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Hypertension management options: 2017 guideline

doi: 10.1097/01.NPR.0000534862.78380.a1
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INSTRUCTIONS Hypertension management options: 2017 guideline

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PROVIDER ACCREDITATION

Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

This activity has been assigned 1.0 pharmacology credits.

Hypertension management options: 2017 guideline

Purpose: To provide information about the ACC/AHA Task Force on Clinical Practice Guidelines' 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Objectives: After completing this continuing-education activity, you should be able to: 1. Distinguish the 2017 hypertension guidelines, procedures for BP measurement, and treatment goals. 2. List nonpharmacologic and pharmacologic therapy for hypertension.

  1. The 2017 hypertension guideline defines hypertension as a BP greater than or equal to
    1. 120/80 mm Hg.
    2. 130/80 mm Hg.
    3. 140/90 mm Hg.
  2. According to the updated guideline, to accurately assess BP, a minimum of two readings must be obtained at least
    1. 1 to 2 minutes apart on one occasion.
    2. 1 to 2 minutes apart on at least two occasions.
    3. 2 to 3 minutes apart on at least two occasions.
  3. Prior to self-monitoring BP at home, patients should avoid caffeinated beverages for at least
    1. 5 minutes.
    2. 30 minutes.
    3. 1 hour.
  4. What percentage of the upper arm should be encircled by the bladder of the BP cuff?
    1. 50%
    2. 80%
    3. 95%
  5. Which test is most appropriate for the patient with resistant hypertension associated with an abdominal systolic-diastolic bruit?
    1. magnetic resonance angiography of the renal arteries
    2. plasma aldosterone-to-renin ratio
    3. ankle-brachial index measurement
  6. Basic lab studies for primary hypertension include
    1. total complement antigen.
    2. apolipoprotein A-1.
    3. thyroid-stimulating hormone.
  7. Men with hypertension should be encouraged to limit their alcohol intake to a maximum of
    1. 1 drink per day or less.
    2. 2 drinks per day or less.
    3. 2 drinks per week.
  8. Which of the following interventions is most likely to decrease SBP by 11 mm Hg?
    1. dietary changes
    2. physical activity
    3. weight management
  9. Adults with stage 1 hypertension and a 10-year ASCVD risk less than 10% should implement lifestyle changes and be reassessed in
    1. 1 month.
    2. 3-6 months.
    3. 6-12 months.
  10. What should be done first for an adult patient diagnosed with stage 2 hypertension?
    1. Start BP-lowering medication.
    2. Implement lifestyle changes and reassess in 1 month.
    3. Calculate ASCVD risk.
  11. First-line medications for the initiation of antihypertensive drug therapy include all of the following except
    1. ACE inhibitors.
    2. CCBs.
    3. direct renin inhibitors.
  12. The preferred diuretic, with demonstrated reduction of CVD risk in clinical trials, is
    1. furosemide.
    2. chlorthalidone.
    3. spironolactone.
  13. Which of the following is the best medication choice for a pregnant woman with hypertension?
    1. nifedipine
    2. captopril
    3. valsartan
  14. Which class of medications should be avoided for patients with HFrEF?
    1. ACE inhibitor
    2. nondihydropyridine CCB
    3. ARB
  15. Which class of diuretic is preferred in heart failure when the glomerular filtration rate is less than 30 mL/min/1/73 m2?
    1. potassium sparing
    2. thiazide
    3. loop
  16. The preferred medication for primary aldosteronism is
    1. propranolol.
    2. spironolactone.
    3. diltiazem.
  17. For a patient presenting with aortic dissection and SBP of 180, the goal within the first hour is to reduce the SBP to less than
    1. 120 mm Hg.
    2. 130 mm Hg.
    3. 140 mm Hg.
  18. The hypertension treatment goal for noninstitutionalized, ambulatory, community-dwelling adults age 65 and older is SBP less than
    1. 120 mm Hg.
    2. 130 mm Hg.
    3. 140 mm Hg.
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