like retinopathy or left ventricular hypertrophy. Incorporate topics often seen in hypertension nursing assessment on the NCLEX, such as signs of end-organ damage and risk factor identification. An easy-to-remember list is "HARD": Headache, Affected vision, Renal changes, and Dyspnea for key symptoms to monitor.

  5. Emergency Management of Hypertensive Crises -

    Distinguish between urgency (no organ damage, treat with oral antihypertensives) and emergency (with end-organ damage, IV vasodilators needed). Knowing this difference is critical when tackling NCLEX questions about hypertension crises and determining appropriate interventions. Always remember: "Urgent - Oral, Emergency - IV" as a quick recall for your next quiz on blood pressure.

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